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From the Townsend Letter
February / March 2016

Oxytocin: The New Hormonal Kid on the Clinical Block
by Dr. Devaki Lindsey Berkson
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During orgasm, oxytocin levels are significantly increased in the brains of both men and women. But, oh, so much more in ladies. Oxytocin remains elevated for about 5 minutes and then levels rapidly decline. Much less is produced by masturbation or sex without orgasm.41,42 If you are solo, you can love the one you're with, but you won't get as much oxytocin signaling.
During orgasm, the woman wins out in that her brain, proved by PET neuroimaging, activates the pituitary more than the guy's.43 When she orgasms, her pituitary is tremendously turned on to secrete more oxytocin and prolactin. So, when she orgasms, she longs to bond and has deep satisfaction (from the prolactin, a satiety hormone in this scenario) with that sensation. The man's pituitary is less turned on and produces less oxytocin, and less bonding sensation.
No matter how much a "friend with benefits" male lover might insist a liaison is only a friendly wham-bang, if it's done repetitively enough, and she orgasms enough, she'll bond with him. Her brain and hormones make her do it. He will only bond if his emotions come along for the ride. But he does not bond based on orgasms alone.

Social Attachment
If oxytocin helps bond, why not use it clinically when there are social bonding issues? Some forward-thinking neurologists and functional medicine docs are using oxytocin replacement therapy to treat specific conditions of "disrupted attachment," such as schizophrenia, eye contact disorders, social discomfort, and phobias. It's even being used to boost decision-making processes when the lack of this ability is disabling.

Case Studies: Hormones Are Stranger Than Fiction
(I've had patients in whom oxytocin replacement therapy did not improve their problems, but the following are a few examples of effective responses, some rather startling.)

Patient 1
. Woman with an attachment disorder that first started when she was pregnant with her first child, in her first marriage. At the end of the first trimester she had an episode that landed her in the ER. She felt that she had a ministroke and half of her body went numb. Nothing significant was found on imaging or exams. Since that time, she claimed that she had a flat affect and was unable to bond. When her child was born, she could not bond. She no longer wanted intimacy or even to interact socially with her husband, who eventually left her. She was then in a second marriage and had the one daughter from the previous marriage. She couldn't seem to bond with either her daughter or the new husband, who she said was a very good man. She now feared losing this marriage, too. She thought the fault was hers and she wanted to know if hormone therapy could help her.
She was put on a 200 IU oxytocin lozenge (at that time I was unaware of the better clinical responses with nasal applications). Within 1 month she returned and reported that both relationships with her daughter and husband were improved. She wanted sex and enjoyed it. She had good feelings during sex, which she hadn't experienced for years. She was now doing things with her daughter, like dance classes and hugging her. This was amazing to her. She cried in the office as she described feeling human for the first time in many years. She finally had hope.
Patients 2 and 3
. 39-year-old woman was married to a 25-year-old man who was a photographer in the model industry. She had gained weight and he had lost interest. He was used to looking at slim models all day long. They were religious, positive people, devoted to each other. In the office they spoke kindly and frankly in front of each other discussing their conundrum. He loved her but he no longer desired or enjoyed sex as much with her. She was on lifelong antidepressants (which she thought had put on her weight) and couldn't get off due to fierce historical rebound issues. They wanted her to lose weight and him to gain interest, and perhaps even for her to get off antidepressants.
They both went on oxytocin (24 IU in one nostril t.i.d.) and also before and during any sexual encounter. They informed me that within several days their intimacy was better than it had been in years. They thought that their marriage was back on track. It's half a year later and they are doing better than ever. She has still not tapered off the antidepressant.
Patient 4
. I worked with this 36-year-old intelligent woman for a year and got nowhere. She had a lifelong history of severe constipation that severely reduced the quality of her life. She had numerous colonoscopies, and the gastroenterologists had consistently reported to her that she had a "dead" area in her sigmoid colon. It could not be "revived" and surgery was her only answer. She had tried hormone replacement, fermented foods, fiber and seeds, neurotransmitter balancing, exercise, colonic therapy, and thyroid replacement, and still she was limited in what she could eat and prone to severe and constant flatulence and pain. She only eliminated once every 2 weeks. It took a lot to achieve that. She had tried numerous digestive enzymes and stomach acid replacement, and was down to only being able to eat a handful of foods without constant pain and bloat. I offered oxytocin as a last resort.
The first week she did 24 IU (twice a day) in one nostril, which changed nothing. I happened to ask her, after that first week, if the oxytocin by chance had made her feel any more intimate or sexy with her husband. It was then, for the first time in a year, that she confided that she did not view herself as a very "connected" person. That even though she loved her husband and her children and did right by them, she was not connected to them as she thought a true loving person would be. On the third week, her dosage was increased to 1 spray in each nostril (3 times a day) and before sex and during sex, which she reported they did once a week. A follow-up phone call within a week found her feeling more at peace with life, and miraculously going easily to the bathroom twice daily for the first time in her life. She now had no gas or belly pain, and could consume a more diverse diet without issues.
The intestinal area is lined with oxytocin receptors. Studies have shown oxytocin to have anticolitis action in rats. In vitro studies have shown it to protect enterocytes and to have protective gut anti-inflammatory, motility, and gut wall enhancing permeability actions.44,45
Patient 5. Woman in her late 20s with trouble with portion control. She had a history of ulcerative colitis and would have flare-ups if she ate too much, which kept her in a flare-up loop, as she continuously ate too much. One week on 24 IU intranasal spray in one nostril b.i.d. accomplished nothing, but when we increased it to one spray in each nostril t.i.d. right before eating, she was able to eat less, lose weight, and avoid continuous flare-ups. Oxytocin has also been shown to act as an anti-inflammatory in the gut.

Future Applications
Because oxytocin receptors are so global, stimulation of them by intranasal oxytocin replacement is being looked at for diverse disorders. Oxytocin cream lubricates the vaginal vault in similar ways to that of estrogens, healing, soothing, and lubricating the mucosa, but without activating the estrogen receptor. Thus, OT is safe for high-risk women to reverse vaginal atrophy.46
Oxytocin signaling is being investigated as an anti-aging tool to protect muscle mass as we age (muscles are exceptionally flush with OTR and signaling helps maintain fiber mass), to reduce overeating by reducing caloric intake, maybe even to decrease leaky gut and systemic inflammation, and possibly as breast tissue protector.47-50 Oxytocin might even be linked to stimulating the newly found happiness epicenter in the brain.51,52
Up with oxytocin. Or shall I say, up your nose with it.
Twitter @BerksonHealth
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Stay tuned for my new books:
Sex: Why Your Brain and Hormones Want You to Do It. The neuroendocrinology of intimacy.
Digestive Freedom: Eat Your Way to Intestinal Wellness. Introducing "Nutritional Gastroenterology."

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