# ‘Dysphoric Milk Ejection Reflex (D-MER)’, 2023 > [!cite] > ‘Dysphoric Milk Ejection Reflex (D-MER)’. Cleveland Clinic, last updated 6 April 2023. [https://my.clevelandclinic.org/health/diseases/24879-dysphoric-milk-ejection-reflex](https://my.clevelandclinic.org/health/diseases/24879-dysphoric-milk-ejection-reflex). > [!abstract] > D-MER, or dysphoric milk ejection reflex, is a condition that affects women who are lactating. It causes you to have intense negative feelings when your milk lets down during a feeding. Research is still ongoing, but there are coping methods available to help. --- ‘One study estimates that between 5% and 9% of lactating women experience D-MER. It’s unrelated to postpartum depression (PPD) and postpartum anxiety, although women may have D-MER in addition to those conditions.’ [[Cleveland Clinic, ‘Dysphoric Milk Ejection Reflex (D-MER)’, 2023|(Cleveland Clinic 2023)]] ^22f3b7 ‘Dysphoric milk ejection reflex, or D-MER, is a condition that affects women who breastfeed or pump milk. It causes sudden and intense negative emotions just before you “let down” or release milk. It’s quick and lasts just a minute or two. However, it can cause intense unhappiness (dysphoria) and other unpleasant emotions. It can also happen if your breasts accidentally have a let down at any other time, which can be common during lactation.’ [[Cleveland Clinic, ‘Dysphoric Milk Ejection Reflex (D-MER)’, 2023|(Cleveland Clinic 2023)]] ^b9309a ‘For most, D-MER resolves within about three months, getting less severe as your child gets older. But there have been cases where a person experiences D-MER until they’re done breastfeeding.’ [[Cleveland Clinic, ‘Dysphoric Milk Ejection Reflex (D-MER)’, 2023|(Cleveland Clinic 2023)]] ^5b954b ‘While some may not understand it, D-MER is a real condition. Fortunately, it’s temporary and there are methods to help you cope. Follow the techniques above to help you manage symptoms of D-MER. Sometimes, just knowing you have a real condition (and others have it, too) can bring you peace.’ [[Cleveland Clinic, ‘Dysphoric Milk Ejection Reflex (D-MER)’, 2023|(Cleveland Clinic 2023)]] ^96650d ‘\[…] most studies show that hormones — specifically, an abrupt decrease in a hormone called dopamine — cause D-MER. Dopamine is a hormone associated with reward and mood. Many studies show low dopamine levels can have a negative effect on your mood and emotions. \[…] When you breastfeed, your body releases prolactin (a hormone necessary for milk production) and oxytocin. Oxytocin is the hormone that triggers the flow or ejection of milk from your breasts when your baby suckles (or you begin pumping). Oxytocin suppresses dopamine, which means your dopamine levels decrease. For reasons researchers don’t completely understand, some people’s dopamine levels drop very quickly and cause a sudden feeling of unhappiness and other negative emotions. This is D-MER.’ [[Cleveland Clinic, ‘Dysphoric Milk Ejection Reflex (D-MER)’, 2023|(Cleveland Clinic 2023)]] ^b4d530