Neuroendocrine Effects of Lactation and Hormone-Gene-Environment Interactions

  • Kirsten Gust
  • Christina Caccese
  • Amanda Larosa
  • Tuong-Vi NguyenEmail author


While correlational studies suggest that lactation may confer a certain level of protection from mental illness, this benefit is not uniformly expressed in all women who choose to breastfeed. We propose here that the neuroendocrine “resetting” induced by lactation may predispose toward positive affect states in a subset of hormone-sensitive mothers, with hormone-gene and hormone-environment interactions determining the ultimate psychological outcome. We find evidence to suggest that higher secretion of prolactin/oxytocin as well as lower secretion of vasopression/androgens in lactating mothers may protect against postpartum depression and anxiety, decrease levels of irritability, and optimize stress responses. On the other hand, while the abrupt withdrawal of estradiol/progesterone in the immediate postpartum period tends to be associated with adverse psychological outcomes, the chronic suppression of estrogens/progestogens induced by lactation may have antidepressant and anxiolytic effects over time. Finally, the hypo-cortisolemic state seen in lactating mothers appears to be associated with improved stress reactivity and circadian rhythms. We also discuss hormone-gene and hormone-environment interactions likely to modulate any potential psychological benefits related to lactation and focus on those factors that are either easy to screen for or known to be modifiable. In sum, neuroendocrine alterations induced by lactation may play a key role in determining reproductive psychiatric risk in a subset of hormone-sensitive women. Using these neuroendocrine factors as an individualized index of risk can help in devising targeted programs to support these women in pursuing lactation or, for those not able or willing, accessing psychological interventions in a timely manner.


Breastfeeding Postpartum depression Estrogens Androgens Cortisol Prolactin 


Funding Information

TVN is funded by Fonds de la recherche en santé du Quebec (FRQS) and Canadian Institutes of Health Research (CIHR) as well as the Montreal General Hospital (MGH) and McGill University Health Center (MUHC) Foundations.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Reproductive Psychiatry Program, Departments of Psychiatry and Obstetrics-GynecologyMcGill University Health CentreQCCanada
  2. 2.Department of PsychiatryMcGill UniversityQCCanada
  3. 3.Integrated Program in NeuroscienceMcGill UniversityQCCanada
  4. 4.Neuroscience DivisionDouglas Mental Health University InstituteQCCanada

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