Trina Doerfler, ND, DC

Oxytocin is a hormone that has been given too little attention outside the well-known arenas of parturition and lactation, and much too little respect in its power to restore health and well-being in today’s modern women. Far more than an agent of uterine contraction and the let-down response, it is an incredibly important and underutilized ally in the battle waged by women to feel well while keeping their multi-tasking, modern lives galloping along.

The Ever-Changing “Role” of Women

In the last 50 or 60 years, the lives of women have changed dramatically. For untold millennia, women occupied primarily the same half of the division of labor pie: birthing and care of the young and elderly, growing and gathering food and other materials for the home, cooking, sewing; activities described without a bit of irony as “women’s work.” These tasks were generally carried out in groups, as it was far more efficient to have social support while performing these vital chores for the human community.

Men’s side of the labor pie was markedly different: much less group-oriented activity was required of men’s behaviors; hunting and defending territory required more individually guided behavior. In this way, the human race thrived for unimaginable amounts of time, and biological systems evolved along these lines. Women’s physiology developed pathways designed to support survival in very different situations, ways that succeed when one has dependents to consider while under a threat. The well-known and much studied fight-or-flight response does not work well when small children are around, or the elderly or infirm.

These strategies now have been practically abandoned by women in modern life, much to our detriment. The new, very different behavior has been studied recently at UCLA by Shelley E. Taylor, PhD of the psychology department, and coined by her as “Tend and Befriend.” This phrase describes quite accurately the behaviors that logically would come into use in groups that have dependents to shelter and care for, are therefore in frequent social contact with each other, and have experienced stress either from outside the group in the form of an attacker (frequently larger and stronger physically), or from within the group in the form of interpersonal conflict. Strategies such as these are quite brilliant in their effectiveness, long built into women to produce chemical changes in the body to help resolve stress, soothing both dependent and caregiver while still keeping the integrity of the group and continuing the activities of feeding, nurturing and caring for the tribe.

Oxytocin is a primary agent in these physiological strategies. Much as I have wished for a supplement to reach for, exogenously given, oxytocin has too many side effects for it to be clinically useful, and what I am talking about here is endogenous production, produced by certain clear and ancient behaviors.

Common Syndrome for Today’s Women

In my practice of 17 years, I have come to recognize a syndrome in too many women, women who are healthy from a conventional medical standard and engaged in living multitalented lives in arenas that were historically divergent. These women too often come in feeling unwell in a vague but unmistakable way: They are stretched almost translucent between the demands of their home life and their worldly life, and they don’t know why this makes them ill; and medical doctors, after standard workups, have told them there’s nothing wrong … perhaps they need an antidepressant.

The constellation of presenting symptoms is often the same: progressive fatigue unrelieved by enough sleep, atypical irritability, insomnia, menstrual irregularities, cold intolerance, mood instability, low energy and/or an inability to de-escalate. Often, there are adjunct symptoms: hair loss, decreased libido, digestive/eliminative problems, frequent respiratory infections, increasing numbers of allergic reactions. Usually, their doctor has checked their thyroid by testing TSH levels, and typically it is well within even the conservative reference range of 0.3 to 3.5. Far too often, this is the end of the workup and a mood modulator is the only help offered. I ascribe this not to any intentional malfeasance, but simply to a blind spot in our thinking and our range of sensitivity in current standard laboratory medicine.

Women in Medical Research

Animal model medical research often excludes female rats from any studies not specific to the estrous cycle, due to the inconvenient variability of the hormone cycles that confound data. Likewise, human studies have been conducted the same way. Until 1995, female research participants constituted only about 17% of medical research. The information we have been operating with until now is true for the population that was studied, but is widely divergent from what is true for women.

The study of Tend and Befriend at UCLA began when Dr. Taylor noticed the difference in behavior in her lab when stress “went around.” The men working in the lab would, by and large, disappear alone into their offices, re-establishing their feeling of well-being in the well-known “caving” behavior distinguished by Dr. John Grey in his Mars and Venus series. The women working in the lab had markedly different behavior: They would more likely gather together, even on their days off, talk and clean the lab. Dr. Taylor wondered if this was measurable in hormone changes in either gender, and learned it clearly was. Oxytocin levels were elevated in the women at these times (not in the men, in whom oxytocin is suppressed due to the presence of testosterone).

Stress Castration

Women under stress behave in ways that produce high amounts of oxytocin, which in turn reduces cortisol, the now familiar perpetrator in many symptoms of modern life disease. Oxytocin is released during nursing and sexual climax, and is thought to play a part in bonding during these essential activities, but has been underestimated in other areas of female life. Oxytocin-driven behavior is Tend and Befriend behavior. Women under stress are soothed by tending to themselves or their beloveds; more specifically, by social and physical contact, warmth and food. These behaviors are cleverly designed to relieve stress without removing the stressed people from the community, therefore allowing care of the young and the community to continue. Research coming out of UCLA is only a few years old, and will take some time to integrate into daily life practices. But it is now quantifiable and specific as to what helps relieve modern life disease in women, a syndrome jauntily referred to as Stress Castration (first used by Dr. Serafina Corsello at an ACAM conference).

Cortisol, the hormone secreted by the adrenal cortex, has been well documented to be deleterious when production is sustained during long-term stress in multiple systems, both male and female. It acts as an extremely effective agent in short-term, life-threatening stress to gather the forces of defense against an immediate threat. In doing so, it suppresses the processes judged by the body to be temporarily dispensable. But when these processes are suppressed long-term, deeply damaging consequences can result: decreased immune competence, digestive integrity and reproductive capacity. These things are relatively unimportant while being pursued by a sabre-toothed tiger in a struggle for one’s life; but when on a constant run from the tiger, these are essential processes that suffer, leaving one feeling unwell in many ill-defined ways. As cortisol levels remain elevated, peripheral estrogen receptor function decreases, insulin sensitivity is compromised, and immune factors colonize and communicate poorly. The hormonal precursor DHEA is preferentially shunted to cortisol when the body perceives stress, leaving deficient other end-products: progesterone, testosterone and estrogen. The resulting imbalance is what has led to the coining of the phrase “stress castration.”

Women under the demands of the dual work/home life are functioning as if these pathways of self-care were not still hardwired within. As far as what each person gets from his or her original work assignments, the biology is still the same. Men historically under stress were acting as individuals, in a much more hierarchical and adversarial environment. Eye contact was used as dominance/submission behavior; likewise, language was used to establish hierarchy. In feminine society, eye contact is used to establish relationship, as is language. These are vastly different uses of basic relationship behaviors. (Interestingly, ADH is just beginning to be studied in men as the mirror hormone to oxytocin, and may account for gender-specific behavior as yet unstudied.)

Fortunately, the practices that restore hormonal balance and well being are not unknown or even unfamiliar to us. They are simple, available (often cost-free) and completely non-toxic: the ideal naturopathic protocol. The potential power in using these simple approaches (see the accompanying text, “Reducing Stress in Women”) has to do with informing the use of these things that women have discarded as unimportant, even self indulgent. By intentional investment in activities that have always worked in this regard, we restore the original potency that nature intended.

The new research being conducted on how it is that women’s bodies thrive under pressure will reinstate, strengthen and validate these simple lifestyle shifts in ways that will improve the lives not only of the women that suffer from modern life disease, but their families and extended communities as well.

Reducing Stress in Women

Basic recommendations:

• Social contact: gathering and talking to each other is a powerful tool in reducing stress in women
• Physical contact: holding or being held in a nurturing manner
• Food preparation: as a creative process as well as a nutritional meal
• Care of the living space: either in a decorative or restorative manner
• Warm water immersion: bathing for relaxation and cleanliness.

Any behavior done with regard to comforting oneself or one’s community will do, but the dampening effect on them of current disregard and dismissal cannot be underestimated. Done with intention and certainty of their physiological effects, they are powerful tools available to virtually everyone.

Each of these behaviors produce higher oxytocin levels in women, a state perceivable by most as becalmed, soothed and more peaceful in one’s own body. These are things that women have long known make them feel better; however, during this process women’s chemistry is normalizing and multiple systems of the body are coming back into balance and functioning at a higher level.

Trina Doerfler, ND, DC was born and raised in NYC, trained as a dancer and a painter before going through premed at Hunter College. Chiropractic training was at Western States Chiropractic College in Portland, Ore., and her naturopathic education was at Bastyr, graduating in 1989 and 1992, respectively. Doerfler has been in private practice since graduating, and also teaches courses at Bastyr. She joined Seattle Healing Arts in 2003.