OCD symptoms may be triggered or worsened during menopause due to hormonal fluctuations and major life changes.
Although some people might notice that their obsessive-compulsive disorder (OCD) symptoms get better with age, others may experience an intensification of their symptoms—especially during major life transitions like menopause.
Menopause is a biological process that marks the end of a person’s menstrual cycles, typically occurring in their late 40s to early 50s. During this time, hormonal fluctuations—particularly estrogen and progesterone—can significantly impact mood and anxiety levels. These factors can trigger the onset of OCD or exacerbate existing OCD symptoms.
Fortunately, both menopause and OCD can be managed effectively with treatment. A holistic approach to treatment that combines health-promiting habits, therapy, and medication (if needed), can make a huge positive impact.
Read on to learn more about how OCD can impact you during and after menopause, and the best strategies for managing symptoms.
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What’s the connection between menopause and OCD?
A 2010 study found that the prevalence of OCD in postmenopausal women was 7.1%, significantly higher than the rate of OCD in the general population.
OCD involves obsessions, which are recurrent intrusive thoughts, feelings, urges, images, or sensations that cause distress. To cope with this anxiety, or to prevent a feared thing from happening, people with OCD perform compulsions, which are repetitive behaviors or mental acts. During periods of hormonal change, such as the perinatal period, perimenopause, and menopause, obsessions and compulsions can become significantly more intense.
Estrogen and progesterone are reproductive hormones that can affect mood, sleep, and stress levels. Estrogen, in particular, plays a key role in maintaining the balance of neurotransmitters like serotonin, which is important for mood regulation. “As the levels of these hormones rise and fall, it can lead to a variety of physical and emotional symptoms—including a worsening of OCD,” says Tracie Ibrahim, MA, LMFT, CST, Chief Compliance Officer at NOCD.
As hormones fluctuate, the resulting imbalances can increase anxiety, depressive symptoms, and irritability—all of which can aggravate the symptoms of OCD. Similarly, the drop in estrogen can lead to disruptions in sleep, which can further contribute to the intensification of obsessive-compulsive behaviors and thoughts.
However, it’s also possible to experience OCD for the first time after a major life change like menopause. Hormonal changes can also worsen existing symptoms of depression and anxiety, both of which often occur alongside OCD.
Does OCD get better or worse with age?
Ibrahim says both are possible. Some people may notice their symptoms decrease as they learn more coping skills, while others see an increase in symptoms due to a lack of effective treatment. In some cases, untreated OCD can worsen over time, as repetitive behaviors or compulsions may become ingrained and routine, making it more difficult to break the cycle.
Life changes that often come with aging, such as the loss of a loved one, career transitions, moving, or chronic health conditions can increase anxiety levels and act as triggers for OCD symptoms, particularly if the person already has a genetic predisposition to OCD.
Some people may also develop a fear of aging, where concerns arise about their appearance and the mental and emotional changes that come with getting older. In OCD, this can cause obsessions and compulsions about your looks, whether you appear older, or how you’re perceived by others. Compulsions can look like checking to see how physically fit or mentally acute you are.
The best treatment for OCD
Exposure and response prevention (ERP) therapy is a specialized form of cognitive behavioral therapy (CBT) designed to treat OCD. ERP involves working with a therapist to gradually expose yourself to your fears, while resisting the urge to perform compulsions, a process known as response prevention.
For example, if you have obsessions around the fear of aging, ERP exposures might involve intentionally provoking fear and anxiety around this topic, one gradual step at a time. Exercises could include looking at images of people who are aging or learning about common health concerns that occur as you get older.
Instead of responding with compulsions—like researching signs of aging or asking a loved one if you look like you’re getting older—your therapist would encourage you to sit with the discomfort without resorting to these behaviors.
As you continue doing ERP exercises, your tolerance for uncertainty and discomfort grows, and the intensity of the anxiety around your obsessions typically decreases.
Managing menopause symptoms
There are also ways that you can support your overall mental health during menopause, which in turn, can have a positive impact on the severity of your OCD.
- Medications including hormone replacement therapy (HRT) may be prescribed to help balance estrogen and progesterone levels, which may reduce symptoms such as hot flashes, mood swings, and sleep issues. For some people, HRT can also have an impact on mental health by decreasing anxiety and improving mood. However, it’s important to discuss the potential benefits and risks of hormone therapy with your healthcare provider to determine the best course of treatment—as individual needs and responses can vary.
- Lifestyle factors like regular physical activity can help improve mood, reduce anxiety, and promote better sleep. A balanced diet can support overall hormonal health, while techniques like mindfulness, yoga, and relaxation exercises can also help with intense emotions.
- Social support: Having a strong support system of friends and loved ones can help you cope with stress and feel less isolated. Peer support groups specifically for people going through menopause or managing OCD can also provide a sense of community and shared experiences.
Bottom line
OCD can spike after big life transitions or hormonal changes, both of which happen during menopause. If you find that your OCD symptoms are worsening—or you think you are having OCD for the first time—reach out to an OCD specialist. They can help you get your OCD symptoms under control, giving you more space to address any menopause symptoms you might be having.
Key Takeaways
- Menopause marks the end of a person’s menstrual cycle. These hormonal changes can trigger obsessive-compulsive disorder (OCD) or exacerbate existing symptoms.
- During menopause, a person may have new or worsening symptoms of depression and anxiety, both of which increase the intensity of OCD symptoms.
- Treatment options like exposure and response prevention (ERP) therapy, medication, and lifestyle factors like diet, exercise, and stress management can be highly effective in managing the symptoms of both OCD and menopause.