Obsessive-compulsive disorder (OCD) is a chronic mental health condition characterized by two main types of symptoms: obsessions (intrusive thoughts, feelings, images, sensations and/or urges) and compulsions (repetitive mental or physical actions done to relieve distress from obsessions or to prevent a feared event from happening). People with OCD end up stuck in a vicious cycle of obsessions and compulsions that tends to get worse over time.
OCD can affect everyone differently, and there are many different subtypes, or themes, of the disorder, each with a wide variety of presentations. However, is it possible that this mental health disorder manifests differently based on gender—particularly between men and women? With the issues that women can face when seeking mental health care, having a better understanding of the warning signs of OCD can ensure they get the proper diagnosis and treatment to manage their symptoms.
Keep reading to learn more about what OCD in women looks like, and how specialized treatment can help.
The right treatment can help you conquer OCD—regardless of your gender or symptoms. Book a free call to learn more.
Is OCD more common in men or women?
According to Tracie Zinman-Ibrahim, LMFT, CST, a therapist at NOCD, OCD is actually far more prevalent in women. In fact, research reveals that women are 1.6 times more likely to have OCD than men. “OCD is extremely weighted towards women,” she says. Key factors like a higher prevalence of eating disorders—which are strongly correlated with OCD—and hormonal fluctuations in different periods of life can leave women especially vulnerable to developing OCD.
Here are some additional statistics on OCD in women versus men:
- Men with OCD are more likely to start developing symptoms during childhood, but women are more likely to have symptoms that begin during their adolescence and adulthood.
- Women with OCD were more likely than men to have more than one mental health condition.
- Compared to men, women with OCD tend to report higher rates of depression and anxiety than men.
- Men with OCD are more likely to be single, while women with OCD are more likely to be married.
OCD is extremely weighted towards women.
The most common types of OCD among women
While research shows that OCD predominantly affects women, both genders can be equally impacted by the many themes this mental health disorder has. “OCD themes are an equal opportunity offender,” Zinman-Ibrahim says.
Though all OCD themes can impact people of any gender, some themes are a bit more common among women. Here are some OCD subtypes women may be more likely to experience.
Harm OCD
Harm OCD is a fairly common subtype of OCD that may cause unwanted and intrusive thoughts, images, or urges about harming yourself or others. According to a 2019 research review, women are more likely to report OCD symptoms that are aggressive in nature—which is a characteristic of Harm OCD.
Contamination OCD
Many research studies have revealed that Contamination OCD is more prevalent among women than men. People with Contamination OCD constantly worry about coming into contact with or spreading germs, and often respond to these obsessions by doing compulsive behaviors like handwashing, cleaning, or discarding items.
For women who are mothers, they may have fears about their children getting sick. “You may freak out about what and who touches your baby,” says Zinman-Ibrahim.
Relationship OCD
“I have pretty consistently seen more women with Relationship OCD and Sexual Orientation OCD,” says April Kilduff, MA, LCPC, LMHC, a licensed therapist and Clinical Trainer at NOCD. Relationship OCD involves obsessive worries and doubts about your relationship, romantic and otherwise. Common compulsions done to respond to intrusive fears may include constantly asking your partner for reassurance, avoiding a family member altogether, or compulsively comparing your relationship to others.
Sexual Orientation OCD
Sexual Orientation OCD involves intrusive thoughts surrounding your sexual orientation. Kilduff shares her experience treating women who were filled with intrusive doubts about their sexuality despite being in committed relationships with men. “It’s simply because they have relationships with men that they care so much about,” she says. “OCD comes in and says, ‘Wait, what if you’re not even into men? What if you need to break up with your boyfriend and start all over again?’”
Perinatal/Postpartum OCD
Research suggests that OCD is more common in people who are pregnant and postpartum than in the general population. Perinatal OCD/Postpartum OCD is an OCD theme that develops anywhere from the beginning of pregnancy up to one year after childbirth. With this OCD theme, obsessions and compulsions often revolve around the fear of harming or contaminating their infant.
According to Zinman-Ibrahim, it’s common for people to develop Perinatal OCD without having been diagnosed with OCD before. “Because of your hormones and all the things from being pregnant, you can develop OCD,” she says. “Sometimes it goes away, sometimes it doesn’t.”
She also adds that women who already are managing OCD may experience a flare-up during or after pregnancy. “It could be a new theme that comes up that you didn’t have, or it could be your usual theme but just flared up,” says Zinman-Ibrahim.
Pedophilic OCD
Pedophilic OCD is an OCD subtype that involves unwanted and intrusive thoughts about children. Like Harm OCD, mothers may have intrusive thoughts about harming their own children, which, of course, can cause a lot of distress.
Kilduff says new mothers may develop both Pedophilic and/or Harm OCD because they’re very protective of their children. “They really, really value their kids, and we know that OCD goes after what you value,” she says. “So it’s not really a surprise when I see moms with Harm and Pedophilic OCD. I tell them it’s just a sign of how much you actually love and care about your kids, and that’s why OCD has picked on it.”
What are the most common obsessions and compulsions among women?
With the many subtypes of OCD women can experience, there are different obsessions and compulsive behaviors that can come with them. These symptoms can revolve around their relationships (especially their children if they’re a parent), their home, and performance. Here are the most common OCD symptoms in women:
Obsessions
- Fears of contamination
- Fears of harming their child or someone else harming them
- Concerns about the way they look, including weight and body image
- Worries about their relationship or their partner’s feelings
- Intrusive doubts about their sexuality
- Desires for symmetry or exactness
Compulsions
- Reassurance-seeking from loved ones
- Trying to stop intrusive thoughts from occurring, also called thought suppression
- Avoidance of stressful or triggering situations
- Compulsive prayer, or trying to pray in a “perfect” manner
- Excessive cleaning or handwashing
- Repeatedly checking things, such as door locks, stoves, and light switches
What factors cause OCD symptoms in women?
While the exact causes of OCD are not entirely understood, there are several risk factors that may increase your risk of developing this mental health condition. For women, in particular, the following factors may heighten their chances of developing OCD:
Hormones
Hormonal fluctuations can play a role in the development or worsening of OCD symptoms in women, notes Zinman-Ibrahim. There’s also research that reveals the hormones estrogen and progesterone have a direct influence on the severity of OCD symptoms in women during periods when their hormone levels are irregular.
According to Zinman-Ibrahim, women may experience OCD symptoms linked to their menstrual cycle. “You can most commonly develop symptoms anywhere from two weeks before or during the menstrual period—or sometimes, both,” she says.
There’s also a link between OCD and menopause. Another research study found that the hormonal changes that occur during the postmenopausal period could increase a woman’s risk of developing OCD.
Eating disorders
Having an eating disorder—such as bulimia or anorexia nervosa—may be an OCD risk factor for some women. According to the National Alliance for Eating Disorders, between 5.5% to 17.9% of young women develop eating disorders, compared to 0.6% to 2.4% of young men. A 2020 review found that about 18% of participants had a lifetime comorbidity with OCD—meaning that those with an eating disorder are more likely to experience OCD later on in their lives.
Genetics
Genetics could also play a large role in the symptoms of OCD in women. Having a first-degree relative—such as a mom or sister—who has OCD may increase the chances of developing OCD. Unfortunately, scientists are unsure of what particular gene or genes are associated with the condition, but there’s ongoing research to find out.
How OCD is treated in women
OCD is not treated any differently in women as it is for men. OCD treatment typically involves therapy to break the cycle of obsessions and compulsions, particularly with exposure and response prevention (ERP) therapy, the gold standard treatment for all OCD subtypes. This specialized therapy involves two components: careful and intentional exposure to your intrusive thoughts and obsessions, and response prevention techniques used to refrain from doing compulsions that make your symptoms worse.
For women who may fear they are bad mothers, for example, Zinman-Ibrahim would have them do imaginal scripting in their ERP sessions. “It could be as simple as writing about being a bad mom and how your kid might not turn out well because of you and the mistakes you make, and just sitting with the discomfort of that possibility,” she explains. “We also teach self-compassion because it’s hard to have OCD, but it’s also hard to be a mom—so be aware of that, and be nice to yourself as you go through this process. As you learn to accept uncertainty around your fears, you may learn to accept yourself, as well.”
Managing OCD can be challenging to do on your own. If you’re a mother living with OCD, Zinman-Ibrahim recommends joining the International OCD Foundation’s (IOCDF) Moms with OCD Special Interest Group for support.
