OCD in Women: How Common Is It & And How Does It Differ From Males?

Obsessive-compulsive disorder (OCD) is a term many people throw around to prove a point or self-diagnosis someone when in reality it is so much more than that. For instance, someone may say, “I forget to lock my door, I am so OCD!” Or, “I am terrified of getting COVID so I keep hand sanitizer with me at all times, I guess it’s just the OCD in me.” The truth is OCD is a common anxiety condition. Over the years, OCD has become unceremoniously linked to orderliness and cleanliness, however, it is a real, diagnosable condition that can adversely affect one’s life.

Haphazardly, throwing around the term, “OCD,” negates or minimizes the struggles that people with the condition face every day. When people casually use the term to score points, it makes the condition seem less valid or authentic, which can make getting an OCD diagnosis and the proper OCD treatment challenging, if not impossible.

A common stereotype or myth of OCD is that it occurs more in men than women, but that simply is not true. The truth is this chronic anxiety condition does not discriminate. It does not care about your race, ethnicity, culture, religion, age, gender, sexual orientation, economic or educational background, financial status, past traumas or experiences, or even your health or well-being. OCD can at any time. So, while most people equate OCD with being solely a “male condition,” that is not necessarily true.

If you are wondering if OCD manifests differently in women than it does in men, you have come to the right place, because this article will discuss the ins and outs of OCD in women and pinpoint the differences between having OCD as a man and having it as a woman. I hope that with a better understanding of OCD, in general, and how it specifically presents in women, you can get the proper OCD help to help you better manage your obsessions and compulsions.

OCD In a Nutshell

Obsessive-compulsive disorder (OCD) is a chronic and persistent anxiety condition that affects a little over 1% of adults in the US. It is slightly more common in the US, as compared to the rest of the world. And, alarmingly, approximately 1% of OCD sufferers commit suicide.

People, who struggle with this condition tend to experience non-stop, unwanted, and intrusive thoughts, fears, doubts, urges, emotions, and mental images (obsession). An obsession can negatively affect your life – i.e., relationships, friendships, job opportunities or employment, your finances, self-esteem and self-confidence, mental health, ability to perform tasks, etc.

While some people with OCD only experience obsessions, others with OCD may also feel compelled to ease their anxiety and stress, and “quiet” their minds by repetitively engaging in compulsive behaviors (rituals or routines).

These compulsive behaviors may include repetitive hand-washing and/or cleaning, checking, organizing, repeating phrases or counting, phobia-like fears of being contaminated or “infected” by something or that something “bad” will happen if certain rituals or routines are not performed.

There are many different types of OCD. Some people need symmetry or for everything to be “just right” or “perfect” to feel at ease, while others may need for everything to be immaculately clean or “germ-free” to feel safe and calm.

Some OCD sufferers grapple with violent or sexual intrusive thoughts, fears, and/or urges that are unpleasant or frightening, while others are afraid of harming themselves or others. It is also common for some people with OCD to develop tics, which can involve repetitive facial movements, grimaces, grunting sounds, blinking, and/or throating clearing.

Similar behaviors have ramped (in non-OCD people) up since the inception of the pandemic, the difference is people with OCD have a hard time controlling these thoughts, fears, urges, and/or behaviors. They do not want to have them, but cannot help it.

And, even if they get a modicum of relief from performing a certain action, this respite is only temporary. The stress, anxiety, intrusive thoughts, fears, etc., eventually return. Engaging in rituals or routines brings never brings long-lasting relief, pleasure, or happiness.

The truth is OCD can take a major toll on your life, especially if you are not being treated for it. However, with the right OCD help, you can “silence” the noise in your head, and live a healthy and productive life.

What Are Possible Causes and Risk Factors of OCD?

Experts are not quite sure why some people develop OCD, and others do not. However, the consensus is that stress, trauma, child abuse, genetics, brain structure abnormalities or brain chemistry changes, environmental factors, personality or “temperament” traits, and a personal or family history of mental illness may trigger or worsen anxiety conditions, like OCD.

But, alas, the jury is still out on the exact cause and risk factor for OCD. OCD symptoms appear to present during adolescence, although they can arise earlier or later than this timeframe. Sometimes, OCD is caused by an illness, such as a streptococcal infection. When a child contracts “strep,” he or she is at risk of also developing a secondary condition, like pediatric autoimmune neuropsychiatric disorder (PANDAS).

Is There a Relationship Between Women and OCD?

Yes, there is.

Contrary to popular belief, the lifetime prevalence of OCD is slightly higher in women (1.5%) than men (1%), which is similar to the statistics found in other mental health conditions. Although, this may seem like a small percentage of people, look at it like this – women are almost 50% more likely to develop the condition than men.

Some factors that may contribute to this statistic could be witnessing or experiencing domestic violence, childhood physical, emotional, or sexual abuse, increased rates of trauma, inequality in income and power, and/or sexism.

Another factor that could cause account for the higher statistics of OCD in women is pregnancy. Women can develop postpartum OCD following the birth of a child. Postpartum OCD accounts for 1-3% of women, who have recently given birth to a baby. Keep in mind, however, that men can also experience postpartum OCD, albeit at a lower rate. New parents are particularly susceptible to developing postpartum OCD.

This condition typically involves unwanted and unrelenting fears or thoughts about the baby and his or her safety and well-being. These fears and thoughts may involve a fear that the baby will be hurt or killed by the mother, father or both – or that something or someone else will harm your child – accidentally or deliberately. A woman with postpartum OCD may continuously check on the baby to ensure that he or she is safe and still breathing.

Note: There is limited research on female non-binary or transgender people with OCD, therefore, it is important to also include these populations in future OCD studies.

Are Women More Likely to Develop OCD Than Men?

Yes, women are typically at greater risk of experiencing OCD in their lifetime than men.

According to a recent study, women are almost 2x more likely to struggle with OCD, as compared to men.

Does OCD Affect Men and Women the Same?

Not always.

Studies have found that men are more likely than women to be single, experience OCD symptoms earlier than women, grapple with chronic OCD symptoms, develop social anxiety, exhibit poor social skills, sexual-religious and aggressive OCD symptoms, and have greater comorbidity with tics and/or substance use disorder. Men are also more likely to develop OCD symptoms at a younger age (under the age of 10) than women (over the age of 10).

Researchers have found that females, on the other hand, are more likely to experience more contamination/cleaning symptoms and greater comorbidity of OCD with eating and impulse-control disorders. So, even though most genetic OCD studies are inconclusive, the consensus is that gender does play an important role in the development and progression of OCD.

Are Women More Likely to Become Substance Abusers?

Yes, women are more likely to experience substance abuse.

Studies suggest that women with OCD have a higher risk of developing a substance use disorder, as compared to men with OCD. More specifically, women with OCD are at risk of developing alcohol-related disorders, acute alcohol intoxications, opioid-related disorders, stimulant-related disorders, and other drug-related disorders.

Conversely, men with OCD tend to be more aware, as compared to women, that their urges, thoughts, fears, and compulsions are illogical. However, knowing that their obsessions and compulsions are unrealistic, does not prevent them from having them. This knowledge also does not make controlling them any easier.

Men with OCD are more likely to experience high levels of emotional distress because of intrusive thoughts, fears, urges, and compulsive behaviors. Thus, it should be of no surprise that many male OCD sufferers also turn to drugs and alcohol (albeit at lower rates) to “escape” their stress, anxiety, and OCD symptoms.

Do Men and Women Manifest OCD Symptoms Differently?

Yes, in some cases, men and women manifest OCD symptoms in different ways.

OCD can manifest itself in a variety of ways, such as:

Harm OCD

Women with OCD tend to manifest this harm OCD by being overly fearful of infecting loved ones, especially parents, children, and romantic partners with a deadly disease. They also tend to experience intrusive thoughts of “accidentally” harming their children, close friends, spouses, or long-term partners. These thoughts may involve getting into a car accident with a loved one or friend in tow, or “accidentally” poisoning them with the food they prepared.

Men with OCD, on the other hand, may manifest harm OCD by constantly checking on things, such as checking the doors, windows, stove, etc., to ensure that everyone is safe and protected. Men with this type of OCD often feel the need to prevent harm from coming to themselves and others by over-protecting them from harm. This stems from the notion that men must be “protectors.”

Contamination OCD

Similar to harm OCD, women with contamination OCD may exhibit this type of OCD by constantly and excessively cleaning and sanitizing the house – i.e., continuously wiping down the walls, washing clothes, etc.

While men with this type of OCD tend to focus on their bodies, for instance, scrubbing their hands into the bleed or taking numerous showers throughout the day. The goal is the same to ensure that everything and everyone is clean and germ-free, however, men and women tend to have different focuses – home vs. body.

Note: Some men with contamination OCD will scrub their hands with abrasive material until they are raw to avoid becoming contaminated or contaminating others by a virus or infection. Women accomplish this task by cleaning the home with abrasive cleaners until their hands crack and clean.

Symmetry OCD

Women with symmetry OCD tend to focus on their appearance. In other words, women with this type of OCD will “fixate” on parts of their appearance that they deem to be “imperfect,” such as blemishes, excess weight, wrinkles, unhealthy or grey hair, etc.

As a result, these women will try to ease their stress, angst, and intrusive thoughts by getting cosmetic surgery, going on extreme weight loss journeys (sometimes leading to eating disorders), piling on makeup, and wearing clothes that are too tight. In some cases, women with symmetry OCD will become obsessed with how their homes look, becoming upset if one thing is out of place or they find a speck of dust.

These individuals fear that something “bad” will happen if their home is not “perfect.” Conversely, men with this type of OCD tend to experience an overwhelming need to organize their thoughts and words, and/or arrange objects until they feel everything is “just right” or “perfect.”

For instance, a man with symmetry OCD may repeatedly rearrange his CD collection, and books (placing them in alphabetical order, etc.). This behavior may extend to his car as well. In this case, the man may become highly agitated if anything in his car is out of place and/or if his car has a speck of dirt or mud on it.

Violent, Religious, or Sexual OCD

Women with violent, religious, or sexual OCD may isolate themselves from others for fear of being judged by loved ones and friends. These individuals may also take a hit in the self-esteem and self-confidence department. These women are prone to suicidal ideation if someone finds out about their thoughts (because they truly care what others think about them), so they become desperate to hide these behaviors from others. This is especially true if the thoughts are sexual, in nature.

Suicidal ideation (thoughts and attempts) likely stems from a woman’s religious upbringing, but it may also stem from past traumas, especially sexual or physical abuse – or cultural beliefs. For women with this type of OCD, the torment is more emotional than physical. For instance, these women become “fixated” on how other people would see them if they knew what they were thinking, so their goal is to prevent these thoughts and fears from becoming a reality. It is also to hide these behaviors from the people they care about.

Men, on the other hand, tend to struggle internally with intrusive thoughts and urges. In other words, men with this type of OCD, are constantly battling unwanted violent, sexual, and/or religious thoughts and fears.

For example, a man with this type of OCD may constantly think to attack a random stranger with a knife but grapple with the knowledge that it is wrong to do so, or he may have urges to have sex with an underage girl, which he knows is immoral and illegal. He is unlikely to act on these thoughts and urges, but they remain in his head.

Note: Women with this type of OCD may have thoughts or urges to hurt romantic partners that hurt them – emotionally or physically. They may envision running over an ex with a car, stalking him, or even sexually assaulting the man as revenge. Although the women may think these things, they are unlikely to follow through with them.

Hoarding OCD

Women, who struggle with hoarding OCD, may continuously “collect” things until their homes are filled with “junk.” These women may refuse to throw anything out, fearing that they will need it later. While men with this type of OCD may add things to the home only to feel the need to throw things out shortly afterward – even necessary things. Thus, a man with OCD may experience stress, anxiety, and intrusive thoughts, if he does not throw things out, while a woman with OCD may experience stress and anxiety if she does not “collect” things.

Is OCD Treated the Same for Men and Women?

Yes!

Although people tend to joke about OCD, it is a real condition that can disrupt a person’s goals and health and well-being, so it is nothing to laugh about. Although there is no cure for OCD, there are ways you can effectively manage your condition, so you have fewer symptoms. Conventional OCD treatments may include cognitive-behavioral therapy (CBT), exposure and response prevention (ERP) therapy, a subtype of CBT, acceptance and commitment therapy (ACT), trauma counseling, addiction counseling, family counseling, couples counseling, etc.

OCD treatment may also include OCD support groups, mindfulness, hypnosis, CBD, vitamins and minerals, developing healthy coping skills and strategies, OCD forums, OCD books, and self-help tools, like Impulse Therapy, an online OCD treatment program that is open to both men and women, who are struggling to get a grip on their OCD symptoms.

In some cases, antidepressants (i.e., Luvox, Zoloft, Prozac, etc.), or other OCD medications may be combined with OCD therapies and added to your prescribed treatment plan. If conventional OCD treatments are ineffective, your OCD therapist may add neuromodulation or TMS (electrical pulses) to your prescribed treatment plan to help you get your OCD symptoms under control.

With the right OCD help, you can accomplish your goals and have a productive life without the constant “noise” of OCD blaring in your head and clouding your thoughts. With the right treatment, you can finally function at an optimal level and fulfill your dreams!

References

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