Obsessive-compulsive disorder and menopause: a scoping review

Obsessive-compulsive disorder (OCD) is a psychiatric condition marked by intrusive thoughts and compulsive behaviors. Female-born individuals are more likely to develop OCD; reproductive events such as menarche and the peripartum are also associated with increased symptom severity. This scoping review identified existing literature on the impact of menopause on OCD onset and symptoms.

We conducted a scoping review following Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for scoping reviews reporting guidelines. Four electronic databases (MEDLINE, Embase, PsycInfo, and CINAHL) were searched from inception to April 15, 2025, for original research studies examining the association between menopause and new onset or changes in preexisting obsessive-compulsive symptoms. We described study characteristics, main findings, and gaps in the existing literature.

Eight studies met criteria for inclusion in this review. All studies used quantitative methods, were cross-sectional, and relied on self-reported retrospective assessment of changes or onset of obsessive-compulsive symptoms in relation to the onset of menopause. Of 373 participants reporting on OCD onset, 17 (4.6%) reported that the initial appearance of their OCD symptoms had coincided with the onset of menopause. Of 265 participants reporting on symptom changes, 72 (27.2%) reported an exacerbation of their symptoms with the onset of menopause, while 30/265 (11.3%) reported an improvement in symptoms. Cross-sectional research suggests that OCD symptoms may change in severity or start with menopause in a subset of individuals. Longitudinal studies prospectively tracking OCD symptoms in the premenopause, perimenopause, and postmenopause phases are needed to confirm these findings. In the meantime, increased symptom monitoring of midlife female-born individuals with OCD is warranted.