Effect of Gonadal Hormones on Neurotransmitters Implicated in the Pathophysiology of Obsessive- Compulsive Disorder: A Critical Review

Obsessive-compulsive disorder (OCD) is a relatively common neuropsychiatric disorder affecting between 1.6 and 3.2% of the population. A number of studies have previously reported increased incidence of OCD, or exacerbation of preexisting symptoms in females during reproductive events. Since these periods are known to involve fluctuating levels of gonadal hormones, these steroids have been suggested to be involved in modulating the course of the disorder. However, to date, only a few studies have measured hormone levels and obsessive-compulsive (OC) symptoms concurrently; thus, direct evidence for this relationship is limited. In turn, investigations into neurotransmission in OC individuals have been more extensive, and have implicated the serotonergic, dopaminergic, and glutamatergic neurotransmitter systems in OCD pathology. There is evidence suggesting that reproductive hormones estrogens and progesterone can modulate neurotransmission in the aforementioned signaling pathways by regulating the expression of recepReceived: July 22, 2016 Accepted after revision: November 22, 2016 Published online: November 28, 2016 Meir Steiner, MD, MSc, PhD, FRCPC Psychiatry and Behavioural Neurosciences McMaster University and St. Joseph’s Healthcare 100 West 5th Street, Hamilton, ON L8N 3K7 (Canada) E-Mail mst @ mcmaster.ca © 2016 S. Karger AG, Basel