Male Hormones and Obsessive-Compulsive Disorder (A Detailed Analysis)

:.::.:.:!This article does not intend to replace the advice of one's therapist, psychiatrist or physician and as such is provided for informational / investigative purposes ONLY! (Area-1255) :.::.:.:

Male hormones (Androgens) such as Testosterone, and Dihydrotestosterone as well as androstanediol have complex effects on human behavior. Their actions in the brain are concentration dependent and the outcome of their actions also depends greatly on their proportion with other hormones such as Estradiol (Estrogen,Female Hormone) and Cortisol (1) (2) (3). 

Dihydrotestosterone in particular, is shown to have protective effects against excitotoxicity and may allow neurons to recover quickly following stress and / or acute overfiring / high stimulatory challenge(!) (!)

Androstanediol (a neuroactive form of testosterone) has been shown to act as a strong positive allosteric modulator of GABA-A receptors (4); these receptors are typically hypoactive in those with anxiety disorders and in those with mania and BiPolar disorder. GABA is the prime inhibitory (calming) in the human / mammalian nervous system - thus , androstanediol acting to increase the rate of opening of the GABA receptor and it's channels and by enhancing the overall activity of the complex - may improve various anxiety pathologies. 

However, androgens roles in obsessive-compulsive-disorder are less clear.. because glutamate has been shown to be elevated in some patients with OCD - but in others, low levels of shown - it may be difficult to assess whether androgens have positive effects across the board (6). With that being said, because those affected with OCD have shown low levels of GABA (7) , androgens may theoretically dampen the 'potency' or severity of the obsessive qualities of OCD-sufferers...additionally, NMDA receptors - a form of glutamate receptor - are also found to be hypoactive (underactive) in OCD; although not to the degree of schizophrenics(8) (9). DHT and DHEA both increase the activity of NMDA receptors which may theoretically, improve obsessive-compulsive symptoms; specifically the compulsive aspect (the acting on thoughts) (10) (11).

The problem amidst all of this however, is that these androgens MUST be in the proper proportion with estrogen ; estrogen can play both a provocative/inciting role in OCD symptoms (when elevated) and a attenuating effect in small amounts (12) ..however, man's usage of estrogen relative to psychological/behavioral effects are dependent on  "Free" testosterone...that means that those 'small' amounts of estrogen can not possibly affect or alleviate any male pathology unless they are converted from testosterone and not being bound by carrier proteins(13). 
Thus Estrogen excess and deficiency can exacerbate OCD symptoms, but even if estrogen is in the normal range - it does not matter if it is not neuroactive (14). 

Further reinforcing the above; obsessive-compulsive subjects have shown elevated serotonin activity (15) - and altered serotonin receptor densities (16) - both DHT and estrogen seem to oppose serotoninergic activity - and thus application of both (but not one or the other) may reduce OCD symptoms (17).

Above all else - and reiterating the above - what must be remembered is that estrogen can not be deficient nor excessive in order for androgens and neuroactive steroids to even touch the severity of OCD-symptoms and science has not fully wrapped it's head around this particular avenue regarding hormones and OCD. 

This article does not intend to replace the advice of one's therapist, psychiatrist or physician and as such is provided for informational / investigative purposes ONLY!

               **OTHER SOURCES/CITATIONS**

~ TESTOSTERONE AND ANXIETY ~

                ANDROGEN'S AND MOOD - TESTOSTERONE'S EFFECT ON ANXIETY

Gender in obsessive-compulsive disorder and obsessive-compulsive spectrum disorders
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