THE RELATIONSHIP OF MENSTRUAL-CYCLE AND PREGNANCY TO COMPULSIVE HAIRPULLING

Background: Trichotillomania (TTM) or compulsive hairpulling is a cycl ical disorder that presents predominantly in females, Anecdotal report s of symptom worsening in the premenstruum and during pregnancy led us to retrospectively study the role of these events in hairpulling beha vior. Methods: Questionnaires assessing demographics, current hairpull ing behavior, and the reported effects of menstruation and pregnancy o n urges, actual hairpulling and behavioral control were administered t o clinic patients and volunteers at a hairpulling conference. The MGH Hairpulling Scale, Beck Depression Inventory and Beck Anxiety Inventor y were also completed. Data from 59 hairpullers were analyzed. Results : Premenstrual symptom exacerbation was reported for actual hairpullin g, urge intensity and frequency, and ability to control pulling and wa s alleviated during menstruation and shortly thereafter. The impact of pregnancy was less unidirectional, with both symptom exacerbation and lessening reported. Conclusions: The menstrual cycle appears to affec t compulsive hairpulling and deserves recognition in both the assessme nt and treatment of this disorder. The impact of pregnancy on TTM is l ess clear.