Community-recruited women with trichotillomania or skin picking disorder showed heterogeneous symptom patterns during pregnancy, with most reporting stable or decreased compulsive behaviors rather than expected hormonal exacerbation. The retrospective survey challenges assumptions about estrogen and progesterone uniformly worsening body-focused repetitive behaviors. This finding adds nuance to our understanding of how reproductive hormones influence obsessive-compulsive spectrum disorders. Previous research has established strong links between hormonal fluctuations and various psychiatric conditions, particularly anxiety and mood disorders, making the variable pregnancy response in these conditions somewhat unexpected. The heterogeneous outcomes suggest individual differences in hormonal sensitivity or protective factors during pregnancy may override general hormonal influences. For women planning pregnancies who struggle with these disorders, the data offers reassurance that symptom worsening is not inevitable. However, the retrospective design limits reliability, as pregnancy experiences may be subject to recall bias or influenced by the emotional significance of motherhood. The authors' call for prospective studies with biological markers represents a crucial next step, as real-time hormone measurements could reveal whether cortisol, estrogen, or other biomarkers predict which women experience symptom changes during reproductive transitions.