ADHD and Hormones: Advocating for Yourself Through Perimenopause and Beyond
By Catherine Mutti Driscoll, PhD, CALC
There is growing awareness of how hormones impact ADHD in girls and women. In their younger years, many women with ADHD experience premenstrual dysphoric disorder (PMDD) during their reproductive years, leading to a noticeable rise in ADHD symptoms in the week leading up to their periods. For many, this can manifest as feeling unproductive or unusually stressed (Wasserstein, 2024). Estrogen, which plays a significant role in regulating dopamine levels, often explains these fluctuations. Since hormones can impact ADHD symptoms significantly, some women are not diagnosed with ADHD until they experience the substantial hormonal shifts that come with perimenopause or menopause.
My Story
Like many women, I was diagnosed with ADHD in my late 30s after one of my children was diagnosed. Tracy Otsuka (2023) called this “the mommy factor.” As I began managing my ADHD symptoms, I noticed another variable that significantly impacted my functioning: perimenopause.
Having experienced how hormones influenced my ADHD during my monthly cycles and pregnancies, I anticipated that menopause could bring new challenges. I started raising this issue with my doctor, but at the time, she told me that I was “a little young” for discussions about menopause. It’s possible this initial, somewhat dismissive response stemmed from menopause not being my doctor’s area of expertise. Still, I continued researching, raising the topic in health visits, and tracking my symptoms.
As I researched, I was surprised by how little knowledge seemed to be available about menopause, even though it impacts half the population. When my doctor left the practice and I needed to transition to a new provider, I took the opportunity to once again advocate for perimenopause support for myself. I mentioned the research about how menopause impacts women with ADHD and Autism, like me. Helpfully, the doctor referred me to an ARNP who specialized in menopause.
When I initially met the ARNP, I was prepared. I brought along my recently published The New Menopause book. I circled all the symptoms I had been experiencing, such as irregular periods, increased irritability, hair loss, brain fog, joint pain, fatigue, gastrointestinal issues, and more (Haver, 2024). My new ARNP agreed that I was likely in early menopause and ordered tests to rule out other possible causes. Within months, I had a diagnosis and began a hormone replacement therapy (HRT) trial.
While I am still adjusting to HRT, I’ve already noticed promising improvements in my mood and overall well-being.
Advocating for Yourself
If you suspect hormones may be playing a role in your ADHD symptoms and you’re within the perimenopause age window (give or take in your early-mid 40s), here are some steps you can take:
Track Your Symptoms
Pay attention to your cyclical patterns and how they impact your mood, energy, focus, and overall well-being. I used the Apple Health app on my phone to collect data for my doctor regarding the increasing fluctuations in my menstrual cycle lengths.Educate Yourself
Read or listen to podcasts about the intersection of ADHD and hormonal changes to help you understand your symptoms and learn you are not alone. Additude magazine is an excellent resource with helpful articles and summaries of this critical issue. Menopause books for general audiences, like The New Menopause by Dr. Mary Claire Haver and Hot and Bothered by Jancee Dunn can provide valuable insights.Be Persistent
Like me, you may need to raise the issue repeatedly or even seek out a provider with specialized knowledge about menopause. It’s okay to be a “broken record,” raising this issue multiple times if necessary.Find the Right Provider
Not all doctors are trained in managing menopause, and some may know about menopause but not recognize its impact on ADHD. If you’re not getting the support you need, don’t hesitate to try a new provider and/or request a referral from your healthcare team.
No matter what stage of life you’re in, you deserve to live your best life with ADHD. For me, the combination of understanding my ADHD and addressing my hormonal health has been crucial. I hope my story inspires you to advocate for yourself and seek the care that you need.
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