ADHD & Menopause
ADHD (Attention Deficit Hyperactivity Disorder) has often been associated with children, but an expanding body of research is shows its significant impact on adults, particularly women. As women transition through all stages of the menopause, the hormonal changes can noticeably alter how ADHD presents itself.
Personally I had no idea I had ADHD until my friend (a psychiatrist) highlighted this as a possibility to me - I was 42 at the time, but wow - it made so many things in my life, make so much sense!!
Pioneers in this area, such as Dr. Louise Newson, a menopause specialist, and Dr. Marie Claire a specialist from the USA, are raising awareness about how menopause can affect women with ADHD. Understanding the intersection of ADHD and menopause is essential to offering better care and support for people navigating this challenging life phase.
Hormonal Influence on ADHD Symptoms
ADHD symptoms in women are strongly influenced by hormonal fluctuations throughout their lives. These fluctuations — during puberty, the menstrual cycle, pregnancy, and menopause — can worsen or modify the presentation of ADHD. Oestrogen, which fluctuates significantly during menopause, profoundly impacts brain function, including the regulation of neurotransmitters like dopamine and serotonin, which play essential roles in attention, mood, and executive functioning — all areas where individuals with ADHD already face challenges.
Dr. Louise Newson explains that during menopause, as oestrogen levels decrease, women may experience a worsening of ADHD symptoms or even the emergence of new ones. The drop in estrogen leads to a decrease in dopamine, which exacerbates the core symptoms of ADHD: inattention, impulsivity, and hyperactivity. For women who have previously managed their ADHD, these changes can feel very confusing and distressing.
Dr. Marie Claire points out that the interaction between ADHD and menopause can very often be overlooked. ADHD symptoms in women are frequently under-diagnosed or misdiagnosed, especially since ADHD symptoms in women tend to be more subtle than in men. Symptoms like daydreaming, disorganization, and emotional dysregulation are easily mistaken for the mood changes or cognitive decline often associated with menopause. This misinterpretation can lead to delayed diagnoses and inadequate support.
Common Symptoms During Menopause
Women I work with living with ADHD and going through menopause frequently report a variety of symptoms that reflect both hormonal changes and a worsening of their ADHD traits. Some of the one I hear most frequently include:
Increased forgetfulness: They may find it harder to remember appointments, deadlines, or even basic daily tasks. Often described as "brain fog," this feeling is common in menopause discussions, but for women with ADHD, it can feel especially overwhelming.
Diminished ability to concentrate: Concentration, already a challenge for those with ADHD, can become even harder to maintain during menopause. Women may find themselves starting multiple tasks but struggling to complete them or getting easily distracted.
Mood swings and emotional dysregulation: While mood swings are common in both ADHD and menopause, their combination can amplify emotional fluctuations. Women may feel more irritable, anxious, or depressed, with a shorter emotional fuse than before.
Impulsivity: Menopause can worsen impulsivity in women with ADHD, making it harder to control impulses, whether in decision-making, spending, or emotional outbursts.
Sleep disturbances: Many menopausal women experience sleep difficulties due to night sweats and hot flushes, and ADHD is also associated with sleep problems. To add insult to injury our melatonin (sleep supporting hormone) also takes a dip during menopause so for people with ADHD and experiencing menopause, these factors can lead to chronic sleep deprivation, which in turn worsens ADHD symptoms like irritability, inattention, and poor memory.
These changes can cause significant emotional distress, especially for women who feel they are losing control over their cognitive abilities. For many, this stage of life can feel very disorientating, isolating and even frightening, with some wondering if their worsening symptoms are simply due to aging or if something more significant is happening.
How Women Feel
Women with ADHD going through menopause often describe feelings of frustration, guilt, shame and even suicidal feelings. Dr. Marie Claire highlights the emotional toll these changes can have on a persons self-esteem. Many with ADHD have spent years developing strategies to manage their symptoms, only to feel as if they’re back to square one when menopause begins.
This can lead to feelings of helplessness or self-blame, as women struggle to understand why they’re no longer able to cope in the ways they previously could. Additionally, the cognitive and emotional challenges can impact relationships, work performance, and overall quality of life. Women may feel less confident in their abilities, which can intensify feelings of imposter syndrome — already common among those with ADHD.
Additionally, many women report feeling misunderstood by their healthcare providers. Since ADHD in women has historically been under-recognised, many doctors attribute cognitive changes solely to menopause, overlooking the ADHD aspect. This leaves people feeling very unsupported and without the proper resources to manage their symptoms effectively.
Strategies to Help
Dr. Louise Newson and Dr. Marie Claire both advocate for a holistic approach to managing ADHD symptoms during menopause. While hormonal fluctuations cannot be entirely avoided, several strategies can help regain a sense of control over their symptoms.
Hormone Replacement Therapy (HRT): One of the most well known and effective treatments for managing menopause symptoms, HRT can help stabilise oestrogen levels, which may improve ADHD symptoms. Dr. Newson supports individualised HRT plans that consider both menopausal and ADHD-related challenges, as balanced oestrogen levels can lead to noticeable improvements in cognition, mood, and overall functioning.
Medication for ADHD: Some may find ADHD medication becomes less effective during menopause. In these cases, Reassessing medication dosage or exploring alternative medications with the guidance of a healthcare provider can be really beneficial. Stimulants like methylphenidate or amphetamine-based ADHD medications can be adjusted to accommodate hormonal changes affecting brain chemistry.
Lifestyle Adjustments: I cannot stress to you enough the importance of lifestyle changes to support cognitive health. Regular physical activity, a balanced diet rich in omega-3 fatty acids, and adequate sleep are all critical for managing ADHD symptoms. Exercise, in particular, boosts dopamine levels, helping to improve focus and reduce impulsivity.
Mindfulness and Cognitive Behavioural Therapy (CBT): Mindful practices and CBT or (CBTI to support sleep) can be invaluable for those struggling with emotional dysregulation and stress during menopause. These therapies help women develop better coping strategies for dealing with the emotional and cognitive challenges associated with ADHD and menopause.
Support Networks: Building a strong support system is crucial. It can be incredibly helpful to seek out communities of others going through similar experiences, whether through, family & friends online forums, our very own @MasteringYourMenopause FB Group, local support groups, or coaching/therapy. Talking about these challenges can help build confidence and connection and reduce feelings of isolation and shame, which often accompany ADHD and menopause.
Conclusion
The intersection of ADHD and menopause is an area of increasing research, largely thanks to the work of experts like Dr. Louise Newson and Dr. Marie Claire. Their insights have brought to light the unique challenges faced by women with ADHD during this life stage, offering hope and practical strategies for symptom management. By recognising the hormonal factors at play and implementing targeted interventions, women can approach this stage of life with renewed confidence and control.
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