ADHD, perimenopause, and how we see ourselves: understanding the overlap
For women like me who have lived with ADHD all their lives, certain patterns and struggles may have shaped their experience and sense of self from an early age. ADHD is often misunderstood, especially in girls and women, which means many go undiagnosed or misdiagnosed for decades. These women might have grown up being labelled as "scatterbrained," "lazy," or "emotional" due to their symptoms, which are often dismissed or misattributed to personality rather than neurodivergence.
ADHD symptoms such as difficulty with organisation, time management, emotional regulation, and focus might have been manageable or masked through strategies they developed over time. However, these symptoms don’t exist in isolation—they impact how women feel about themselves. Many women carry an ongoing sense of guilt, shame, or inadequacy, often internalising the idea that they are somehow "failing" to meet expectations.
The perimenopausal shift: why symptoms worsen
As women approach perimenopause, everything can change. This hormonal transition—often beginning in the early to mid-40s—can exacerbate ADHD symptoms significantly. But why? Hormones play a vital role in brain function, especially in areas linked to ADHD. Oestrogen, in particular, helps regulate dopamine and serotonin—neurotransmitters crucial to focus, motivation, and emotional regulation.
As oestrogen levels decline during perimenopause, these chemical imbalances can cause ADHD symptoms to worsen. Women often report increased forgetfulness, greater difficulty concentrating, heightened emotional sensitivity, and even struggles with tasks they previously managed well. For someone already navigating life with ADHD, this hormonal upheaval can feel like a tidal wave, knocking down the coping mechanisms they’ve relied on for years.
The impact on how we see ourselves
The worsening of ADHD symptoms during perimenopause can have a profound impact on how women feel about themselves. They may begin to question their competence, feel increasingly frustrated with themselves, or even experience a resurgence of the shame and guilt they’ve carried since childhood.
Tasks that once felt challenging but achievable might suddenly feel insurmountable. Forgetting a meeting, losing track of tasks, or being overwhelmed by emotional swings can lead to thoughts like, “Why can’t I just pull myself together?” or “I’m falling apart.” These feelings can erode self-esteem and heighten feelings of inadequacy, especially in a society that often dismisses both ADHD and the struggles of menopause.
It’s important to acknowledge the emotional toll this can take. Many women feel isolated, as if they are the only ones experiencing this shift. They might worry that they’re “losing their minds” or “not trying hard enough.” This sense of isolation can deepen the negative self-perception many women with ADHD already carry.
Breaking the cycle: knowledge, support, and compassion
The overlap between ADHD, perimenopause and hormones is still not widely discussed or understood by many, even healthcare professionals. Many women report that their concerns are dismissed when they seek help, with symptoms chalked up to stress, anxiety, or “just part of getting older.” This lack of understanding can make women feel invisible and unheard.
But raising awareness is key. Recognising that hormonal changes can amplify ADHD symptoms helps women put their experiences into context. It’s not that they’re “failing” or “falling apart”—their brains are responding to a significant hormonal shift. This shift is valid, real, and deserves support.
Practical steps can include:
Educating GPs and specialists: Women may need to advocate for themselves during perimenopause, requesting hormone tests or exploring treatments like HRT (hormone replacement therapy). Dr. Louise Newson’s Balance app is a valuable tool, offering resources and a symptom tracker to help women articulate their needs.
ADHD coaching: Coaching can help women identify strategies that work for them during this phase of life, such as breaking tasks into smaller steps, prioritising self-care, and establishing routines that account for fluctuating energy and focus.
Community and connection: Finding others who understand—whether through ADHD support groups or menopause-focused networks—can help women feel less alone and validate their experiences.
Reframing the narrative
Perhaps most importantly, women deserve to reframe how they see themselves. ADHD and perimenopause are not personal failings—they are part of how their brains and bodies function. Learning to approach these changes with kindness and self-compassion is crucial. Women can give themselves permission to adapt, set boundaries, and let go of the impossible standards they may have held themselves to for decades.
The journey through perimenopause with ADHD can be challenging, but it’s also an opportunity for growth. With the right tools, support, and understanding, women can reclaim their sense of self and thrive through this new stage of life.
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