How does the drop in oestrogen during perimenopause affect ADHD?
For many women, perimenopause brings about a significant shift in both physical and mental health due to fluctuating hormone levels, particularly oestrogen. For women with ADHD, these hormonal changes can amplify existing challenges, creating a complex interplay between neurodivergence and menopause symptoms.
The role of oestrogen in ADHD and brain function
Oestrogen is a key hormone that influences the production of dopamine and serotonin—neurotransmitters essential for focus, mood regulation, and executive functioning. These neurotransmitters are already naturally lower in people with ADHD, which is why oestrogen plays such an important role in balancing their effects.
During perimenopause, as oestrogen levels decline, the brain's dopamine system can become even more dysregulated, exacerbating classic ADHD symptoms like inattention, impulsivity, and emotional dysregulation. This hormonal drop may also worsen other co-occurring conditions such as anxiety, depression, and sleep disturbances.
The unique impact on women with ADHD
Women with ADHD often report a worsening of symptoms during perimenopause. These can include:
Increased forgetfulness and brain fog: Tasks that were previously manageable can feel overwhelming, and memory lapses may become more frequent.
Heightened emotional dysregulation: Many women notice increased sensitivity, irritability, or feelings of being easily overwhelmed, which can also be linked to Rejection Sensitivity Dysphoria (RSD).
Lower energy and motivation: Fatigue and loss of drive can feel debilitating, especially when paired with ADHD’s inherent challenges with task initiation.
Worsening executive dysfunction: The ability to organise, prioritise, and complete tasks may become more difficult as hormone levels shift.
The links between ADHD and hormonal conditions
ADHD also has documented links with hormone-related conditions such as PMDD (Premenstrual Dysphoric Disorder), postnatal depression, and menopause. These conditions can intensify ADHD symptoms and lead to additional struggles, such as difficulty managing relationships, work, and daily responsibilities.
How to manage the challenges
While the effects of oestrogen decline on ADHD can feel overwhelming, there are strategies and treatments that can make a big difference:
Hormone Replacement Therapy (HRT): Many women with ADHD find that HRT, particularly those that include oestrogen and progesterone, can help stabilise symptoms during perimenopause and beyond. Consult your GP or menopause specialist to explore this option.
Medication adjustments: Stimulant or non-stimulant ADHD medications may need to be reviewed as hormonal changes can impact their effectiveness. Work with your doctor or psychiatrist to tailor your treatment plan.
ADHD coaching: Working with an ADHD coach can provide tailored strategies for managing increased executive dysfunction, emotional dysregulation, and other symptoms. Coaching helps identify tools and techniques to navigate these challenges more effectively.
Nutrition and lifestyle changes: A balanced diet, regular exercise, and good sleep hygiene can improve overall brain function. Omega-3 supplements, for example, are known to support dopamine regulation.
Mindfulness and stress management: Incorporating mindfulness practices, such as meditation or yoga, can help manage anxiety and emotional dysregulation. Techniques like "The Power of the Pause" can also create space to process emotions and respond intentionally rather than reactively.
Advocating for yourself
One of the most important steps is learning to advocate for yourself. If you suspect that hormonal changes are affecting your ADHD, track your symptoms and bring clear information to your GP or menopause specialist. Tools like the Balance app can help you monitor patterns and provide evidence to support your concerns.
Final thoughts
The relationship between ADHD and oestrogen is complex, but understanding how these factors interplay during perimenopause can empower women to seek the support and treatments they need. With the right strategies and resources, it’s possible to regain control, thrive through perimenopause, and manage ADHD effectively.
If you’re navigating these challenges, you don't have to do it alone. If you are looking for personalised support, ADHD coaching can be a transformative tool to help you build long and short-term strategies that work for your unique and brilliant brain.
Wondering how ADHD coaching can work for you?
Book your FREE 15 minute discovery call and I’ll be happy to chat about your options.