ADHD & Perimenopause: What You Need to Know

Written By Shannon Wright

Understanding the Connection

If you have ADHD and are entering perimenopause (typically starting in your 40s), you may notice your ADHD symptoms getting worse. This is not your imagination—research shows that nearly all women with ADHD (97.5%) report worsening symptoms during menopause.[1]

Why does this happen? Estrogen, a hormone that declines during perimenopause, plays an important role in brain function, particularly in areas that affect attention, memory, and impulse control. When estrogen levels drop and fluctuate during perimenopause, it can make existing ADHD symptoms worse.[2-3]

What Symptoms Might Worsen

Women with ADHD going through perimenopause often experience:

  • Increased difficulty concentrating and focusing

  • More forgetfulness and "brain fog"

  • Worsening executive function (planning, organizing, completing tasks)

  • Greater emotional sensitivity and mood swings

  • More severe sleep problems

  • Reduced effectiveness of ADHD medications that previously worked well[2][4]

Women with ADHD also tend to have more severe perimenopausal symptoms overall compared to women without ADHD, including hot flashes, mood changes, and sleep disturbances.[5]

What You Can Do

Track Your Symptoms

Keep a simple daily log of your ADHD symptoms, mood, sleep quality, and any perimenopausal symptoms (hot flashes, night sweats, etc.). This helps you and your healthcare provider identify patterns and adjust treatment as needed.[2]

Talk to Your Healthcare Provider

Discuss both your ADHD and perimenopausal symptoms with your healthcare provider. Many women find that their ADHD is overlooked when they seek help for perimenopausal symptoms, or vice versa. Make sure your provider understands you're dealing with both.[2]

Consider Treatment Adjustments

Your ADHD medication may need adjustment during perimenopause. Some women report that their usual dose becomes less effective during this time. Work with your healthcare provider to find the right approach for you.[2][4]

Explore Hormone Therapy

While research specifically on hormone replacement therapy (HRT) for ADHD symptoms is limited, HRT can help with perimenopausal symptoms like hot flashes and mood changes. Discuss with your healthcare provider whether HRT might be appropriate for you, considering your individual health history and symptoms.[2][5]

Prioritize Self-Care

  • Regular exercise can help with both ADHD symptoms and perimenopausal symptoms

  • Good sleep hygiene is especially important as both conditions can disrupt sleep

  • Stress management techniques like mindfulness or yoga may help

  • Healthy nutrition supports overall brain and hormonal health[6]

Seek Support

Consider joining a support group for women with ADHD or women going through perimenopause. Connecting with others who understand your experience can be invaluable. Some specialized treatment programs focus specifically on women with ADHD and hormonal changes.[7]

Important to Remember

  • Your worsening symptoms are real and have a biological basis

  • You're not alone—this is a common experience for women with ADHD

  • Treatment options are available, even though research in this area is still developing

  • With proper support and management, you can navigate this transition successfully

Questions to Ask Your Healthcare Provider

  • How might perimenopause be affecting my ADHD symptoms?

  • Should we adjust my ADHD medication?

  • Would hormone replacement therapy be appropriate for me?

  • What other treatments might help with my symptoms?

  • Should I see a specialist who understands both ADHD and menopause?

References

Shannon Wright