ADHD, Women and Hormones

Over the last few years as I have worked with clients who have ADHD, I’ve noticed a trend – a lot of women are being diagnosed in their mid-thirties and forties. So many of these women have been and still are high achievers but as they have gotten older, they just haven’t been able to keep up with things as well as they used to and have then gotten their diagnosis.

ADHD has traditionally been viewed through a male-centric lens, and because of that so many females who are neurodivergent have gone unnoticed, but increasing awareness has highlighted how it uniquely affects women. One critical aspect often overlooked is the interplay between ADHD, women, and hormones. Understanding this relationship is crucial for effective diagnosis, treatment, and support.

The Underdiagnosis of ADHD in Women

ADHD is frequently underdiagnosed in women due to several factors. Women often show more inattentive symptoms rather than hyperactivity, which can be mistaken for daydreaming or a lack of focus rather than a neurological condition. Societal expectations and gender norms also play a role, as women may be better at masking their symptoms, leading to a delayed or missed diagnosis. The increasing understanding that ADHD is more about emotional dysregulation than a lack of focus or the

Hormonal Fluctuations and Their Impact

Hormones significantly influence the severity and manifestation of ADHD symptoms in women. Unfortunately, there are limited studies available on ADHD and the transitions women go through during their lifespan. One of the hypotheses that is currently being explored is that of the impact of estrogen. Estrogen is an important hormone for psychological health in females since it modulates many neurotransmitters like dopamine (important for executive functions), serotonin (regulates mood) and acetylcholine (involved in memory). Here's how different hormonal stages can affect women with ADHD:

Puberty

During puberty, the surge in estrogen can exacerbate ADHD symptoms. Young girls might experience increased difficulty with attention and especially emotional regulation, often coinciding with academic and social pressures. Unfortunately, these changes can be mistaken for typical adolescent behavior.

Menstrual Cycle

The menstrual cycle causes fluctuating estrogen and progesterone levels, impacting ADHD symptoms. Many women report that their symptoms worsen in the premenstrual phase when estrogen levels drop and progesterone peaks. This can lead to heightened irritability, mood swings, and difficulty concentrating.

Pregnancy

Pregnancy brings a dramatic increase in estrogen levels, which can temporarily alleviate ADHD symptoms for some women. However, the postpartum period, characterized by a sudden drop in estrogen, can lead to a resurgence of symptoms. This, combined with the demands of new motherhood, can be particularly challenging.

Perimenopause and Menopause

Perimenopause, the transition phase before menopause, is marked by significant hormonal fluctuations. Women in this stage often report a worsening of ADHD symptoms, including increased forgetfulness, distractibility, and emotional instability. For many women this is often when they get a diagnosis of ADHD. Menopause, characterized by a steep decline in estrogen, can also exacerbate these symptoms.

What can be done?

Understanding the link between hormones and ADHD in women is essential for effective management. Here are some strategies that can help:

Personalized Treatment Plans

Treatment should be tailored to your hormonal cycle. For instance, medication dosages might need adjustment during different phases of the menstrual cycle to manage symptom fluctuations effectively. Start keeping a mood and energy journal so that you can let your health care provider know how well your medication is working at each stage of your cycle.  

 Hormonal Therapies

For some women, hormonal therapies such as birth control pills or hormone replacement therapy (HRT) during perimenopause and menopause can help stabilize estrogen levels and mitigate ADHD symptoms. It's crucial to consult with a healthcare provider to determine the best approach.

Lifestyle Adjustments

Regular exercise, a balanced diet, and sufficient sleep are vital for managing ADHD symptoms. Exercise, in particular, can help regulate dopamine levels and improve mood and focus. It is important to pay attention to how you feel after a particular kind of workout so you can determine whether it is the right kind of workout for you at this time. Yoga and walking are two wonderful exercises that help balance hormones and promote calm and focus.

Working with an ADHD coach or a therapist

Working with a knowledgeable coach or therapist, trained in working with neurodiversity can be very empowering. Executive function skill building, mindset shifts and body awareness techniques are very effective.

Support Networks

Connecting with support groups, either in person or online, can provide invaluable encouragement and understanding. Sharing experiences and strategies with others facing similar challenges can be empowering.

Conclusion

The relationship between ADHD, women, and hormones is complex and multifaceted. By recognizing and addressing the unique ways in which hormonal changes impact your ADHD symptoms, you can advocate for yourself and receive more accurate diagnoses and effective treatments.

Read more:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7422602/

Menopause, Hormones, and ADHD Symptoms in Women: An Overview (additudemag.com)