Hormones and ADHD in women have led many to report a noticeable increase in their symptoms during specific times in their menstrual cycle—generally, the week leading up to their period—and during significant hormonal shifts such as puberty, pregnancy, post-partum, and menopause.
This amplification in symptoms coincides with low levels of estrogen, thus pointing to an intimate connection between estrogen levels and ADHD symptom severity in women.
With centuries of cultural stereotypes about women’s supposed lack of intellect, women with ADHD are often overlooked and
unacknowledged. 50%-75% of ADHD cases in females are missed.
Inattentive ADHD, the most common ADHD presentation in females, tends to be mental rather than physical. Since many of these symptoms occur inside the mind, they can be easy for to miss. And when doctors diagnose girls and women with ADHD, they rarely consider hormonal fluctuations when developing a treatment plan.
Estrogen and the Brain
Estrogen impacts various neurotransmitters such as serotonin, norepinephrine, and dopamine – all closely associated with attention, mood regulation, and executive functions.
Dopamine, a key neurotransmitter involved in the regulation of mood, sleep, attention, learning, and reward systems, is crucially linked with ADHD pathology.
Estrogen increases dopamine levels and enhances the brain’s sensitivity to dopamine. This signifies that plunges in estrogen levels can cause a decline in dopamine function, thereby exacerbating ADHD symptoms.
Hormonal Fluctuations Throughout Life
Major hormonal milestones in a woman’s life can significantly affect the manifestation of their ADHD symptoms.
For instance, during puberty, hormonal changes may intensify ADHD symptoms and other psychological experiences, including feelings of sadness, rejection-sensitive dysphoria, and social anxiety. However, these might be dismissed as typical adolescent behaviour or mood swings.
Pregnancy often brings about a significant hormonal shift that could potentially exacerbate ADHD symptoms. Evidence suggests that each trimester’s hormonal roller coaster may heighten the symptoms, with some relief potentially during the second trimester when estrogen levels peak. The post-partum period, characterized by a sudden drop in hormone levels, can lead to post-partum depression or anxiety.
Lastly, menopause and reduced estrogen levels can lead to worsening procrastination and time management habits, memory problems, feelings of being overwhelmed and greater overall disorganization.
Find more information on how stages in women’s lives impact their experiences of ADHD on the ADDitude Website.
Why Cycle Syncing Is Essential
Understanding one’s menstrual cycle and identifying symptom patterns linked to hormonal fluctuations can empower women to seek proper treatment and interventions.
The Follicular Phase lasts approximately two weeks, starting on the first day of your period and ending with ovulation. You can expect to experience typical symptoms — cramps, headaches, bloating, fatigue, moodiness — during your flow, and aggravated ADHD symptoms like forgetfulness, trouble focusing, and emotional dysregulation.
- Try to slow down and decrease your to-dos.
- Avoid foods that worsen menstrual cramps.
- Get your body moving.
- Use pain relievers.
- Rest and get enough sleep.
During the Rest of the Follicular Phase, estrogen levels start to rise about a week after the start of your period, and continue to climb for about seven days, shooting up and peaking just before ovulation.
Many women recognise the week after their period is when they feel most productive, focused, and energetic.
- Work on your big projects and cross off your to-do list.
- Schedule your appointments and social events during this time.
- Take your workouts up a notch.
- Do your future self a favour.
Find more information on the other phases of the menstruation cycle on the ADDtiude Website.
Navigating and Managing Hormones and ADHD for Women
Utilising Cycle Tracking Applications or other tools can assist in identifying when certain stages of the menstruation cycle are in play and can track various physical and psychological symptoms to begin implementing routines and habits that can provide relief.
This can be especially useful in stages of life when cycles aren’t as regular, such as throughout hormonal imbalances, puberty and approaching menopause.
Lifestyle changes like regular exercise, a balanced diet, ample sleep, and stress management, along with cognitive behavioural
therapy can work effectively for many.
The Takeaway: Need for More Research
While the complex, multifaceted interaction between hormones and ADHD in women remains a budding area in ADHD research, it is clear that hormones undeniably influence the severity and presentation of ADHD symptoms. However, there is an undeniable need for more extensive research, focusing on the various hormonal stages that a woman undergoes throughout her life.
The findings could potentially transform ADHD diagnosis and management in women, making it more individual-centred and leading to overall better mental health outcomes for women with ADHD.