Balancing Acts: ADHD and Menopause

For many women, the onset of perimenopause symptoms and menopause marks a significant life transition.  Menopause is a natural part of ageing, bringing many physical, cognitive and emotional changes. 

But what happens when this transitional life stage coincides with ADHD? 

For some women, menopause might be the first time they recognise that they have been living their life with ADHD. When these two conditions overlap, they can bring many new challenges, and their symptoms can be confusing and overwhelming and significantly impact a woman’s quality of life.  This blog explores the intersection of ADHD and perimenopause/menopause.  Let’s delve into how ADHD and menopause interact and what you can do to manage them both effectively.

graphic of a woman in a blue top sitting down contemplating the menopause

ADHD in Women

ADHD traits in women usually present with problems around executive functioning and emotional regulation. These traits can be highly challenging; unfortunately, until recent years, the traits may not have been recognised by medical professionals or mistaken for other conditions such as anxiety and depression.   

Many women receive an ADHD diagnosis after years of struggling with daily life. A late diagnosis can often come at the time of menopause when hormonal fluctuations can trigger a range of cognitive, behavioural and physical changes that can have a life-altering impact.

Cognitive Shifts During Menopause

Menopause occurs due to hormonal fluctuations, typically between ages 45 and 55. Although, perimenopause can start much earlier. During this time, the body undergoes significant hormonal shifts, particularly in oestrogen levels. These hormonal changes can lead to cognitive symptoms, often referred to as menopausal brain or brain fog. During menopause, you might forget things more often, struggle to concentrate or feel mentally sluggish.  The impact of these hormonal changes can lead to other issues, such as sleep problems, emotional dysregulation, mood changes, fatigue, disorganisation, and executive functioning issues.

Does this sound familiar? These symptoms can mirror ADHD, making it difficult to distinguish between the two. For women with ADHD, the symptoms of menopause can feel like their ADHD traits are suddenly much worse, adding another layer of challenges to daily life.   As well as cognitive changes, women can notice physical changes such as weight gain, and they may experience sudden hot flashes; together, these cognitive and physical symptoms can have an impact on confidence and self-esteem.

Why Symptoms Can Intensify During Perimenopause and Menopause

Why do ADHD and menopause seem to overlap with such intensity? New research on the relationship between ADHD and perimenopause/menopause is still developing, but studies suggest that decreased oestrogen and progesterone levels can heighten the traits of ADHD. ADHD often involves deficiencies in dopamine, a neurotransmitter which is necessary for managing attention and emotional responses. During perimenopause, the decline in oestrogen can disrupt dopamine regulation, leading to symptoms such as forgetfulness, brain fog, and emotional dysregulation.

Dopamine is essential for attention, motivation, and reward processing, and oestrogen levels can influence its production and regulation. Research from 2021 indicates that a decline in oestrogen can intensify ADHD symptoms by affecting dopamine functioning.

The Challenges of Diagnosis and Misdiagnosis

One of the challenges women face during menopause is the potential for misdiagnosis. Cognitive symptoms associated with menopause, such as forgetfulness and brain fog, can overlap with those of ADHD, and both can be mistaken for depression, anxiety, or the natural effects of ageing. This overlap can sometimes lead to being undiagnosed or a misdiagnosis.

Misdiagnosis is more likely if healthcare providers are not aware of a patient’s history. If you suspect that menopause or ADHD might be influencing your symptoms, bring it up with your doctor. Keeping a detailed journal of your symptoms can be helpful as it will ensure you cover all the relevant issues so you can confidently advocate for yourself during your appointment.

Managing ADHD During Menopause

Although the overlap of ADHD and menopause can be challenging, there are strategies and lifestyle changes that can help manage both: 

Medical Treatment:  Speak with your GP or Healthcare Provider about your treatment options. ADHD medication can be effective during menopause; both stimulant and non-stimulant medications are suitable. Hormone replacement therapy (HRT) might also be considered to help stabilise oestrogen levels, potentially lessening both menopausal

Mindfulness and Stress Reduction: Techniques like mindfulness, meditation, yoga, and diaphragmatic breathing exercises can help ease many of the symptoms of ADHD and menopause. Meditation helps regulate emotions, manage stress, and quieten a busy mind. Meditation and breathing exercises can also help with sleep issues and physical symptoms such as hot flashes, headaches, and muscle tension. 

Counselling and ADHD Coaching: Working with an ADHD coach or therapist can offer valuable tools for effectively managing your symptoms by providing practical strategies to make daily life much easier. Cognitive Behavioural Therapy (CBT)  can help you navigate the challenges of both ADHD and menopause by guiding you in managing your thoughts, emotions, and behaviours more effectively. Additionally, discussing your difficulties with a counsellor can be a great way to release some of the feelings you may be holding on to. 

lady sitting in a chair contemplating the menopause and ADHD

Establish a Routine: Creating a structured daily routine can provide stability and help manage brain fog and disorganisation. Calendars, planners, and to-do lists can help you remember important appointments. Breaking tasks into smaller, more manageable parts can help with focus and prevent procrastination. Check my blog on goal-setting for some more strategies.

Lifestyle Adjustments:  Regular exercise can help regulate mood, increase cognitive functioning, and ease many traits of ADHD. Choose activities you enjoy. If you can get out in the fresh air, a brisk walk is ideal for boosting your overall well-being. Do some brainstorming to find activities you enjoy.  Eating the correct foods and taking supplements can help your overall well-being during menopause. A  healthy diet for women experiencing menopause can positively impact many areas, including regulating hormones, bones and heart health, weight management and increased energy levels.  

Sleep Hygiene:  Establish a bedtime routine, as a good night’s sleep will enhance cognitive function and emotional well-being. Night sweats often occur during menopause. Keep your bedroom cool by opening a window or using an air conditioning unit or a fan for a good night’s sleep. Similarly, it can be helpful to wear loose-fitting nightwear to stay calm and light, as well as breathable bedding and natural fibres like cotton. Consider specialist bedding such as moisture-wicking sheets or cooling pillows to help regulate body temperature.

Sharing Your Experiences: You’re Not Alone

It’s important to remember that you don’t have to go through this alone. However, if you feel alone or want to speak to others experiencing similar challenges, consider joining an online community or local support group. These groups can be a great form of emotional support, as you can ask questions and share experiences and information, which can positively impact how you feel.

Three smiley mature woman on the ground facing upwards supporting each other

Finding Support and Moving Forward

If you’re struggling to manage the symptoms of ADHD and menopause, reach out for help. Ask your healthcare provider, seek support from friends or family, and research both conditions. Knowledge is power, and understanding what’s happening in your body is the first step toward taking control.

Remember, menopause and ADHD may complicate your life, but with the right tools and support, you can manage both and continue to thrive.

Conclusion: Embrace the Journey

The intersection of ADHD and menopause can pose challenges, but it’s also an opportunity to learn more about yourself and to find new ways to manage and embrace life’s changes. By understanding how these two conditions interact, you can take proactive steps to improve your overall well-being. Don’t be afraid to seek help, share your story, and connect with others on the same journey.