Living with ADHD while going through menopause can be challenging, but there are ways to manage both.

What do ADHD and menopause have in common other than mood changes and inattention?

Though some symptoms are observable on the outside, folks around you may not understand even half of what you’re handling internally, let alone that you’re managing both at the same time.

Living with attention deficit hyperactivity disorder (ADHD) comes with its own challenges. And if you’re going through perimenopause or menopause, you may face more difficulties.

ADHD

ADHD is a neurocognitive disorder that has three presentations:

People can receive a diagnosis early in childhood as well as late in life.

Menopause

Dr. Ellen Littman, a clinical psychologist in New York state, explains that estrogen has powerful effects on brain chemistry throughout your lifetime.

Menopause is among the top biggest events to change estrogen in your body, among starting your period and becoming pregnant.

Estrogen is considered neuroprotective, in that high levels increase the availability of neurotransmitters (brain messengers) like dopamine and serotonin, which enhance cognition, mood, sleep, verbal memory, and even ADHD symptoms,” Littman says, who is publishing an upcoming review article about the female hormonal effects on ADHD.

However, your levels of estrogen decline beginning in perimenopause and are spent during menopause.

While people face some symptoms off and on during menopause, Littman says those who also have ADHD experience intensified symptoms.

“By understanding the relationship between menopause and increased ADHD symptoms, they are less likely to be ambushed by the amplified difficulties they experience,” she says.

How they overlap

Both ADHD and menopause are known for patternless shifts in brain activity and hormone changes.

So, you might begin to see how overlapping symptoms happening concurrently or one after the other can worsen the experience of both conditions and make them difficult to manage.

SymptomADHDMenopause
impulsivity
hyperfocus
disorganization
sharp fluctuations in
neurotransmitters
(chemical brain messengers)
focus issues
negative self-image
fatigue
forgetfulness
anxiety
mood changes
sleep issues
libido changes
depression
gynecological changes
changes to skin, hair, muscle,
bone, and weight management
hot flashes

A 2016 study even looks at the effectiveness of using ADHD medication to treat people experiencing executive function issues during menopause.

While going through menopause when you have ADHD can feel overwhelming, there are ways you can manage both conditions.

1. Consult your psychiatrist

Finding a psychiatrist who’s well versed and experienced in treating ADHD in people going through menopause can help you get the care you deserve.

While it might not be easy to find a psychiatrist with experience in this area, start by asking your current mental health professional or gynecologist for recommendations.

If you can’t find a psychiatrist who’s familiar with research demonstrating hormone involvement in ADHD symptoms, Littman suggests sharing information or articles (like this one) with them.

“If you feel that your credibility is being questioned, it’s important to feel entitled to finding the clinician who best fits your needs,” she says.

2. Consult your gynecologist, too

Littman suggests finding a gynecologist who’s experienced in treating people going through menopause, and who will also work with the doctor who treats your ADHD.

“Since women now spend about a third of their lives in menopause, it is critical to find a treatment regimen tailored to your specific needs,” she says.

According to a 2019 survey of postgraduate resident trainees in family medicine, internal medicine, and obstetrics and gynecology in U.S. residency programs, only 6.8% of them reported feeling just “adequately prepared to manage women experiencing menopause.”

No one clinician is knowledgeable about all aspects of each individual experience, but Littman says finding doctors who will collaborate and communicate with your gynecologist can help tailor treatment.

For instance, if your ADHD medications need adjusting, as well as your decreasing estrogen levels, having both your gynecologist and doctor who treats your ADHD collaborate could help.

“While pharmacologists often adjust the dosage to meet the new challenges, increased estrogen could address both menopausal and ADHD symptoms. Bioidentical hormone replacement therapy (HRT) is one route to increased estrogen for many women,” Littman says.

Although your doctors may be hesitant to communicate with each other, being assertive and informing them of your conditions, as well as bringing information from each doctor to your appointments, can help ensure they’re in tune with what’s going on with your body.

3. Check your blind spots

While there’s a wide range of menopausal symptoms that occur on a continuum, Littman points out that ADHD can worsen symptoms like impaired cognition and mood.

In fact, a 2019 research paper suggests that ADHD symptoms, and even concurrent symptoms from other conditions, are also vulnerable to the hormonal changes experienced during menopause, says Littman.

Both conditions can muddle with your executive functions, a clinical term for your:

  • self-awareness
  • prioritizing and planning
  • governing of impulses and emotions
  • memory
  • real-time ability to adapt to the unexpected
  • ability to initiate and complete tasks

If you find that these areas of your life are becoming more difficult to manage, coming up with a plan to help navigate them can make your days easier.

For instance, if keeping and organizing appointments and commitments is difficult, setting an email calendar reminder so you get notifications on your phone, tablet, and desktop can help you stay on track.

If self-monitoring is a blind spot as of late, you could try leaning on your inner circle to gently give you a signal if agitation or strong emotions are coming off more than intended.

You might also look into present moment awareness to reconnect with mindfulness and strengthen your self-awareness.

4. Create an ‘ADHD-friendly life’

In addition to seeing a professional, Littman suggests pursuing your own psychoeducation. Consider bookmarking the following resources:

“The more you can understand about the relationship between your [brain’s response to ADHD] and your body in menopause, the more you can be an active participant in your treatment. And the more your support network understands about your challenges, the more supportive and compassionate they can be,” Littman says.

While managing your ADHD while going through menopause can be challenging at times, there are ways to make the process easier.

Littman says that on the clinical front, new research brings hope for better treatments ahead.

“We’re on the brink of an exciting new understanding of the experience of women with ADHD,” she says. “As new studies continue to implicate the powerful role of hormones in women’s experience of ADHD, the potential for more comprehensive and successful treatments may be on the horizon.”

You can stay tuned for Littman and team’s upcoming study on ADHD and estrogen, titled: ADHD in Females Across the Lifespan and the Role of Estrogen. It publishes August 2021 in The ADHD Report.