“I thought it was me, that I couldn’t control my temper, communicate effectively with the people around me, focus on work, think clearly, then I realised it always was much worse before my periods”
Until recently, ADHD was associated with that naughty boy at school who couldn’t sit down and wasn’t allowed to drink Kia-ora. Girls didn’t get a look in. Why? Because boys' symptoms are understood to be more overt, and so they are more likely to be referred for diagnosis. For every three boys diagnosed with ADHD only one girl is. These figures even out in adulthood, but what is going on in the teenage years that means so many girls are overlooked and therefore unsupported?
Girl’s symptoms are different, they are more likely to present as inattentive, moody, and be seen as ‘emotionally unstable’. Girls invariably want to please, so while they resist the urge to disrupt class, they may instead twiddle with their hair, tap their toes or jiggle their legs. Girls mask symptoms. Girls are much more likely to be diagnosed with depression before being diagnosed with ADHD or labelled as being emotionally dysregulated, or ‘oh it’s her periods’, ‘she’s moody’, unstable and so on.
Hormones play a huge part in how pronounced ADHD symptoms appear, this is because the more oestrogen you produce, the more dopamine is also produced. The more dopamine, the quieter the ADHD symptoms.
Unfortunately, during puberty, the menstrual cycle and menopause, oestrogen levels rollercoaster up, then down, which is why symptoms can feel unmanageable. So let’s start with puberty to understand how this affects girls.
During puberty, a girl’s body is slowly ramping up to have more oestrogen in it so oestrogen and progesterone levels surge and drop in sharp upwards and downwards spikes as the menstrual cycle begins. Oestrogen dips can cause ADHD medication to become less effective, increase emotional volatility, heightened impulsivity, mood swings, difficulty concentrating, and challenges in organisation and managing daily tasks. In other words, young women navigating this transitional period may find their ADHD symptoms more pronounced and harder to control. The interplay between rising hormone levels and ADHD can make this period particularly challenging, as the brain's reward system and executive functions are still developing. If girls internalise symptoms and / or are not supported, the constant feeling of ‘not managing’ can lead to chronic anxiety issues.
The menstrual cycle introduces a monthly ebb and flow of hormones that can affect ADHD symptoms. In the first two weeks of the cycle, rising oestrogen levels often lead to improved
focus and mood. However, during the luteal phase (the two weeks before menstruation), progesterone levels increase, reducing the positive effects of oestrogen on the brain and potentially negating the effectiveness of stimulant medications. This is when the individual may feel ‘out of control’ emotionally, impulsive, unable to focus, unproductive, irritable, and forgetful. This cycle each month can be massively disruptive to a woman (and those around them), particularly if undiagnosed, as they can’t fathom why they’re not able to work consistently or be emotionally stable throughout the month.
During pregnancy, some women experience respite from ADHD symptoms and enter a phase of emotional stability and consistent cognitive function. The reason for this is that there is a dramatic increase in oestrogen and progesterone, and the up and down of the menstrual cycle is put on pause.
After their child is born, however, as the sudden drop in hormones after childbirth kicks in, ADHD symptoms increase, leading to the potential of post-natal depression.
As women reach their late 30s, perimenopausal symptoms begin. The body approaches menopause and alongside it, a decrease in oestrogen levels. Very similar to puberty, the body begins a downward rollercoaster of hormones. When oestrogen levels drop, so too can serotonin and dopamine in the brain. This hormonal shift can exacerbate ADHD symptoms, causing increased moodiness, irritability, fatigue, and cognitive difficulties.
It’s no surprise that many women are diagnosed with ADHD later in life during the seismic hormonal shifts experienced in menopause. The sharp decline in oestrogen levels can have a profound impact on ADHD symptoms manifesting as inattention, mood swings, and cognitive difficulties.
In postmenopause, some women report a stabilisation of their ADHD symptoms as their hormones settle into new, lower levels. However, the overall decrease in oestrogen can continue to affect cognitive function and mood regulation.
To better manage ADHD symptoms across these hormonal phases, the following strategies can help:
Keep a journal to identify patterns in your ADHD symptoms throughout your menstrual cycle and life stages. This can help you anticipate and prepare for challenging periods.
Consult with a nutritionist to ensure your diet supports hormonal balance and brain health. Certain nutrients can help stabilise mood and improve cognitive function. Noops nootropics is a well researched brain supplement backed by science and nutritional experts. Click here for Nutritional Experts.
Work with your healthcare provider to potentially adjust ADHD medication dosages during different phases of your cycle or life. Some women benefit from increased medication during more symptomatic phases.
Implement regular exercise, maintain a balanced diet, and prioritise sleep hygiene to help stabilise mood and improve focus. These habits can have a significant positive impact on both hormonal balance and ADHD symptoms.
Seek healthcare providers who understand the interplay between hormones and ADHD to develop tailored treatment plans. This may include considering hormone therapy or other interventions to address hormonal imbalances.
Mindfulness practices can be particularly beneficial in managing the emotional aspects of ADHD.
Build a strong support network of friends, family, or online or offline support groups who understand the challenges of ADHD and hormonal fluctuations. Having a safe space to share experiences and coping strategies can be invaluable.
formulated for women
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