ADHD and Menopause: Exploring the Connection

“I felt very alone in my overactive, inner world,” says Reed Roberts, 51, a social employee in Cambridge, England, and mom of two. “I felt I used to be handled in a different way and typically felt very misunderstood.”

About 5 years in the past, Reed Roberts entered perimenopause and confronted a complete host of signs, together with hot flashes, migraines, and sore breasts. On the identical time, the fixed ideas that had all the time swirled in her head additionally elevated. She grew to become simply irritated and pissed off, and her battles with brain fog left her struggling to recollect phrases and dates.

“Multitasking grew to become a ginormous burden. It grew to become an unattainable feat for me,” she says. “I used to be all the time articulate and clever. I’ve two grasp’s levels. However every little thing grew to become very effort-full. I used to be unable to prioritize, so I shut down, simply overwhelmed.”

Reed Roberts grew to become so involved about her personal cognitive decline that, whereas working with dementia sufferers, she examined herself for early-onset dementia. Fortunately, she did not have dementia, however she was nonetheless left looking for solutions as to what was occurring. That was till a detailed good friend instructed the chance that she may need consideration deficit hyperactivity dysfunction, or ADHD.

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After seeing a psychiatrist at age 48, Reed Roberts was formally diagnosed with ADHD. “I felt a complete gamut of emotions. Forty-eight years of my life, I used to be dwelling in a approach the place I didn’t have my wants understood,” she recollects.

Because it seems, noticing an uptick in ADHD signs throughout menopause isn’t unusual. In a 2024 survey of 1,500 girls (with identified and undiagnosed ADHD) from the useful resource group ADDitude, 94 % of girls reported worsening ADHD signs throughout perimenopause and menopause. Seventy % additionally stated that mind fog and reminiscence points had a “life-altering influence” of their 40s and 50s. The typical age of prognosis for respondents to the survey was 43—which means, like Reed Roberts, many had lived for many years with undiagnosed ADHD.

Why is that this necessary? Properly, women with ADHD usually tend to battle melancholy, and so they have greater suicide charges than girls with out ADHD, per a January 2021 examine within the Journal of Psychiatric Research. Girls with undiagnosed ADHD are much more in danger, particularly whenever you add on the psychological, bodily, and emotional signs that may come throughout perimenopause and menopause, says Ellen Littman, PhD, a medical psychologist who works with girls and women with ADHD.

“These are severe public well being issues, and nobody is acknowledging them,” says Littman, who co-authored the 2021 report ADHD in Females Across the Lifespan and the Role of Estrogen².

If any of this resonates with you, there may be hope. Learn on to be taught extra in regards to the ADHD-menopause connection, signs of grownup ADHD in menopausal girls, and methods to deal with each circumstances to really feel higher mentally and bodily.

The connection between ADHD and menopause

ADHD is marked by ongoing patterns of inattention and/or hyperactivity-impulsivity (both or each sorts of signs may be current) that intrude with functioning or improvement, per the National Institutes of Health (NIH). It is unclear what precisely causes ADHD, however genetics are believed to play a big function, as ADHD usually runs in households.

A fast Google search will present lots of of articles and private accounts about ADHD and menopause. However medical analysis on the subject is almost nonexistent, says Jeannette Wasserstein, PhD, a medical neuropsychologist and co-author of the report on the function of estrogen in ADHD.

“The closest factor we’ve got to analysis is anecdotal proof that, with ADHD, what was all the time there will get worse and may be tougher to handle with drugs,” Wasserstein says.

Physiologically, there are legitimate explanations as to why ADHD would worsen throughout perimenopause (the time proper earlier than menopause when estrogen and progesterone hormones start to fluctuate) and menopause (outlined as going one 12 months with out a menstrual interval). Folks with ADHD have already got low ranges of dopamine, and in menopause, estrogen ranges can drop as a lot as 65 percent, affecting the manufacturing of dopamine, serotonin, and different necessary neurotransmitters governing cognition, reminiscence, and temper.

“Estrogen is a very necessary hormone,” says Wasserstein. “It’s not solely a intercourse hormone. Estrogen is a modulator of dopamine and serotonin, and can be good for the mind and helps neurons” operate correctly.

As estrogen drops, these neurotransmitter ranges plummet additional, resulting in worsening signs, significantly focus and focus—which many ladies with ADHD expertise in perimenopause and menopause, in accordance with a June 2021 examine in Materia Sociomedica on ADHD signs in females at totally different life levels. Not surprisingly, greater than half of the ladies who responded to the ADDitude survey stated menopause was the time when ADHD had the best general influence on their lives.

The ADHD has possible all the time been there

It’s necessary to notice that though many ladies obtain late-in-life ADHD diagnoses, they aren’t newly growing ADHD, says Wasserstein. “ADHD is a neurodevelopmental dysfunction, which means it happens within the improvement of the nervous system,” she says. “When you by no means had ADHD and signs first got here in your 40s, it’s not ADHD.”

As a substitute, for ladies who’re undiagnosed in midlife, the decline of estrogen together with life modifications (akin to youngsters leaving dwelling and caring for growing old mother and father) creates an ideal storm for worsening ADHD signs, says Littman.

“Excessive-functioning girls would possibly now be struggling sufficient that they get identified,” says Littman.

Reed Roberts says she additionally battled melancholy and self-inflicted “character assassination” earlier than her ADHD prognosis. “You see your self as a flawed human being as a result of you may’t do what different folks do naturally,” she says.

Why ADHD may be tough to diagnose throughout menopause

As a result of many cognitive and emotional signs of ADHD and menopause overlap, it may be tough for ladies and even their medical doctors to know which is at play. As a result of ADHD is considerably genetic, having members of the family with the situation may be one clue as to what is perhaps inflicting your signs, says Wasserstein.

“ADHD is extraordinarily inheritable,” Wasserstein says. “If nobody in your loved ones has ADHD, I might possible attribute signs to menopause. If ADHD runs in your loved ones, I’d say you have been a borderline one that has shifted over the border.”

For a lot of girls, getting a correct prognosis is difficult by the truth that, on the whole (however particularly throughout menopause), their issues aren’t all the time taken critically by well being care suppliers. Littman says many clinicians who deal with ADHD aren’t conscious of the connection between worsening signs and menopause.

“There’s a gender bias and ladies usually could also be dismissed,” says Littman. “Clinicians see probably the most observable signs, so girls may be misdiagnosed and given antidepressants.”

Roberts Reed says neither of the 2 male psychiatrists she noticed after her prognosis have been conversant in the hyperlink between worsening ADHD and menopause. “I already knew in regards to the perimenopause connection, however they didn’t talk about it till I introduced it up,” she says. “It wasn’t included the evaluation and menopause was not acknowledged or mentioned as being a part of it.”

“An added think about late ADHD prognosis is girls’s pure tendency to really feel responsible and even cover their struggles,” says Littman. “Girls are purported to be “superwomen” and put everybody else first and look good whereas doing it,” she says. “In my follow, I see high-IQ, ADHD girls who have been informed they’ll’t have ADHD as a result of they’re excessive functioning, with nobody realizing how a lot they battle to look that approach.”

The signs of ADHD throughout menopause

Not surprisingly, the majority of analysis on ADHD has been finished in males, and diagnostic standards relies on signs in males, not females, says Littman. Females usually tend to have ADHD signs like inattention and overthinking, whereas males usually tend to be impulsive and hyperactive, in accordance with 2020 analysis in PLOS One.

It’s additionally well-known that ADHD symptoms can change all through somebody’s lifetime. Girls over 40 who responded to the ADDitude survey have been extra possible than their youthful counterparts to have overwhelm, mind fog and reminiscence points, procrastination, and time-management difficulties.

Littman says frequent signs she sees within the girls she treats with midlife ADHD embrace:

• Feeling overwhelmed, like you may’t probably juggle every little thing
• All the time being late and different challenges with time
• Pushing aside issues it’s essential to do, and doing nothing or scrolling in your cellphone as an alternative
• Withdrawing from friends

Girls ought to by no means really feel responsible about any of those behaviors as a result of it’s not one thing they may help, advises Littman. “You would possibly take into consideration issues it’s a must to do, however your ADHD mind says, “Sorry, that’s too boring. I’m not going to do that,”” she says. “You’re really making an attempt desperately to get these items finished, however your mind isn’t engaged.”

The way to navigate ADHD throughout menopause

Stimulant and nonstimulant drugs together with psychotherapy and behavioral remedy can all assist enhance ADHD signs and enhance functioning, per the NIH. However ADHD menopausal girls may also profit from hormone replacement therapy (HRT) as a result of it’s identified to assist with temper and cognitive operate, although no analysis has been finished on HRT’s particular results on ADHD, says Wasserstein. HRT may help enhance bodily and emotional signs of menopause if began inside 10 years of menopause and earlier than the age of 60, per the Cleveland Clinic.

The catch-22 is that many psychiatrists who deal with ADHD don’t prescribe HRT, say Wasserstein and Littman. Each consultants suggest girls with ADHD in perimenopause and menopause see a psychiatrist, and in the event that they’re nonetheless going through difficulties after remedy? Seeing an OB/GYN with menopause coaching both in-person or nearly to debate HRT.

Littman additionally suggests asking your clinician how many individuals in menopause they’ve labored with, and taking articles on ADHD and menopause to appointments. “You’ll be able to handle signs, and many coping abilities may be taught. You’ll be able to flip issues round, achieve success, and have better relationships and a greater life,” she says.

Different coping abilities you may strive at dwelling for ADHD signs embrace the next, per ADDitude:

• Every day train
• Yoga, meditation, and deep respiratory
• Cognitive behavioral remedy
• Setting day by day, weekly, or month-to-month targets
• Making to-do lists
• Rewarding your self for getting duties finished

With remedy, Reed Roberts is feeling significantly better, however nonetheless engaged on attending to the place she must be. “With a mix of HRT and drugs, I’ve undoubtedly improved and moved ahead,” she says. She additionally finds that assist teams and interesting in ADHD activism (within the type of podcasts and different initiatives) assist her alongside her ADHD journey.

She additionally encourages different girls who’ve worsening ADHD signs, particularly if undiagnosed, to hunt assist. Simply getting a prognosis was an enormous reduction as a result of she realized her signs weren’t one thing she might assist, however a product of her neurodivergence, she provides.

“ADHD isn’t an sickness or a illness, however one thing I used to be born with,” Reed Roberts says. “Being identified was empowering and liberating. There was much less self-blame and I might reframe my life otherwise. Prognosis isn’t a label. It’s a roadmap to your self.”