Menopause is a significant life transition, in which plummeting estrogen and progesterone levels have a significant impact on memory, mood, and cognitive function. For women with Attention Deficit Hyperactivity Disorder (ADHD), menopause can have a notable impact on symptoms, especially if they're experiencing stress, pressure from a demanding schedule, and significant life changes all at the same time.
If you're in perimenopause or menopause and you've managed ADHD well up to this point, the impact of hormonal shifts you're experiencing may suddenly make you feel overwhelmed. Just as you've started to feel like you have a grip on your ADHD symptoms, new ones might appear, or existing ones, such as mood swings and trouble focusing, might get worse.
We’ll explore the connection between ADHD and menopause, the symptoms that can arise for women with both conditions at the same time, and how to cope.
How Menopause Can Affect ADHD
In ADDitude's study1, which asked more than 1,500 women with ADHD to answer the question, “Does menopause exacerbate your symptoms of ADHD?” 94 percent said that their ADHD symptoms got worse during perimenopause and menopause.
For more than half of the women, ADHD symptoms grew so severe during their 40s and 50s that they considered menopause to be the period in their lives in which “ADHD had the greatest overall impact.”
Here’s what changing hormones during menopause can look like:
- Decreased memory, attention, and executive function
- Diminished dopamine production
- Reduced energy production in the brain
- Increased emotional lability
- Difficulty with sleep, coping with stress, and managing overwhelm
Studies show that ADHD can affect women somewhat differently2 than men due to the effects of hormonal fluctuations and transitional periods of life.
The hormonal changes that take place during menopause can interact with ADHD symptoms3, potentially leading to increased challenges in mood, attention, and productivity. Research has also found that women with ADHD tend to experience more severe symptoms4 of hormone-related mood disorders than women without ADHD.
Here’s a detailed look at how menopause can potentially exacerbate ADHD symptoms:
1. Changes in Hormone Levels (Including Low Estrogen and Progesterone)
During menopause, significant hormone changes occur including a decline in estrogen and progesterone levels. Estrogen, which has neuroprotective effects5, plays a crucial role in cognitive functions such as memory, attention, and executive function, so a drop in estrogen can impact a woman's mental health6 and cognitive performance.
Most women's moods and energy are more positive when estrogen levels increase. On the other hand, low estrogen (which can occur during PMS7, after childbirth, and during menopause) can potentially lead to cognitive impairments and worsen ADHD symptoms such as inattention.
Progesterone fluctuations can also impact mood and cognitive function. Low progesterone levels can contribute to increased anxiety and mood swings, which can further complicate ADHD management.
2. Changes In the Brain (Such as In Dopamine and Norepinephrine)
ADHD symptoms are closely linked to the dysregulation of neurotransmitters8 such as dopamine and norepinephrine. Estrogen influences executive functioning (mental processes that help people coordinate cognitive, behavioral, and emotional tasks) and regulation of these neurotransmitters.
With declining estrogen levels, there can be an imbalance in dopamine and norepinephrine, making ADHD symptoms more pronounced.
Estrogen affects brain areas involved in executive function, such as the prefrontal cortex, and lower estrogen levels can impair cognitive functions9 like attention, staying on task, working memory, and impulse control—which are often already challenging for those with ADHD.
Many menopausal women experience symptoms such as depression, difficulties with task management, and issues with memory and sleep. For those with ADHD, these menopausal symptoms can further complicate concentration and planning ahead.
3. Increased Stress and Emotional Dysregulation
Menopause can be a stressful period due to hormonal changes and associated symptoms like hot flashes, sleep disturbances, brain fog, and mood swings. Stress can further contribute to ADHD10 symptoms by impairing concentration, leading to sleep deprivation, causing mood changes, and increasing impulsivity.
Women with ADHD often experience emotional dysregulation, which menopause-related hormonal changes can intensify11. This may lead to heightened emotional responses and increased difficulty managing stress during the premenopausal and menopausal years.
4. Sleep Disruptions
Hot flashes, night sweats, and other menopausal symptoms can lead to poor sleep quality. Sleep disturbances can also significantly affect ADHD symptoms, as inadequate rest impairs mood, attention, focus, and overall neurotransmitter production and cognitive function.
People with ADHD are already prone to sleep difficulties. Menopause-related sleep issues can make sleep deprivation even worse, increasing daytime sleepiness and reducing cognitive performance.
What Does ADHD Look Like in Women?
ADHD (Attention-Deficit/Hyperactivity Disorder) is a neurodevelopmental disorder characterized by persistent patterns of inattention, hyperactivity, and impulsivity that can significantly impact daily functioning.
Among women, ADHD typically presents12 as:
- Inattention and trouble with executive functioning, including lack of focus and difficulty staying on task and organized
- Hyperactivity, usually experienced as an inner sense of unease and restlessness
- Emotional dysregulation, including mood swings and intense emotional responses
- Trouble managing stress
- Difficulty sleeping well
- Social challenges, such as difficulty maintaining friendships and relationships with family members, interrupting others, or having trouble listening well
- ADHD also often occurs along with other psychiatric conditions13, including behavioral issues, anxiety, depression, substance use/abuse, and autism
Tips for Managing ADHD During Menopause
No matter a woman's age or life stage, certain lifestyle habits and strategies14 can often help to manage her ADHD, including:
- Balanced diet
- Regular exercise
- Consistent sleep schedule
- Cognitive behavioral therapy
- Stress reduction techniques
- Supplements including omega-3s, vitamin D, Rhodiola, magnesium, and others
- Therapy and support groups
- Medications, if needed, including stimulants or hormone replacement therapy
Here's more about remedies that can help women in menopause to cope with ADHD:
| Evidence-Based Options for ADHD | How to Implement |
| Nutrient Dense Diet | Use the free recipe guide here to help you get started. |
| Quality Sleep | Practice the sleep hygiene tips found here Leverage supplements that support sleep |
| Exercise | Aim for 150 minutes of moderate physical activity weekly or as advised by your medical provider. |
| Cognitive Behavioral Therapy | Meet with a trained mental health professional who has trained in the unique needs of ADHD |
| Stress Reduction | Tai chi, yoga, meditation, acupuncture, journaling, therapy, and support groups |
| Mindfulness or Meditation | YogaTai chiMindfulness or meditation apps |
| Vitamin D | Sunlight exposure Foods: fatty fish, fortified foods, mushrooms Vitamin D3/K2 supplement |
| Omega-3 Fatty Acids | Eat cold-water fish, walnuts, and other omega-3 food sources Omega Plus |
| Hormone Support Nutrients | Vitamin B6, C, folate, calcium d-glucarate, Vitex, selenium Balance Women’s Hormone Support |
| Rhodiola rosacea | Adrenal Support Note: avoid in cases of bipolar disorder diagnosis |
| Pharmaceutical Therapy | Stimulants vs. Non-stimulants: Treatment options should be discussed with a qualified, licensed healthcare professional |
| Hormone Replacement Therapy (HRT) or Menopause Hormone Therapy (MHT) | Topical estradiol may help improve brain function Oral progesterone may help reduce anxiety and improve sleep |
1. Follow A Nutritious and Balanced Diet
A diet following the Mediterranean or DASH diet pattern that's rich in omega-3 fatty acids (from fish like salmon), antioxidants (from fruits and vegetables), and protein (such as lean meats, yogurt, eggs, and legumes) can help support brain health and cognitive function15.
For a detailed guide on recipes that support hormone health and blood sugar balance, download my recipe guide here.
2. Get Adequate Sleep
Adults with ADHD and women in menopause often experience sleep difficulties, including delayed sleep phase disorder, where sleep and wake times are significantly shifted. Poor sleep can worsen ADHD symptoms, making good sleep hygiene essential.
Tips for better sleep include:
- Setting a consistent bedtime and sticking to a schedule.
- Reducing screen time before bed.
- Creating a quiet, cool, and dark sleep environment.
- Practicing relaxation techniques like meditation or a warm bath.
- Trying melatonin and L-theanine supplements
- Regular exercise and sunlight exposure during the day.
3. Follow Mind-Body Practices
Cognitive Behavioral Therapy (CBT) can teach coping strategies for managing ADHD symptoms, such as time management and emotional regulation.
Mindfulness practices, including meditation and yoga, can also improve attention span and impulse control.
Physical activity has a role in managing both ADHD and menopause symptoms, too. Exercise naturally enhances mental health by regulating dopamine and serotonin levels, improving focus and mood stability, and reducing hyperactivity. Aerobic exercises, in particular, can improve attention, reduce impulsivity, and support overall hormone balance.
4. Incorporate Supplements like Omega-3s
Omega-3 fatty acids (from sources like salmon) and vitamin D play crucial roles in managing ADHD symptoms. Omega-3s support brain function and neurotransmitter health, while vitamin D can help alleviate inattention. Consider high-quality supplements like Omega Plus for omega-3s and vitamin D3 with vitamin K2 for optimal hormone balance.
5. ADHD Supportive Supplements
A number of natural supplements can support hormonal balance and indirectly benefit ADHD, including:
- Vitamin B6
- Myo-Inositol
- Zinc
- Magnesium
- Probiotics
- Melatonin
- Selenium
- Rhodiola
- Phosphatidylserine
For a complete list of supplements to help ADHD, including dosages, check out our Natural Remedies for ADHD.
For more help choosing supplements that can help manage menopause, refer to these detailed articles:
6. Medication Options for ADHD
While natural approaches can be effective, medications may also be necessary. Stimulants medications like methylphenidate (Ritalin) and central nervous system stimulants (Adderall, Vyvanse) can often improve concentration and executive function16 in women with ADHD, no matter their age or life stage.
Non-stimulant options, such as atomoxetine (Strattera) and guanfacine (Intuniv), offer alternative treatments by targeting different neurotransmitters, although these are usually used as secondary options and often prescribed to children17 with ADHD.
For women who are candidates, hormone replacement therapy (HRT) may help alleviate menopausal symptoms18 and stabilize hormone levels. In my clinical experience, it can help improve cognitive and executive function, as well as mood in menopausal women. Many women experience improvements with HRT and in cases where ADHD specific medications are being utilized, my patients often report improvement in the medication efficacy.
Key Takeaways on How ADHD and Menopause Impact One Another
- Menopause can have a significant impact on ADHD symptoms, primarily through hormonal fluctuations, neurochemical changes, and associated stressors.
- Many women with ADHD report feeling more unfocused, anxious, moody, irritable, and scattered during menopause.
- By combining medical guidance with lifestyle adjustments, women can better manage their ADHD symptoms during menopause and improve their overall quality of life.
- Lifestyle factors can often impact ADHD during menopause. For example, adequate sleep is essential for managing ADHD symptoms and should be considered an important part of a holistic approach to treatment, as should regular exercise and a balanced diet.
- Other approaches to managing ADHD during menopause include the use of supplements like zinc, myo-inositol, Rhodiola, and phosphatidylserine, as well as hormone replacement therapy and stimulant medications.
References
- https://www.additudemag.com/menopause-symptoms-adhd-survey/ ↩︎
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8385721/ ↩︎
- https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-020-02707-9#Sec3 ↩︎
- https://www.sciencedirect.com/science/article/abs/pii/S0022395620311134? ↩︎
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8385721/ ↩︎
- https://www.mdpi.com/2077-0383/13/7/2106 ↩︎
- https://www.sciencedirect.com/science/article/pii/S1877575624000302?via%3Dihub ↩︎
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8385721/ ↩︎
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4631394/ ↩︎
- https://www.additudemag.com/add-and-menopause-how-hormones-affect-adhd-symptoms/ ↩︎
- https://www.sciencedirect.com/science/article/abs/pii/S0022395620311134?via%3Dihub#xd_co_f=ZTQ2MWNkMzItMjFlYy00OGJiLTgzMTMtYjhkNzVkNTlmNGM5~ ↩︎
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8385721/ ↩︎
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9616454/ ↩︎
- https://www.additudemag.com/adhd-lifestyle-changes-food-sleep-exercise-genes-environment/ ↩︎
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10444659/ ↩︎
- https://magazine.medlineplus.gov/article/what-medications-are-used-to-treat-adhd ↩︎
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11001204/ ↩︎
- https://www.berkshirehealthcare.nhs.uk/media/109514308/4-adhd-guide-menopause.pdf ↩︎
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