 ADHD + Women: Part Two This is the second article in a series about the unique challenges that neurodivergent women and gender diverse folks experience. For adult women with ADHD, the different stages of life can be an unwelcome roller coaster of emotional upheaval and physical discomfort. Estrogen plays a key role in the production of dopamine, which supports working memory, pleasure, and focus. When dopamine levels are high, alertness, focus, and happiness come easily. For ADHD’ers that already struggle with low dopamine levels, changes in estrogen production throughout life can be deeply frustrating. In addition, once women reach their 40’s and 50’s, some of the symptoms of perimenopause and menopause mimic and overlap with ADHD, leading to even more confusion. Given that a large amount of the existing research focuses on the male experience of ADHD, it can be mystifying to understand what’s happening. The good news is understanding how hormones interact and influence the brain throughout life can go a long way in helping you feel empowered to make healthy choices, wherever you are in your discovery journey. Big changes Once in adulthood, women experience three distinct stages that have a dramatic impact on hormones, especially estrogen:
 Reproductive years
As previously posted on the Adult ADHD Centre blog women of reproductive age experience fluctuating hormones that can impact their ADHD symptoms. For women during their reproductive years, the time of the month when estrogen levels drop just prior to the menstrual cycle, can be especially challenging. Low mood, anxiety, sleep disturbances, changes in appetite, difficulty focusing, can all take a toll on well-being. For those that have children, the post-partum time can feel even more depleting and disorienting. Having children, work, and other responsibilities during this time can feel overwhelming. Neurodivergent people need support and self-compassion during these hectic years. Perimenopause The literal translation of perimenopause is “around menopause”. It’s a natural transition that happens to most people with a uterus, but can feel alarming and scary, which is why it’s so important to have all the facts. How does this impact ADHD symptoms for women? The dramatic changes in estrogen levels can wreak havoc on concentration and mood and depending on whether you take medication, can also make the usual dose less effective. For most people, perimenopause starts in their 40’s, but some report symptoms as early as 35. Here’s what happens: the rate of estrogen production by the ovaries begins to decrease. Some women refer to this as estrogen’s storm season, with good reason. It’s unpredictable, sudden and can cause emotional upheaval. Some days, estrogen levels can be high, the next, very low. This can lead to insomnia, anxiety, and depression. It’s important to consult a doctor or nurse practitioner during this time. Some women find relief with hormone replacement therapy, but it doesn’t work for everyone. Menopause Women that have not had a menstrual period for 12 months are considered to be in menopause. During this time, the ovaries are no longer producing estrogen and menstruation stops. For those that have had a hysterectomy, this can happen much earlier in life. For some, this can be a relief from the monthly stressors of menstruation, but for others, diminished libido, hot flashes, low mood and insomnia can cause tremendous distress. For ADHD women that already struggle with healthy sleep, it can feel completely overwhelming. Finding what works for your life situation is absolutely crucial. Not everyone wants or needs hormone therapy. For gender diverse people, this time can be even more challenging, but there is help available. Information is key Given that women are often diagnosed later than boys and men, when hormones may have started fluctuating, this can be a difficult time. The grief that comes with an adult ADHD diagnosis can also contribute to feelings of inadequacy. If it’s available to you, work with a counsellor or coach to help sort through the complex emotions that arise with an ADHD discovery. Informing yourself, asking questions, and talking with others on the ADHD discovery path can be empowering and minimize the confusion and stress of these natural phases of life. Most importantly, be gentle with yourself as your body changes!
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