In addition to the typical cognitive burden that ADHD can bring, women with ADHD also have to deal with an ever fluctuating hormone environment. Changes in estrogen can intensify the symptoms of ADHD, particularly during the menstrual cycle, puberty and menopause. It is important for women diagnosed with ADHD to be aware of how estrogen affects their condition, and to take steps to lessen the impact.
The brain is one of the organs of the body targeted by estrogen. In addition to being one of the main hormones that is responsible for regulating the female reproductive system, estrogen also plays a role in cognitive function. It modulates the neurotransmitters serotonin, dopamine, and norepinephrine. These neurotransmitters help with focus, concentration, mood, and memory.
When estrogen levels are low, you may experience increased feelings of irritability, moodiness, and depression, problems with sleep, anxiety, difficulty concentrating, fuzzy thinking, forgetfulness and memory problems, fatigue and loss of energy, as well as hot flashes. Women with ADHD can be particularly sensitive to lower estrogen levels since ADHD is also associated with a dysfunction in the neurotransmitter systems in the brain.
Estrogen levels may impact the effectiveness of ADHD stimulant medications. Progesterone can also have an impact. Higher estrogen levels seem to aid the effectiveness of ADHD medications, while progesterone seems to decrease their effectiveness. Thus during times when hormone levels change significantly, ADHD medications may be more or less effective at managing symptoms.
Puberty – With the onset of puberty, estrogen and progesterone levels can both increase dramatically. Teenage girls with ADHD may experience intense mood swings and irritability, and notice that their ADHD medications are not working as effectively..
PMS – During the menstrual cycle, estrogen and progesterone levels change, and this may play havoc with ADHD medications.
Pregnancy – During pregnancy, estrogen levels are much higher. This may help ease ADHD symptoms for some women. However, many physicians have their patients stop taking ADHD medications during pregnancy which can counteract any potential positive effect of more estrogen.
Postpartum – Following birth, estrogen levels drop which can exacerbate ADHD symptoms and feelings of depression. The extra stress of the new baby, plus lack of sleep, can further intensify ADHD symptoms.
Perimenopause – Perimenopause typically begins in the late 30s or early 40s. The fluctuating estrogen levels may cause many women diagnosed with ADHD to notice a worsening of symptoms. An increase in stimulant medication may be prescribed to offset the effect of changing hormone levels.
Menopause – Menopause usually occurs between 45 and 55 years of age and brings with it a significant drop in estrogen levels. However, during menopause, these levels tend to stabilize. If ADHD symptoms worsen during this time, doctors may prescribe additional stimulant medication, or hormone replacement therapy, which may make additional stimulants unnecessary.
For many women with ADHD, fluctuating hormone levels can make managing the symptoms of the condition more challenging. The interplay between the effects of hormones and medication is ever changing. However, there are things you can do to help during those times when the estrogen levels are fluctuating and ADHD worsens.
- Work with your doctor to find an appropriate medication level.
- Simplify your daily life in as many ways as possible to lower stress.
- Get more sleep.
- Get regular exercise.
- Maintain a healthy diet.
Better awareness of how hormone levels impact ADHD symptoms is the first step toward minimizing their impact throughout your life.