We now know that ADHD stays around for life. Many adults adapt to ADHD by develop coping strategies to deal with the symptoms such as inattention, hyperactivity, and impulsivity, which can impact their daily life and functioning.
In fact, both women and men with ADHD report the greatest symptom severity from ages 50 to 59— during menopause and andropause (a kind of male menopause), respectively. Recent research has suggested that changes in hormone levels, specifically testosterone in men and estrogen and progesterone in women, may play a role in how ADHD presents in adults.
Testosterone and ADHD
Testosterone is a hormone that is primarily found in males, but it is also present in females in lower amounts. It is a type of hormone called an androgen. Testosterone plays a crucial role in the development of male physical characteristics, such as facial hair, muscle mass, and a deep voice. It is also essential for the development of sperm and the maintenance of bone density.
Researchers have identified that within the brain, there are specific androgen receptors. Think of these receptors as light switches that only androgen hormones can activate. They also know that testosterone can cross the blood-brain barrier. This barrier is a protective mechanism in your brain designed to keep substances that could potentially damage it out, and allow other substances in (including some medications). The fact that testosterone can cross the blood-brain barrier means that it could cause some changes in thinking or brain functioning.
Some of testosterone’s protective effects on the brain include:
- Delaying nerve cell death
- Improving nerve cell regrowth after damage
- Reducing the effects of nerve damage
- Having anti-inflammatory actions on the nerves
Studies have found that men with ADHD tend to have lower levels of testosterone compared to men without the disorder. This could be due to the fact that testosterone is necessary for the development and maintenance of the prefrontal cortex, the area of the brain responsible for executive functioning, which is often impaired in individuals with ADHD. Additionally, testosterone has been shown to improve attention and mood, which can both be areas of difficulty for men with ADHD.
Estrogen, Progesterone and ADHD
The two hormones that affect ADHD symptoms in a woman are estrogen and progesterone. Estrogen acts like the key that unlocks happiness, satisfaction, and even cognitive performance in our brains by triggering the release of dopamine, serotonin, and norepinephrine.
Progesterone, on the other hand, triggers the release of GABA. And GABA acts to calm everything down. While this may sound great, to an ADHD brain that needs more dopamine, the depressing effect of GABA can feel like kryptonite because it erases all the more positive feelings unlocked by estrogen. It can exacerbate ADHD symptoms and result in fatigue, irritability, sadness, brain fog, and inattention.
Over the course of a woman’s life, as her estrogen and progesterone levels change dramatically, so will her mood, energy, and other ADHD symptoms. Through puberty, during pregnancy, into perimenopause and finally menopause, the shifting balance between estrogen and progesterone can either moderate or intensify ADHD symptoms.
Understanding the role of testosterone and estrogen in ADHD can have significant implications for treatment. For example, testosterone replacement therapy may be considered for men with low testosterone levels and ADHD to improve executive functioning and mood. Similarly, hormonal replacement therapy with estrogen may be considered for women with low estrogen levels and ADHD to improve cognitive function and mood.
However, it is essential to remember that hormone replacement therapy comes with its own set of risks and side effects. Hormone therapy should only be considered under the guidance of a qualified healthcare provider who can help weigh the potential benefits and risks for each individual.
Recent research has suggested that changes in testosterone and estrogen levels may play a role in how ADHD presents in adults. While more research is needed to fully comprehend the relationship between hormones and ADHD, understanding the potential implications of hormone levels on ADHD symptoms can help inform treatment decisions and improve overall outcomes for individuals with the disorder. Other treatment options should also be considered, including therapy, meditation, and changes in diet and exercise routines.