The link between hormones and ADHD
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental condition characterised by difficulty with attention regulation, impulsivity, and in some cases, hyperactivity. The brain is dysregulated due to differences in structure and function; it may have trouble regulating and organising emotions, thoughts and behaviours. Research shows that hormonal fluctuations can influence these symptoms.
The teenage years
Studies have shown that girls with ADHD may experience a worsening of their symptoms during puberty, mainly due to hormonal changes. Those changes can impact neurotransmitters which are responsible for attention, motivation, and emotional regulation. As a result, girls tend to struggle more with concentration, impulsivity, and hyperactivity (which can be 'internal hyperactivity') and can have trouble with organisation. Girls may also experience emotional instability and mood swings as a result of hormonal shifts during the menstrual cycle.
The menstrual cycle
The menstrual cycle can have an impact on ADHD symptoms.
The follicular phase is the first part of the menstrual cycle, starting on day one of the period and ending with ovulation. During this phase, oestrogen gradually increases, which plays a supportive role in neurotransmitter activity in the brain, such as dopamine, serotonin and norepinephrine. Menstruating people with ADHD tend to experience less severe symptoms and be more productive.
However, during the luteal phase, which is the period of time between ovulation and the start of the next period, they may experience an increase in symptoms. During this phase, the levels of oestrogen decrease while progesterone levels increase. This may contribute to ADHD symptoms like impulsivity, disorganisation and difficulty regulating emotions. ADHD medications may also be less effective. Lifestyle changes, as well as adjusting medication with your healthcare provider, may help you during this tricky phase of the menstrual cycle.
ADHD and PMDD co-occurrence
PMDD (premenstrual dysphoric disorder) is a serious condition that occurs in some women during the luteal phase. It causes intense emotional and physical symptoms, such as mood swings, depression, irritability, anxiety, and digestive issues that are severe enough to interfere with daily life.
Some research suggests that some of the same brain chemicals and pathways that are involved in ADHD may also play a role in PMDD.
A high percentage of women with ADHD also meet the criteria for PMDD. While more research is needed to fully understand the connection, we can see links between the two conditions.
Pregnancy and postpartum
Some women with ADHD report feeling better after the first months of pregnancy. Once again, it is thought to be related to hormonal shifts.
During pregnancy, oestrogen levels increase steadily and reach their peak in the last trimester. Some research also suggests that pregnancy may change brain chemistry in a way that reduces ADHD symptoms. For some, pregnancy can feel like a temporary respite from ADHD symptoms.
However, postpartum can be a tough time for new mums with ADHD. The sudden drop in hormone levels after childbirth can have a big impact on neurotransmitters and affect mood and attention. The sleep deprivation and the stress of caring for a newborn baby can also make symptoms worse.
Seeking support during this time is crucial. Whether it’s talking to your healthcare provider or a therapist, joining a support group with other new mums, or just asking for help from family and friends, all these can make a big difference in managing postpartum ADHD symptoms.
Note that if you experience symptoms like persistent sadness, anxiety or feelings of hopelessness, do not hesitate to seek help. ADHD is an important risk factor for postpartum depression.
Perimenopause and menopause
Perimenopause, which is the transition period before menopause, can be like a wake-up call for many undiagnosed women. It is now quite common for women to get diagnosed with ADHD after their children get a diagnosis, which often happens when mums are in their 40s or early 50s. As they learn more about ADHD, they may realise they have been struggling with similar symptoms for years.
The decreasing oestrogen levels during this transition can make ADHD symptoms more pronounced, such as increased mood swings, irritability and brain fog. Also, physical symptoms like hot flashes, sleep disturbances and fatigue can further affect concentration and forgetfulness.
Many women also experience more stress and anxiety during this time. The combination of hormonal, physical and emotional changes can make it harder for women to mask their ADHD symptoms. If you are struggling during this transition, once again, it is important to seek help and talk to your healthcare provider.
In the same way that ADHD is highly individualised, not all girls and women with ADHD are affected by hormone fluctuations, but a lot of them are. Sensitivity to hormones is a common factor, particularly during the luteal phase of the menstrual cycle, pregnancy, postpartum and menopause. The severity of symptoms can vary a lot from person to person.
ADHD medication can be very effective in helping manage symptoms and lead more productive and fulfilling lives. But it’s worth noting that medication is one tool in the toolbox. Developing healthy dietary and lifestyle habits, addressing deficiencies and imbalances, as well as seeking support, can all play a role in supporting quality of life. It will also have a positive ripple effect on your hormone health.
This is a subject I help clients with, so if you’d like to learn more about how we can work together, do get in touch via my Nutritionist Resource profile or website.