If you’ve been living with ADHD for a while, you may feel like you have your condition under control. But hormone changes before and during menopause could set you back.
Not only can a drop in estrogen during perimenopause and menopause cause hot flashes, weight gain, and trouble sleeping, but it can also lead to new or worse symptoms of ADHD.
How Does Estrogen Affect Your Brain?
You might have recognized the impact that hormones have on your ADHD symptoms as early as your first period.
ADHD symptoms tend to be milder at times when estrogen levels are higher in your body, like during and shortly after your period. You might notice more ADHD symptoms when estrogen levels are lower, like when you’re having PMS. Your medication might not work as well then, either.
Estrogen levels rise during pregnancy, which often reduces major ADHD symptoms. After childbirth, though, it’s common for ADHD symptoms to get worse.
But how exactly do female hormones influence symptoms of ADHD? Estrogen affects the brain in many ways. But for people with ADHD, the most important are its impact on the brain chemicals serotonin and dopamine.
When estrogen levels drop, so does your brain’s ability to release these two chemicals. Less serotonin can lead to mood changes, like feelings of sadness and anxiety. Dopamine promotes pleasurable feelings. It also plays a role in what’s known as executive function, which is things like focus, memory, and concentration.
How Menopause Can Affect ADHD
Perimenopause is the time before menopause when your periods become less regular and your body’s estrogen levels stay lower for longer stretches of time. It varies from person to person, but perimenopause tends to last 5 to 8 years.
You’re considered to be in menopause when you’ve had no periods for a year. The average age for menopause in the U.S. is 51.
Along with the physical changes that happen before, during, and after menopause, many women have symptoms like depression, trouble staying on task, and memory and sleep problems. For people with ADHD, this could make things like concentrating and planning ahead even harder.
The combination of ADHD, hormonal changes, and life events can become a triple threat for women in their late 40s and beyond.
If you’ve had mild ADHD up to now, hormone-related changes may have you feeling overwhelmed for the first time.
Some people don’t get diagnosed with ADHD until hormonal changes make their symptoms serious enough that they seek treatment. And ADHD that was previously well-managed may feel out of control.
At the same time, midlife is a time when you may find yourself caring for aging parents while still helping your children find their way. You could be adjusting to an “empty nest.” The pressures of your career could be at an all-time high. You might even be dealing with divorce or the death of a spouse.
All these emotional challenges and stresses can make your ADHD symptoms worse.
Managing Midlife ADHD
If you feel your ADHD symptoms have become unmanageable, lifestyle changes, medications, and other therapies can help.
You might start by tracking your ADHD symptoms in a journal or app. If you still get your period, you can see if there’s a link to your cycle. Over a few weeks or months, you should be able to see if you’re having a harder time sticking to plans, aren’t sleeping as well, are more anxious, or have other issues you hadn’t noticed before.
Work with your doctor. If you’re already on ADHD medication, they might change your drug or your dosage. They can also prescribe other drugs like hormone therapy or antidepressants to relieve your symptoms.
Stimulants could be a solution in more ways than one. Research has shown that the ADHD drug lisdexamfetamine (Vyvanse) may improve things like memory, task management, and organization in perimenopausal and menopausal women even when they don’t have ADHD.
If you’re not getting it already, consider cognitive behavioral therapy (CBT). This type of psychotherapy has been shown to help people with ADHD regulate their emotions and better manage their daily tasks, whether or not they also take medication.
You can also try changing your diet. Research suggests that the Mediterranean diet – mostly plant-based foods with healthy fats like olive oil – could improve your quality of life and even help relieve menopause symptoms.
People with ADHD may be prone to deficiencies in nutrients like vitamins A, B, or D; omega-3 fatty acids; and minerals like magnesium or zinc. Poor nutrition can make ADHD symptoms worse. If you have trouble following a healthy diet, ask your doctor about testing for deficiencies and whether supplements could help.
Regular exercise not only helps prevent menopause-related weight gain, but can also help you sleep and reduce your risk of depression and anxiety. Further, it’s a brain booster that can improve school performance and executive function. Try to do moderate-intensity activity for at least 150 minutes each week, or 75 minutes a week of harder exercise.
Research shows that meditation and mindfulness training may improve mental and emotional symptoms of ADHD in adults. These practices can teach you to be more “present,” improve your executive function skills, and help you regulate your emotions.
An ADHD coach can also help you deal with the practical aspects of life and career challenges during midlife, as well as teach you skills to help you stay on top of your daily tasks.