Navigating ADHD and Menopause

By Naomi Braun, MPH, MSW • Published 12/11/2023

Medically Reviewed by Dr. Shannon Chavez, PsyD, CST

head with disorganized lines symbolizing ADHD, a brain disorder that makes it hard to stay focused

Menopause is a big transitional phase in your life. And while this phase can be challenging on its own, those who have Attention-Deficit / Hyperactivity Disorder (ADHD) face even more unique day to day struggles during this time.

ADHD is a brain disorder that makes it hard to stay focused. While ADHD is often thought of as a condition in children, more adults are being diagnosed. While researchers are still trying to understand what causes ADHD, there is some evidence to suggest that it’s related to a combination of genetics and environment.

It’s estimated that 2-3% of adult female in the United States have ADHD. Since other mental health conditions, such as depression and anxiety, often co-occur with ADHD, the diagnosis of ADHD may be confused with some of these other life challenges.

Of the three primary types of ADHD, adult women are often diagnosed with the inattentive type, as opposed to the hyperactive-impulsive type or a combination of the two. The most common symptoms of inattentive ADHD include:

  • Making careless mistakes.
  • The inability to multi-task.
  • Difficulty organizing and completing tasks.
  • Failing to meet deadlines.
  • Frequently losing things like books and keys.
  • Appearing to not listen when spoken to.

The biology behind why the inattentive type of ADHD occurs more in women has to do with the structure in the brain called the hippocampus, which plays an important in learning and memory. This brain structure is filled with estrogen receptors, which are activated by estrogen. The more estrogen, the better the hippocampus can function. As a result, the progression of ADHD symptoms is often directly related to fluctuating estrogen levels that occur throughout life and especially during menopause.

woman stretching and exercising to help improve mood as a way to manage her ADHD and menopause symptoms

The connection between ADHD and menopause

Menopause is primarily associated with a decrease in hormone levels, specifically estrogen and progesterone. Estrogen plays a very important role in protecting the brain and the nervous system. The brain is made up of nerve cells called neurons, which communicate through complex networks. These networks help different parts of the brain work together to control things like thinking, memory, and overall brain function.

During perimenopause, the fluctuating levels of estrogen can lead to changes in brain structure and function, including decreased memory, attention, and problem-solving skills.

Since these brain functions are also challenged for a person with ADHD, the changing levels of estrogen can intensify already existing ADHD symptoms. One of the symptoms that people with ADHD may experience is a more pronounced version of “brain fog,” which is a term often used to describe the feeling of mental confusion, forgetfulness, and difficulty concentrating that often accompanies menopause.

Estrogen also helps regulate things in the brain called neurotransmitters, which are your body’s chemical messengers. They carry messages from nerves to other nerves and muscles, helping your body function properly. Two specific neurotransmitters, called serotonin and dopamine, are essential for mood and focus. When estrogen levels decline over time, the body can’t produce as many of these neurotransmitters.

As a result of a decrease in serotonin and dopamine during menopause, people often experience mood swings, irritability, and anxiety. This, along with the emotional challenges associated with ADHD, can make it even harder to manage feelings and reactions.

In addition, both ADHD and menopausal symptoms can disrupt sleep patterns. People with ADHD may already struggle with sleep due to racing thoughts and restlessness. Those going through menopause may experience night sweats and hot flashes because of decreased estrogen negatively impacting the functioning of the hypothalamus, the part of your brain that regulates your body temperature. When these two issues happen at the same time, sleep challenges can become worse, leading to chronic fatigue and daytime drowsiness.

person with ADHD during menopause practicing an easy time management technique by writing to-do list in a planner to stay organized

How to cope with ADHD and menopause

Managing ADHD and menopause symptoms can be frustrating, but there are some things you can do to help you focus and increase your concentration during this period of your life:

  • Reduce stress. Practice stress management techniques such as mindfulness, meditation, or yoga. These practices can help both with ADHD symptoms and the emotional challenges that come with menopause.
  • Sleep well. Set up a sleep routine and create a healthy sleep environment to improve the quality of your sleep. Make sure your room is dark, the temperature is cool, and ambient noises are minimized. Avoid caffeine and electronics before bedtime to help keep the brain, and your thoughts, calm before pulling laying your head on the pillow.
  • Exercise regularly. Getting regular physical activity has been shown to have positive effects on your ability to stay focused and concentrate. Exercise increases blood flow to the brain, can help to improve mood, and supports overall brain health. Talk to your healthcare provider before starting or changing any exercise regimen.
  • Eat a healthy diet. Eat a diet rich in antioxidants, found in berries, tomatoes, spinach (and dark chocolate!), and omega-3 fatty acids, found in eggs, walnuts, salmon, and tuna. Both nutrients can support brain health.
  • Consider cognitive-behavioral therapy (CBT). CBT can be highly beneficial for those managing both ADHD and menopause symptoms. It can help you develop coping strategies, improve time management, and address emotional challenges by helping you change your current thinking patterns.
  • Find support networks. Lean on friends, family, or support groups for emotional support. Sharing your experiences with others who understand your struggles can provide a sense of validation and reduce feelings of isolation.
  • Practice “easy” time management techniques. Use tools, ideally ones that you’re already using in your day-to-day life, like electronic calendars, to-do lists, and reminders to stay organized and manage your daily responsibilities effectively. Try adding color coding to your tasks, and/or break them up into smaller, more manageable steps to try and reduce feeling overwhelmed.
  • Manage medications. If you have ADHD, it's essential to discuss your symptoms with a healthcare provider, especially during menopause. They may adjust your medication dosage or recommend different treatments to better manage symptoms during this time.
  • Talk to your healthcare provider. If you find that ADHD and menopause are significantly impacting your daily life and well-being, don't hesitate to seek professional help. Therapists, counselors, and psychiatrists can provide tailored strategies and treatments.

ADHD and menopause are two complex and often challenging parts of a person’s life. When they both happen at the same time, the symptoms can be overwhelming. Remember that seeking support from healthcare providers, loved ones, and support networks is a great way to help manage ADHD and menopause effectively. With the right tools and resources, you can not only survive but thrive during this phase of your life.

Last Updated 2/15/2024

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