For many women, the menopause brings physical, emotional and cognitive changes. Women with ADHD (attention deficit hyperactivity disorder) may find that previously manageable symptoms become more difficult to control. Others may only recognise ADHD traits during perimenopause, when difficulties with concentration, organisation and memory become more noticeable.
Perimenopause is the transition towards menopause, during which oestrogen levels fluctuate. This can cause changes in periods as well as symptoms such as hot flushes, sleep difficulties, mood changes, joint aches and problems with concentration and memory.
Menopause is reached when a woman has not had a period for 12 consecutive months. Oestrogen levels are then lower, and the ovaries no longer release eggs. In the UK, the average age of menopause is around 51, although it can occur between approximately 45 and 55 years.
ADHD is a lifelong neurodevelopmental condition affecting attention, concentration, impulse control, emotional regulation and executive function. It is associated with differences in brain signalling involving neurotransmitters such as dopamine and noradrenaline.
ADHD is thought to be underdiagnosed in women and girls. Symptoms may be less obvious than the visible hyperactivity often associated with ADHD in boys, with difficulties such as inattention (may present as ‘daydreaming’) and internal restlessness being more common. Many girls and women also develop strategies to compensate for their symptoms, which can make ADHD harder to recognise.
Research into the relationship between ADHD and menopause is still very limited, but some women report that their ADHD symptoms become more difficult to manage during perimenopause. Some women notice changes in ADHD symptom severity during their menstrual cycles.
One possible explanation is that changing oestrogen levels may affect dopamine signalling. Women with diagnosed ADHD may find that strategies or treatments that previously worked well become less effective, while those without a previous diagnosis may become more aware of longstanding ADHD traits that have become unmasked.
Importantly, menopause does not cause ADHD. ADHD is a lifelong condition. However, hormonal changes, alongside changes in sleep, mood and life circumstances, may make existing symptoms more noticeable or harder to manage.
When assessing possible ADHD, clinicians will explore whether relevant symptoms were present earlier in life rather than attributing new symptoms solely to menopause.
Symptoms may include:
These symptoms are not specific to ADHD and can also occur during menopause. A comprehensive assessment can help identify the contributing factors.
If you take ADHD medication and notice a change in your symptoms, speak to your prescribing clinician rather than changing your dose yourself.
Research into ADHD medication specifically during perimenopause and menopause is currently limited. Your clinician can consider your ADHD symptoms alongside sleep, mood, anxiety, other medications and menopausal symptoms.
Hormone replacement therapy (HRT) can be used to treat menopausal symptoms. It usually contains oestrogen and, for women who have a womb, a progestogen to protect the womb lining.
HRT is not currently an established treatment for ADHD. However, treating menopausal symptoms such as hot flushes and sleep difficulties may improve overall wellbeing and may make ADHD symptoms easier to manage for some women.
Whether HRT is appropriate depends on your individual symptoms, medical history and the potential benefits and risks. Your healthcare professional can discuss the available options with you.
Speak to your GP or another healthcare professional if:
Keeping a record of symptoms, periods, sleep and medication can help you and your clinician identify patterns.
Practical strategies can help during the menopause transition, including:
ADHD and menopause can overlap, making symptoms such as poor concentration, forgetfulness, sleep problems and mood changes difficult to untangle. Hormonal changes during perimenopause may make existing ADHD symptoms more noticeable or harder to manage.
If you notice a significant change in your symptoms, speak to a healthcare professional for further support.
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