Do I Suddenly Have ADHD Now that I’m in Perimenopause?

Perimenopause and menopause are finally making their way into the social media spotlight. With the removal of the black box warning from estrogen and the new research on hormone replacement or menopausal hormone therapy, more and more women are talking about seeing menopause focused providers. Menopause specific online providers are popping up everywhere. Multiple doctors have been making their views known on social media, thankfully spreading the word and educating women so that they no longer need to “white knuckle” their way through perimenopause. 

Over the last two years, I’ve been experiencing my own perimenopause journey. I have experienced multiple perimenopause symptoms, including sudden weight gain, hair loss, night sweats, hot flashes, irritability, and sleep problems, to name a few. The worst of them all was brain fog. I literally couldn’t finish a sentence without losing my thoughts. As a mental health professional running a business, this was embarrassing and extremely frustrating. I literally felt like I was losing my mind. Luckily, I was able to advocate for myself and get myself the support that I need, but many women have to fight the medical system in order to feel heard and receive appropriate care. 

 With perimenopause comes a fluctuation in the hormones that make it possible for most of us to function. Estrogen receptors are all over our bodies. When estrogen drops, our dopamine and serotonin are impacted in our brain. Our prefrontal cortex also has estrogen receptors – this is the part of our brain that manages executive function and problem solving. Dopamine and serotonin are neurotransmitters that impact mood regulation, decision making, attention, and memory. As these neurotransmitters are not functioning optimally, neither are the women experiencing these changes.  It creates a perfect storm in a woman’s brain. 

Women who already have an ADHD diagnosis can notice medications being less effective on their own and an increased difficulty managing day to day life. Women who were never diagnosed may suddenly notice a shift in their functioning and that old strategies are no longer effective. It can be upsetting, alarming, and debilitating for a lot of women. 

What are effective tools for managing these changes? 

Talk to a medical professional: If you suspect that you have ADHD and have never been diagnosed, talk with your doctor and ask about being tested. This can happen with a psychiatrist and many professionals offer adult ADHD testing. Advocate to get your hormone levels tested (including testosterone) and attempt to tease out if these changes are due to hormones or something deeper. 

Look back at your childhood: Did you struggle in school growing up? Were you constantly behind? Do you experience rejection-sensitive dysphoria? Were you constantly late or disorganized? Do you have 100 unfinished projects around your house? Did you get in trouble for spacing out as a kid or being too out of control? Oftentimes, women are not diagnosed with ADHD as children because the “hyperactivity” is in their own minds. Oftentimes, girls become better at “masking,” accommodating, and figuring out how to function in school and get by. 

Chicken or the egg: Anxiety, trauma, and depression can look a lot like ADHD – difficulty concentrating, trouble staying still, getting caught in thought loops, hyperfixating on a problem. It can be good to track your symptoms, write them down, and explore them to truly tease out if the root cause is ADHD or if it’s another mental health concern. These things are best explored in therapy with a licensed clinician. 

Move your body: Every study on movement proves over and over that movement, exercise, and strength training improve brain function, mood, and overall health. As much as our brains can resist exercise, it’s one of the best protective factors for us. 

Be careful about diagnosing yourself from reels: It can be very easy to watch reels and think “oh, that’s me!” It’s important to be mindful that creators are attempting to pull at our heartstrings and make us feel things. ADHD can only be formally diagnosed by a medical professional. Not an online quiz or from things we hear in reels. 

Be thoughtful about what you put in your body: Focus on small changes like drinking more water and eating more whole, nutrient-rich foods. Start paying attention to how your mood can shift and change based on what you eat. 

Cognitive Behavioral Therapy: Cognitive Behavioral Therapy (CBT) can be useful in managing how your thoughts and behaviors are impacting your day-to-day life. You can get support from a licensed clinician to develop strategies to cope more effectively. 

Nervous system regulation: More buzz is also happening around nervous system regulation. These are tools to calm our bodies and minds so that we are less reactive and more grounded and in control. 

Being a woman is a challenge. Our bodies go through drastic shifts throughout our lives, and we have to figure out how to ride the waves. We need to be advocates for ourselves, be our own cheerleaders, and prioritize our needs. This is no easy feat. Be proud of yourself for all that you have accomplished! "A woman with a voice is by definition a strong woman. But the search to find that voice can be remarkably difficult." — Melinda Gates

If you’ve been considering starting or returning to therapy, now is the best time to start your journey!