When ADHD Met Perimenopause
Spoiler: They had babies named Brain Fog, Forgetfulness, and Mood Swings
I'm standing in my kitchen, staring blankly at the open fridge. Why am I here again? Did I come for water? A snack? To solve world hunger? As I close the door, empty-handed and still clueless, a hot flash hits me like a tidal wave and I need to sit down. Welcome to the wild rodeo that is ADHD meets perimenopause.
As a card-carrying member of what some call the "lost generation" of Gen X women with ADHD (diagnosed at 35 and unmedicated until 47), I've become intimately acquainted with this chaotic dance. If ADHD is a constant juggling act, perimenopause adds a few flaming torches to the mix. Suddenly, you're not just dropping balls — you're not even sure what you were juggling in the first place.
So, let’s wade in together, my fellow sweaty queens. Whether you're living with ADHD, navigating perimenopause, or just trying to figure out why your brain and body feel like they're staging a coup, you're not alone in this chaos.
What is ADHD and Why Does Perimenopause Make It Harder to Cope?
Not too long ago, I was invited to be on Dr. Fiona Lovely’s podcast, Not Your Mother’s Menopause, to talk about this intersection. (Yes, that’s her real name. Is she lovely? Also, yes.) We dove deep into this hormonal hurricane that no one seems to be talking about: how ADHD symptoms can go haywire during perimenopause. You can listen below (I come in around the 11
For those just scanning for quick answers, let's start with some clear definitions.
ADHD isn’t just for restless kids in classrooms. It messes with how our brains process information, manage time, and handle emotions. As I told Dr. Fiona Lovely on her podcast, "We [ADHD brains] tend to overestimate how much we can get done and underestimate how long things take." Think of it as your brain's executive assistant constantly calling in sick.
Perimenopause is the hormonal decline leading up to menopause. It's when your ovaries start to retire, causing estrogen levels to fluctuate wildly. This can start in your 40s or even late 30s and last anywhere from a few years to a decade.
Now, imagine these two joining forces. ADHD symptoms like forgetfulness, difficulty focusing, and emotional dysregulation? Perimenopause says, "Hold my Pinot Grigio," and amplifies them all. It's like your brain decided to throw a chaotic farewell party for your estrogen.
Why Estrogen is the Missing Piece
Here’s where things get especially interesting (and by interesting, I mean challenging). Estrogen, one of the core hormones that begin to fluctuate during perimenopause, plays a key role in regulating dopamine, which is already in short supply in ADHD brains. Dopamine is that magical neurotransmitter responsible for motivation, focus, and mood regulation.
As I explained on Dr. Lovely’s podcast, "ADHD symptoms tend to be milder when you have estrogen in your body." When estrogen levels dip, it’s like your brain is running on fumes. Suddenly, symptoms like forgetfulness, mood swings, and emotional dysregulation aren’t just a nuisance — they feel life-altering.
Menopause itself is officially diagnosed when you've gone 12 consecutive months without a period. What we get wrong is that it’s really a one-day event. But it’s also not a reason to give up hope of a good life. As Dr. Mary-Claire Haver explains in The New Menopause:
“Put simply, perimenopause and menopause signal significant changes to your health, and you should be able to make an informed choice about the future of it.”
This transition can take years, during which neurodivergent brains can really suffer more than the average woman. As Dr. Lovely pointed out, "Women [in perimenopause] struggle with memory, word retrieval, cognitive activities as their estrogen declines. Well, ADHD people already have this!"
This diagram pretty much nails it: when ADHD and perimenopause collide, it’s like your professional self and personal life are thrown into a blender. Suddenly, you’re juggling tasks, hyperfocused on the wrong things, and completely exhausted from all of it.
Common ADHD Symptoms Exacerbated by Perimenopause
According to an ADDitude Magazine survey, a staggering 94% of women reported their ADHD symptoms worsening during perimenopause. Let’s look at the main culprits:
Executive Dysfunction: Planning and organizing? Good luck when your brain feels like it’s stuffed with cotton candy. Women reported that memory problems and overwhelm had a “life-altering impact” in their 40s and 50s.
Emotional Dysregulation: Ever feel like your emotions are sitting on a hair-trigger? Hormonal fluctuations only intensify ADHD’s emotional rollercoaster, leading to mood swings that make PMS look like a walk in the park. In the ADDitude survey, 56% of women cited emotional dysregulation as a major challenge.
Sleep Disturbances: Perimenopausal sleep issues (night sweats, itchy ears, waking up at 3 a.m. for no reason) exacerbate ADHD-related issues like focus and mood regulation. Sleep? She doesn’t even go here!
This is why many of us feel like our tried-and-true ADHD coping mechanisms are suddenly about as useful as “tits on a log." The hormonal shifts of perimenopause combined with ADHD can make even the simplest task feel like running a marathon. And let’s not even get into how these symptoms can mess with relationships, careers, and basic daily functioning.
As this infographic shows, menopause affects dopamine production, energy levels, and emotional regulation, all of which impact ADHD symptoms. Understanding these connections can help women make informed decisions about their treatment options.
But don't despair! This might mean it's time to revisit your treatment plan. Working with healthcare providers to adjust medication or explore hormone replacement therapy (HRT) can help balance both ADHD and hormonal symptoms. Remember, it's not you — it's your hormones and neurotransmitters throwing a midlife rager!
Oh, and if anyone tries to solve all this for you with a simple, “Just get up and work out!” you can direct them to my last post.
So What Helps When You’ve Got ADHD AND Perimenopause Happening?
So, what can we do when ADHD and perimenopause collide? The good news is, it’s not all doom and gloom. There are ways to adjust your treatment plan to account for these changes, whether that’s tweaking your ADHD meds, exploring hormone replacement therapy (HRT), or incorporating cognitive-behavioral therapy (CBT).
But I’ll save the deep dive into practical strategies for managing ADHD and perimenopause for next week. In the meantime, take heart. We’re talking about this now and that will lead to amazing new discoveries.
Reflection Questions for You:
Has perimenopause taken your ADHD symptoms on a wild joyride? How have hormonal shifts affected your ability to focus or manage day-to-day tasks?
Did getting (or thinking about getting) an ADHD diagnosis in midlife give you a new perspective on self-care? Or are you still trying to piece together why everything feels harder than it used to?
What’s your ADHD/perimenopause survival toolkit looking like these days? Whether it’s meds, therapy, or just a lot of deep breaths, what’s been working for you—and what’s still a hot mess?
Stay tuned for next week's post, where we'll explore practical strategies for balancing ADHD and perimenopause.
Oh, PS: I gave an interview to the Kit that will be coming out in a few weeks in the Toronto Star on this very subject. I can’t wait to share it with y’all. In the meantime, peep my IG for a sneak peek.