For many women, the transition into perimenopause and menopause can feel like a seismic shift – physically, mentally, and emotionally. But for women with ADHD, this life stage can bring with it a particularly tough set of challenges. If you’ve found that your ADHD symptoms have intensified during menopause, you’re not imagining it. There’s increasing awareness and growing research that hormonal changes, particularly the sharp drop in oestrogen, can significantly exacerbate ADHD symptoms. Understanding what’s happening in your brain and body during this time is the first step in regaining a sense of control and learning how to manage both conditions with greater confidence.
Why Does Menopause Make ADHD Feel Worse?
Oestrogen plays a crucial role in regulating neurotransmitters like dopamine, noradrenaline (norepinephrine), and serotonin – all of which are essential for attention, memory, emotional regulation, and executive functioning. These are also the very areas that ADHD tends to disrupt. So, when oestrogen levels drop during perimenopause and menopause, those neurological systems can become even more dysregulated. It’s no wonder so many women report a noticeable uptick in ADHD symptoms like forgetfulness, disorganisation, emotional reactivity, and mental fatigue at this time. In fact, research suggests that low oestrogen levels can intensify both inattention and hyperactivity-impulsivity symptoms in women with ADHD, with particular challenges around emotional regulation and executive function.
For some, it’s the first time they even begin to suspect they might have ADHD. As Dr Russell Barkley, a leading expert in the field, has noted, clinics often see a spike in referrals around menopause, with many women realising for the first time that they’ve been managing undiagnosed ADHD for decades.
Symptoms That Might Get Worse During Menopause.
While everyone’s experience is unique, there are common ways ADHD symptoms can show up more intensely during menopause. The most common symptoms to be exasperated by menopause are:
- Worsening forgetfulness and brain fog
- Increased distractibility and poor focus
- Greater difficulty organising tasks or sticking to routines
- Heightened emotional sensitivity or mood swings
- More impulsive behaviour or disinhibited reactions
- Decreased motivation and energy
- Sleep problems and insomnia
Combine these with the usual perimenopausal symptoms like hot flushes, night sweats, anxiety, and physical discomfort, and it's easy to feel overwhelmed.
Ways Forward.
ADHD is not an illness and menopause isn’t something to be ‘cured’. However, both can have a real and sometimes difficult impact on daily life. Accordingly, both deserve understanding, validation, and practical support. Here are some of the most important avenues to explore.
Revisit Your ADHD Treatment Plan.
What worked for you five or ten years ago may not be cutting it anymore. Menopause can change the way your body processes ADHD medications, and you may need a different dosage or formulation. At Beyond Clinics, a private ADHD clinic in Manchester, we have worked with many women to restructure their ADHD treatments in menopause. Some clinicians have tailored stimulant doses around hormonal cycles or offered adjunct treatments for specific symptoms, such as sleep aids or non-stimulant ADHD medications.
Explore Hormone Replacement Therapy (HRT).
There is promising evidence that HRT can help stabilise mood, improve cognitive function, and ease other symptoms related to both menopause and ADHD by restoring some oestrogen balance. However, HRT isn’t suitable for everyone, so it’s important to discuss risks and benefits with a knowledgeable healthcare provider who understands ADHD and menopause.
Prioritise Sleep.
Sleep is a foundational pillar of ADHD management and menopause can throw a serious wrench into that. Poor sleep impacts memory, concentration, mood, and even how well medications work. To help this, it will be important to keep to a consistent bedtime and wind-down routine, limit screen time and caffeine in the evening, and to practice calming rituals such as a warm bath, meditation or stretching. If none of these methods help, it can be useful to speak to a clinician about natural or medicinal sleep aids.
Structure and Routine.
Structure and routine are important for everyone – especially those with ADHD. During menopause, it’s even more vital to establish clear systems of structure and routine. It’s not about becoming super-organised overnight, but rather building systems that support your brain, especially when executive functioning is harder than usual. To make this easier, it can be useful to utilise visual planners, timers, and alarms to break down tasks. It will be a good idea to keep routines simple and repeatable, while using a single calendar to keep track of everything can also help. If you are still finding it difficult to stick to a clear routine or structure, ‘body doubling’ – working alongside someone, in-person or virtually – can help you to stay on track.
Ask for Help.
It’s easy to fall into the trap of self-criticism, but your brain is navigating two major neurobiological processes at once. It’s not a lack of willpower – it’s a call for more support. During this time, it’s a good idea to talk to your manager at work about what reasonable adjustments can be made, to involve family in planning and housework, and to lean on ADHD or menopause support groups, where shared experiences can be incredibly validating.
A Time for Re-Evaluation and Growth.
For many women, menopause is a time of reckoning and renewal. The chaos of such a seismic change can also bring clarity. Some find that as they finally understand their brains and they’re empowered to let go of unrealistic expectations, perfectionism, and people-pleasing. That freedom, combined with proper diagnosis, support, and treatment, can make a profound difference.
ADHD and menopause can be a messy, tiring, sometimes bewildering combination. But it’s also one that is manageable, provided you have the right knowledge, tools and support. At Beyond Clinics, we understand the complexity of these overlapping experiences and we’re here to help you make sense of it all – from assessment and diagnosis to treatment and ongoing support.
Start your journey with an expert team who understands ADHD – and the real-life challenges that come with it. Contact us to book a consultation or speak to one of our friendly team today.
