ADHD used to be considered a condition that mostly affected boys.  But awareness is increasing around the ways it can show up in women.  The rate of girls and women receiving a diagnosis is increasing for ALL ages.  And perhaps like many women hitting their perimenopause, you might find it thoroughly bewildering to work out: why are you suddenly noticing so many of the traits of ADHD?  Is it just hormones going haywire?  Let’s discuss in this blog.

One minute you’re just about holding life together with a brain that thinks quickly and gets stuff done, then perimenopause hits.  Suddenly it’s not just hot flushes that you are contending with, but brain fog and memory problems like you’ve never experienced before.  What is going on?

Then when you really dig deep, you realise that the brain fog isn’t all that unfamiliar.  Yes, it’s maybe a lot harder to ignore now, but overwhelm is your old friend.  And overwhelm can make your ability to think straight stop in it’s tracks.

Overwhelm is a big part of ADHD.  So let’s explore ADHD and perimenopause in more detail.

There are going to be phrases used here in this blog that many women (in fact many humans) find triggering.  Please know that although I am using well-known terms, I would like to turn some of these phrases on their head.  So please don’t shoot the messenger and bear with me!

You can hear more about my personal journey with the world of ADHD in my blog here

Two common reasons for identifying ADHD for women in adulthood

It may be true that many of those women happen to make this discovery about their own ADHD traits as they seek out help for their own neurodiverse children.  But there is another factor that causes ADHD symptoms to become more pronounced at this life stage – perimenopause!

Tthere’s a big reason why girls are missing an ADHD diagnosis and it’s only being spotted in adulthood.  Although some females will display the more hyperactive traits of ADHD, many more will slip under the radar with the Inattentive or Combined presentations.

And whilst we’re using quite clinical terms here, let’s not forget that every human on this earth is completely unique.  Uniqueness in people either considered neurotypical (apparently without any major difference in the way their brain operates compared to the majority of other individuals) or neurodiverse (everyone who has some kind of significant difference in the way they think and experience the world due to neurological differences) means that we’re all different. 

So how ADHD looks from person to person can vary greatly too.

Why it’s harder to spot in girls

Girls in particular learn to perfect the arts of masking (hiding your true feelings and imitating the mannerisms of other people to fit in) and people pleasing from an early age.  Not intentionally but because it is the best way to minimise the repercussions of not conforming.

There is a heavy cost for this.  It is exhausting to keep this act up and most women will know that deep down they have never felt like they fit in.

It’s not a conscious act to mask, but it is a survival tactic that starts at an unconscious level.  Our tendency to mirror and faun to “belong” is hardwired in us from ancient ancestors – when we lived as tribes and relied on belonging to that tribe to eat, have shelter and be safe from predators and other tribes.

So ADHD brings a dichotomy of lots of atypical traits and interests, paired with unconscious programming to hide who we are to fit in.

Now you might see why a recognition of a life half lived with much of yourself hidden from the world is going to take quite a lot of processing if you are coming to this realisation in your adult years.  And research has shown that an ADHD diagnosis in adulthood for women has impacts on social-emotional wellbeing, difficult relationships, lack of control, and self-acceptance after diagnosis.

So why is it so commonly discovered during perimenopause?

The research into female hormonal effects on ADHD presentation is still in it’s early days.  However, rapid declines in oestrogen during the menstrual cycle have been linked with a reduction in executive function and impulse control.  This is often most pronounced during puberty and for some women on certain days of their cycle each month.  The fluctuations and decline in oestrogen during perimenopause would also therefore contribute to similar effects.

It may be helpful to explore the “symptoms” associated with ADHD and how these coincide with many menopausal symptoms.  Bear in mind that these are the signs that clinicians are looking for to classify the type of ADHD also:

Inattentive Signs

Hyperactive/Impulsive ADHD Signs

For inattentive or hyperactive/impulsive type ADHD, the diagnostic criteria is 6 of the symptoms for children up to 16 and 5 symptoms for adults and teens over 17 years old.  There is also a classification of combined, involving a mix of symptoms from both of these lists.

These symptoms must have been present for 6 months or more and inappropriate for the developmental age.  For a diagnosis, several of these symptoms must have been present under the age of 12, must be present in at least two different environmental settings (ie, school, work or home) and cannot be otherwise explained by another mental health condition. 

It is also relevant whether the symptoms interfere with daily life and affect the quality of social, work or school functioning.

Many women do not see a need for an official diagnosis.  But if you are considering this for yourself it is worth having a conversation with your GP or find a reputable private clinic to advise you.

Why is ADHD in perimenopause such an issue?

Many women will likely experience symptoms such as brain fog and impaired memory during this time.  And oestrogen may have been helping to compensate somewhat for the neurological differences that cause ADHD until now.  The drop in oestrogen can be like a plug being removed and those symptoms are no longer so well hidden.

It also happens that many women are managing more different responsibilities than at any other time in their lives.  With more work responsibility, team members to manage, household bills, finances to oversee, children, pets, perhaps parents or family members needing help or care.  Stress can have a huge impact on perimenopause regardless and this is far from optimal for an ADHD brain!

It also happens that women seeking medical help and disclosing some of these mental symptoms may find themselves being diagnosed with depression or anxiety and being offered medication that likely will not address the underlying causes.

So what can you do to support your mental and physical wellbeing?

Lifestyle is more important than ever.  In fact many children and women may find that they can manage their symptoms significantly with appropriate lifestyle measures.  Here are several that can generally provide meaningful benefits:

Feed your brain – Consider improving the types of carbohydrates you are consuming and reducing quick release sugars and processed carbs such as white flours and rice.  Make sure you are eating plenty of protein, healthy fats and a good variety of rainbow coloured fruit and veg.

Stay hydrated – Drink plenty of water and herbal teas.  Minimise caffeine (although some people with ADHD find a moderate amount is helpful) and alcohol.

Consider supplementing – ADHD brains burn through certain vitamins and minerals more quickly.  So a well designed multi or a combination of supplements can be helpful.  Always consult with a doctor or nutritionist if you are unsure what is right for you.

Regular activity – Find types of movement that you enjoy and incorporate small amounts of movement into your working day too.  Getting out into the fresh air makes it even more beneficial!

Seek support – There is a huge range of different ways you can get support and what is best for you in very individual.  While some women will find talking to friends and close family helpful, others may like the sense of belonging of an ADHD community or need a specialist such as a counsellor or other therapist.

Streamline your life – This may sound easier said than done, but it may be worth assessing everything that is requiring your attention at present and considering which might not be priorities.  If life feels overwhelming, there are ways to regain control such as certain organisational apps or tools, or hiring some help with tasks such as decluttering, admin or childcare.  Spending some time with a coach or putting everything down on paper might help you to sort through what you need.

Find some stress relief tools – There are lots of different options such as breathwork, meditation, massage and other therapies.  Claiming back some time for more sleep or a wind down routine can also help.

Victoria Bell is a Registered Nutritional Therapist, Health Coach, Breathwork Coach, Yin Yoga Teacher and qualified as a Mindfulness Teacher for Children.  To enquire about getting support you can contact her here or book a free 30-minute Health Review here.

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