Have you been walking into rooms lately and realizing you have no idea why you’re there? Or maybe you set out to fold the laundry, and half an hour later you’ve started six unrelated projects and have exactly two folded towels. If you’re a woman in your late 30s, 40s, or early 50s, join the club. Cognitive hiccups are a common—and annoying—phenomenon of perimenopause.
But here’s something else to consider: Studies show that the number of women being diagnosed with ADHD has skyrocketed in recent years. The classic “disruptive schoolboy” stereotype is starting to shift as researchers learn more about ADHD and how it presents in adults. As a result, more women are recognizing ADHD symptoms in themselves.
Both ADHD and perimenopause can mess with focus, memory, organization, and emotional regulation. Both can make you feel scattered, forgetful, and not quite like yourself.
“I’ve actually had quite an uptick in the last few years of women in perimenopause and menopause, just because there’s more awareness surrounding ADHD now,” Sanam Hafeez, PsyD, a neuropsychologist at Comprehend the Mind in New York, tells SELF.
To be clear, ADHD isn’t something you suddenly develop in midlife. It’s a neurodevelopmental disorder, which means you have it when you’re born. But in past years, girls were less likely to get an ADHD diagnosis as kids because their symptoms weren’t disruptive or hyperactive in stereotypical ways. Instead, they’re often daydreamy, disorganized, chronically overwhelmed, or constantly overcompensating.
Sound like you? Read on.
Two different conditions with some similar symptoms
In order to understand the link between perimenopause and ADHD, it’s important first to understand how both impact brain and cognitive function.
Perimenopause is the long, confusing stretch of time leading up to menopause (one full year without a period). It can be hard to tell when you’re perimenopausal, because there’s no official diagnostic test for it. And the time period varies wildly from person-to-person.
During perimenopause, hormones like estrogen start fluctuating unpredictably. Estrogen receptors exist all over your body (including your brain), and those shifts can affect way more than your cycle. These shifts impact cognitive function.
“Some of these symptoms can last for seven to 10 years on either side of when that last period is,” Sara Deatsman, MD, a certified menopause practitioner through the Menopause Society and clinical assistant professor of ob-gyn at the University of Florida College of Medicine, tells SELF.
“It causes changes in verbal memory,” says Dr. Deatsman. “Things like not recalling names, losing focus, or losing your train of thought.”
ADHD on the other hand, is tied to how certain neurochemicals (dopamine and norepinephrine) work in your brain areas responsible for executive functioning. These are the skills you need for planning, time management, working memory, staying focused, and finishing tasks. They’re also the types of symptoms women with ADHD are most likely to experience: prone to misplacing things, forgetting information, and trouble staying on task.
Even the “hyperactive/impulsive” symptoms of ADHD can look different in women than you might expect, says Dr. Hafeez.
“People don’t have to bounce off the walls to have hyperactivity or impulsivity,” she says. “They can be sensation seeking, which means they need something to get them going. And this is why they can be hooked on caffeine or Red Bulls, for example. Or need a deadline to get things done.”
Yes, both can coexist.
Sometimes perimenopause exposes ADHD that’s been flying under your radar for years. Your fluctuating hormones can amp up symptoms you’ve previously been able to mask or compensate for.
Camille A. Clare, MD, MPH, CPE, FACOG, president-elect of the American College of Obstetrics and Gynecologists tells SELF that although studies are inconsistent in showing there’s a relationship between ADHD and menopausal symptoms (some research shows no difference at all), there is some data suggesting that menopause can significantly worsen ADHD symptoms.
“In those with decreasing hormonal levels, especially estrogen levels, this decline affects another hormone called dopamine, which causes brain fog, problems with attention and memory, and disorganization. This can worsen symptoms in those with ADHD.”
Your symptoms may have been manageable for years, but now hormones have changed the equation. Strategies that once worked may suddenly fall apart. Medications may feel less effective. And that’s because your brain chemistry has shifted.
Here’s the reassuring part: perimenopause may be long, but it isn’t forever. “For the majority of women these things can rebound post-menopause,” says Dr. Deatsman. “This is not a permanent forever thing.”
Look to your health history for clues, and then speak with a doctor.
It’s useful to collect some information for yourself before seeking out help, not so you can self-diagnose (bad idea), but so you can have an informative and productive conversation with a healthcare provider.
To start, ask yourself if these struggles feel brand new, especially if they showed up alongside cycle changes, sleep issues, hot flashes, or mood shifts. If so, perimenopause may be the main driver. Brain fog usually doesn’t completely derail executive functioning.
But if you can’t get through your workday or finish basic tasks, that’s a sign to look deeper. Also, ADHD usually has receipts—behavioral patterns you’ve overlooked in your past—so it’s time to check them, says Dr. Hafeez.
“Think about your childhood, your teenage years, the trajectory you took to get to where you are now,” she says. “How many things did you start and not finish, for example? Doing that investigative work can help clarify who you should go see for help.”
Depending on your symptoms, that might include an ob-gyn, psychiatrist, neuropsychologist, or your primary care physician. Any of them can refer you to a different provider if you have a need for more specific treatment for ADHD or other conditions.
Related:
- What Women Are Actually Getting Out of Those Menopause Retreats
- There’s a New Guidebook for Women in Perimenopause and Menopause Who Just Don’t Care
- 4 Ways ADHD May Affect Your Eating Habits—ande How to Get Back on Track
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