Feeling Hot, Hot, Hot? ADHD, Menopause, and Why Your Brain Suddenly Feels Different
Conversations with women have been turning hot lately. No, it’s not the spicy summer romance novel book clubs. It’s the buzz of menopause and perimenopause that have us chirping. There is a lot of hype on the socials about perimenopause and menopause. I love this gal on IG. It’s the pantiliner stuck in her headband that really cracks me up. IYKYK.
What’s been showing up in the sessions? Women who have been doing just fine until now. It’s like the things they used to be able to do with their eyes closed feel like climbing Mt. Everest. Coming up with a word, regulating emotions, staying organized, remembering the to-do list or the grocery list. They were getting by on caffeine and gangster rap and now – shit is hitting the fan.
Someone at some point mentioned ADHD to these women and they brushed it off. Or maybe they used Adderall in college when they really had to focus, but no longer use it. They have a surface level understanding of ADHD and what it looks like, but when we dive into how ADHD has shown up throughout their lives, there are some big “Aha” moments.
This blog will cover a brief description of ADHD symptoms, a summary of hormone fluctuation across the lifespan, and how these two topics intersect.
Main points, no filter:
✅ The wheels didn't suddenly fall off—you've been driving uphill without realizing it.
✅ Hormones can change how well your ADHD brain functions from month to month and year to year.
✅ Menopause often reveals ADHD that has been compensated for decades.
✅ If your planner, caffeine, and sheer determination aren't cutting it anymore, there's a biological reason.
✅ You deserve answers grounded in science—not just another TikTok telling you everything is perimenopause.
First, I want to do a quick recap of ADHD. For a more in depth read, check out my previous blog on ADHD and women or this page that outlines ADHD in adults.
Understanding ADHD Before We Talk About Hormones
What is ADHD?
ADHD is what psychology refers to as a “neurodevelopmental disorder”. This means that it starts in childhood and impacts how the brain grows and functions. In ADHD specifically, dopamine, norepinephrine, and serotonin levels inhibit the brains ability to focus, sustain motivation, and regulate emotions (plus more). Under the umbrella of neurodevelopmental disorders are a handful of other diagnoses like autism spectrum disorder, specific learning disorders, and communication disorders.
The clinical diagnosis of ADHD comes with what clinicians call “modifiers”. The modifier specifies the type and severity of ADHD. The three types are inattentive, hyperactive, and combined (a mix of both inattentive and hyperactive). These symptoms show up before the age of 12 and are persistent across various domains. The symptoms show up at home, school/work, and other contexts. Please remember that this is not a comprehensive list of symptoms and that each person’s presentation of symptoms shows up in different ways.
The Three Presentations of ADHD
The inattentive symptoms of ADHD
These are the daydreamer type presentation. Folks with inattentive ADHD have a hard time getting started on tasks, are forgetful, have a tough time completing tasks, and are easily sidetracked.
Hyperactive-Impulsive Symptoms of ADHD
These symptoms are the “driven by a motor” symptoms. Folks with the hyperactive ADHD subtype have trouble sitting still, can interrupt others when talking, overly talkative, or impulsive.
The combined presentation
As the name suggests, this is a mixed presentation of symptoms.
Why ADHD Looks Different in Girls and Women
One of the tricky things with ADHD is that the symptoms listed above can present differently in girls and women. This article from ADDitude Magazine states “ADHD symptoms in women and girls aren’t “hidden” or “easy to miss.” They are obvious, persistent, and often quite serious.” Girls experience the same symptoms as boys but here’s what else is happening:
they more often mask the symptoms because they are taught early by society to “sit still and look pretty”
the symptoms are attributed to another diagnosis like anxiety or depression
for teens and women, the symptoms fluctuate with hormones so there is a lack of consistent presentation throughout the cycle.
“Women with ADHD face many of the same symptoms as their male counterparts, it’s true — but they also labor under the added burden of restrictive gender roles, fluctuating hormones, and a greater tendency towards self-doubt and self-harm. And emerging research reveals that while their daily symptoms may mirror each other, in the long-term, men and women with ADHD actually face dramatically different outcomes.” Read more from the article here.
How Hormones Change Across a Woman's Life
If we want to be informed about hormonal impact on ADHD symptoms, we first need to understand the hormonal fluctuation.
Puberty and the menstrual cycle
Puberty begins typically between ages 9 and 11. When this happens estrogen and progesterone levels increase. The menstrual cycle begins with menstruation (your period) and has distinct phases and events. The Cleveland Clinic has an in-depth description of each phase. What we will focus on here is the change in hormones during each phase.
Phase 1: The menses phase – Aunt Flo comes to town and hormone levels drop
Phase 2: The follicular phase - estrogen starts to increase
Phase 3: Ovulation
Phase 4: The luteal phase - there is another less dramatic increase in estrogen before it starts to decline again
Pregnancy and the postpartum period
Hormones steadily increase during pregnancy and then go back to the previous levels after birth.
Perimenopause and menopause
The buzzword we’ve been hearing is perimenopause. The start of perimenopause can begin up to ten years before menopause and includes a drop of hormones by 65%. Menopause, the official retirement of your ovaries, is marked after 12 months of no periods. Then you shift into postmenopause with a relief of those acute menopause symptoms and a permanently lower level of hormones. Caution! The hot flashes are gone, but there is an increased risk of health conditions like osteoporosis and cardiovascular disease for you to look out for.
The science behind hormones and ADHD
Now that we have a better understanding of the hormone changes across the lifespan, let’s talk about how this impacts ADHD symptoms.
The Connection Between Estrogen, Dopamine, and ADHD
Remember the dopamine, norepinephrine and serotonin mentioned earlier? They ride shotgun with estrogen. As one increases so does the other. And as one plummets, so does the other, just like Thelma and Louise.
When ADHD Symptoms Tend to Increase
✅Before your period
✅During adolescence
✅During perimenopause
✅During menopause
Why ADHD Often Feels Worse During Menopause
Why Your Usual Coping Strategies Stop Working
The marked decrease in estrogen also means there is a decrease in the ability to handle all the things that you have been handling. During menopause you are less able to focus and regulate emotions. The strategies that you have developed over the years stop working, because they were based off a certain level of hormones and chemicals in your body. The sleep disruptions from hot flashes or night sweats make these changes even worse.
Is it ADHD, menopause, or both?
The changes that happen during perimenopause and menopause can mimic symptoms of ADHD. The level of dopamine decreases as estrogen decreases so the executive functions will be impacted.
ADHD can become more noticeable during menopause because your skills that have been working all along relied on your pre-menopause level of hormones. This explains why some women are diagnosed later in life, they just can’t keep up anymore.
It is important to get a comprehensive assessment by a professional with experience in ADHD in women. You can look up local professionals on the CHADD website.
Managing ADHD During Perimenopause and Menopause
Adjusting Your ADHD Treatment Plan
Sometimes just knowing that your symptoms will fluctuate can help. You can give yourself some grace and set different expectations on low energy days. If you are taking stimulant medication, talk to your doctor about adjusting the dose around your period. And, as always, prioritizing sleep, exercise, and therapy will help.
Considering Hormone Therapy
You can work to better balance your hormones with supplements or medications. You may be a candidate for hormone replacement therapy. This is a personal choice and should be done with the guidance of a medical professional that knows your history.
Don't Get Your Medical Advice from TikTok
With the increased hype, there is also increased misinformation. Social media and AI are easy to use and readily available which can make it seem that every symptom is linked to perimenopause or menopause. Ladies, the best way to advocate for yourself is to not use social media and AI as your reference. Read respected and validated publications. Instead of taking TikTok as gospel, use it as a starting point. I am not saying that the information is wrong I am saying look further into the information that is presented to you and get the full context. If you aren’t sure where to start, I have listed some articles below.
Final thoughts
If you need support understanding ADHD symptoms or navigating the shit storm of fluctuating hormones, I’m here to talk. Schedule a consult to see if we are a good fit.
Looking for a place to start? The articles below were referenced in this blog.
ADHD Symptoms in Women Aren’t ‘Hidden.’ They Are Misinterpreted.
[Self-Test] Is It Perimenopause or ADHD?
“ADHD and Menopause: The Perfect Storm No One Warned Us About”
“I Could Have Been Myself for So Much Longer.”
“My ADHD Was Hidden Beneath Layers of Success — Until It Wasn’t.”
A collection of women’s health articles form ADDitude Magazine