General/Women's Health

ADHD and Hormones

It was during a meeting when my Chair Louise asked me whether I had considered that I might have ADHD.  I was on Zoom (obviously) having a meeting with her, taking notes, checking emails and painting my nails. What was abnormal about that, I wondered. Isn’t this how everyone has meetings online?

Turns out it wasn’t and a lot of things about me and my life dropped quietly into place after further reading. It took a year of investigations, some therapy and eventually a meeting with a harassed psychiatrist online to formally diagnose me with Combined Adult Female ADHD. It was like my life had gone from 35mm film to Super HD and the jury is still out as to whether I am happy about that change. For one thing I am terrified about my kids inheriting it (it tends to run in families) and for another, it just feels like people actively want it. Which is a bit weird as frankly I’d have loved not to have it.

Because, it’s quite trendy now, ADHD, isn’t it? I say that hesitantly, as I know for many it’s a lifeline to find out why you’re just so whacky but to be honest, I find the amount of press it has had slightly infuriating. The Guardian reported that the NHS has been ‘swamped’ with people seeking diagnosis, Woman’s Hour have done several segments on it (I love a bit of Woman’s Hour so that’s ok). Even the Daily Fail reported on it (link not here….sorry).

In some ways it’s been good. I finally have reasons for my slightly bizarre and nonsensical behaviors. I understand why I get so demotivated (like…ridiculously so these days) and why I cannot bear certain sensations and noises. And why I never….stop….talking.

And then it’s been bad. Why do I have to be the kid who struggled socially, who couldn’t focus, who was smart but clueless? I feel angry about it to be honest. All that bullying and being told I was lazy over and over and over as a child and teenager until I believed it just feels like wasted time.

Get to the point : What’s ADHD got to do with being a Clever Cnt?

I wanted to highlight just how much your body can push things like ADHD into the foreground. Diagnosing ADHD in a child can dramatically help with their future ‘adult ADHD’ and as we all know being Clever about your body is important.

My usual disclaimer. I am not a qualified Doctor. I am not a qualified psychiatrist. I am a normal, tired woman who likes to explore these things because I am….well, interested. In no way did I start this website after hyperfocusing on fertility when I was TTC #1 (facepalms self).

I have written on my blogs before about how my hormonal changes, specifically those estrogen related, seem to put my depression and anxiety into a fever pitch. Well, turns out it’s an ADHD thing as well.

Most of the 3% of adults with ADHD will have been misdiagnosed with depression and/or anxiety in their lives and many of us who were undiagnosed as children or teenagers are finding it’s hitting us hard now in our later thirties through to our late forties. Which is when we tend to have babies or start perimenopause.

Rising estrogen levels coupled with falling progesterone levels have been shown to impact teenage girls and make their ADHD symptoms worse (click for the study). ADHD is a situational condition as well however, so often we’ll have been coasting and masking through primary school and hit secondary where we’re expected to ‘adult’ more, and it all goes to shit, so you have to consider that aspect of it too and not rely solely on the biology. 

ADHD and its comorbid disorders affect the female sex throughout its life. The hormonal fluctuations and transitional periods of life seem to influence the symptoms of ADHD more.

Higher awareness is thus required by health professionals about ADHD behavioral characteristics in girls, adolescent girls and women in their productive period or in menopause to identify the special signs defining the disease, to treat them early and protect the women’s mental health.” 

                       – ADHD Symptoms in Females of Childhood, Adolescent, Reproductive and Menopause Period

In my case and in hindsight my symptoms started worsening during times of high stress or perceived rejection. A boy only had to not call and I was sobbing. If we’d slept together it was worse. I was told again and again that I needed to ‘harden up’ and I never could. I was ghosted by an employer the other week (which happens in freelance world) only to be upset by a social media photo of their admin team all together. The rejection is real in my world and constant.

I remember the weird anxiety I got when I thought my husband wasn’t going to propose. The time friends told us they were pregnant when we were trying for a baby and I sobbed in a toilet for an hour. Then the awful postnatal anxiety when all the estrogen left my body, doing it all again a year and a half later but releasing it MUST be hormone related and finally the grinding mini-breakdown where I was finally given some help through CBT. I’d have to say, snaps for the psychologist who urged me to go and get properly diagnosed in my late thirties.

In laymen’s terms, the reason for these emotional ups and downs is that unlike men (men also have hormonal cycles but they are far less dramatic) our hormones fluctuate at far greater levels and with varying amounts of each hormone. It’s an insanely complex system; when you add in pregnancy and breastfeeding which come with their own hormonal cocktails, it’s even more complex.

Hormone fluctuations affect brain function. One of the places storing hormones is the hippocampus. Women have a larger hippocampus than men (don’t worry men, you have a larger amygdale and hypothalamus) and guess what stores your estrogen receptors? The hippocampus. Hormone fluctuations literally affect brain function; if you can believe it. Women in the menopause are thought to have an increase in blood flow to the peripheral cerebral area caused by estrogens. This affects metabolism and a whole host of other things including cognitive function. 

When you consider that young girls are less likely to be diagnosed with ADHD than boys (this is for a variety of reasons; one example being that they present as un-focused in school which is less disruptive than the hyperactivity that boys often present with) you have a lot of un-diagnosed women who will go into major events in their lives ill equipped and potentially vulnerable. This quotation was one which for me resonated hard:

“Postpartum women with ADHD are very possible to present a deterioration of their symptoms after labour with the presentation of depressive symp-toms. The new challenges of mothers in the postnatal period affect functional skills, skills that ADHD women were already trying to achieve throughout their lives. If they have chosen to stop their medications, ADHD symptoms can come back. ADHD symptoms are similar to those of depression and the symptoms of anxiety are shadowed by the ones of ADHD. Many women in the postpartum period are diagnosed as having depression because clinicians may not know the special characteristics of ADHD in women and may focus on comorbid disorders. Unfortunately, many women with ADHD receive treatment for other disorders but not for ADHD. Semple et al, proposed in 2011 to check women in the perinatal period for depression but also for ADHD symptoms”

                       – ADHD Symptoms in Females of Childhood, Adolescent, Reproductive and Menopause Period

I don’t think my (amazing) GP at the time even considered the idea that I might have had ADHD and neither, let’s be honest, did I. But it shows how these (now obvious with hindsight) symptoms can make something less than obvious. I’m keen to highlight to any of you finding your depression or anxiety peaking with a hormonal change to at least consider a questionnaire to see if you might have ADHD.

If you do find you struggle with hormonal changes and you have ADHD (or suspect you might) then you can help yourself until diagnosis and possible medication. Things are usually smoother in the first two weeks of your menstrual cycle; as estrogens in the brain decrease in the last two weeks, so ADHD symptoms worsen. Taking the pill will help and linking pills will also help and avoid the ‘shelf’ like effect of hormones dropping off every month – ADDitude website says ‘Three weeks of pills that are formulated with estrogen alone, followed by one week of progesterone alone, seem to be especially helpful.’. If you’re a teenage girl please be aware, you are more vulnerable to a number of things like social anxiety, eating disorders and mood swings. 

If you, like me, would like to be a vampire that refuses to get up with the sun, speaking to your GP about a melanin prescription is also helpful. Melanin in a hormone which works to regulate sleep. It can have side affects however as can anything that adjusts hormone levels, so please do discuss this with your GP. You need to have it on prescription.

Taking a good strong dose vitamin D is ALWAYS useful if you’re a fellow pasty Brit to boost mood and eliminate tiredness (as you’ll know from burnout it can be rough, so every little helps), vitamin B12 will also help with the above and many people have suggested a magnesium supplement as well. Magnesium is another thing we’re all deficient in here in the UK so taking one does of 250-300mg can also have ‘a calming affect on the brain’ (read more on vitamins useful for ADHD here). If you want a bit of actual science please see the study below (it is on children so not conclusive):

“Vitamin D and magnesium supplementation in children with ADHD was effective on conduct problems, social problems, and anxiety/shy scores compared with placebo intake, but it did not affect psychosomatic problem scores, significantly”

 – Effect of Vitamin D and Magnesium Supplementation on Behavior Problems in Children with Attention-Deficit Hyperactivity Disorder

So there we are. 

Your hormones do and will affect your ADHD. There are ways you can be helped and help yourself. Look at a good vitamin supplement/supplements (but also be aware science is a liiiiittle hazy – see here). Be prepared for all life stages. Keep an eye on your body as it changes. 

If you are a teenager, please consider the pill but only do so if you’re not medicating your ADHD as it can affect your medication and ALWAYS do so under supervision of a medical professional (but girls, take no bullsh*t eh? Be a clever cnt and do your research! Peer reviewed studies mind, not what Susie read in Glamour).

If you’re planning to get pregnant, have experienced a miscarriage or have had an abortion, be aware these hormone changes might affect you. Raise this with your midwife/clinician/GP/Health visitor during your booking in. Be loud. Please. As someone who experienced this first hand, you will almost certainly need support. Take it. Be kind on yourself. I breastfed fine unmedicated for a year with both babies and it can be done but the advice is to come off all medication during this time. If you feel you need more help and want to continue breast feeding it’s worth looking at the progesterone only pill or a combined pill you can take while feeding. I took it with Baby #2 and it was magic (link to suggested study here, around citation 167) 

Starting menopause? Yes, ADHD is meant to get worse. But it’s Ok! You’ve got this. HRT is a really good option to smoothe those hormones out:

Treatment of ADHD with medication can improve the symptoms which both ADHD and menopause share, and have a positive impact on everyday tasks. Equally, where appropriate, accessing HRT to help stabilise hormonal levels can help out with some of the shared symptoms of menopause and ADHD.”

Women and ADHD: How the menopause can affect women with ADHD

The good news is that if you’re medicating for ADHD it can seriously help with menopausal brain fog so silver linings!

Medicine is incredible and don’t forget the usefulness of talking therapies like CBT or mindfulness. 

I’d love to hear your thoughts on this subject. Please do comment below if you have any ideas, ways to improve or correct information or just say hi!

Links to research Articles and extra reading:

Understanding ADHD in Girls and Women

DIRTY LAUNDRY: Why adults with ADHD are so ashamed and what we can do to help

The ADHD Parenting Guide for Girls: From Toddlers to Teens Discover How to Respond Appropriately to Different Behavioral Situations

Women with Adult ADHD: An Unconventional Guide to Breaking Through Barriers! Learn Essential Life Skills from Theory to Practice to Deal with ADHD and Stop Feeling Like a Failure

Some good ADHD influencers to follow:

Amanda Perry :

I am Paying Attention :

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