ADHD in Women

This is the first in a series of blogs about how women with ADHD navigate their unique challenges. She/her pronouns are used, but these concerns can impact those in gender transition and/or anyone with a uterus.

Andrea used to think she was losing it. For several days every month, she’d be unable to focus, sad, and more disorganized than usual.

“It was like I fell off a cliff. All the systems I had in place to keep me on track were pointless and I would cry if someone looked at me the wrong way on the street,” she says.

For years she wondered why she couldn’t muster the energy or focus to execute basic tasks at home and work around the same time each month.

Diagnosed with ADHD in her late 20’s, Andrea takes stimulant medication and has stabilized on a dose that overall works very well for her. When she noticed it wasn’t as effective as usual, she started to wonder why her male friends with ADHD didn’t have the same experience.

Concerned and curious, she spoke with her doctor.

The estrogen connection

Turns out estrogen plays a crucial role in the production of neurotransmitters in the brain, including dopamine, norepinephrine, and serotonin. They all play a role in cognitive function, so when they’re running low, it can have dramatic and unwanted impact.

When someone with a uterus experiences an average 28-day cycle, estrogen levels remain steady, but around the 14-day mark, called the luteal phase, progesterone production begins to minimize the beneficial effects of estrogen.

For women with ADHD this time of the month, emotional storm clouds gather and it may feel like stimulant medications aren’t working.

“Even with my medication, I would struggle to get to work on time and it felt like I had to make excuses for late deadlines,” says Andrea. “It was like walking through a soupy fog for two or three days.”

In addition to lowered focus, decreased estrogen can lead to anxiety, irritability, trouble sleeping, low libido, and even depression.

It’s no wonder Janice struggled!

​Neurotransmitters and Medication

Widely considered the standard treatment for ADHD, stimulant medications are either methylphenidate based or amphetamine based and they work by blocking re-uptake of dopamine and norepinephrine, leading to higher available levels in the space between nerve cells, known as the synapse. Note: not everyone benefits from this treatment, it’s important to speak with a professional familiar with stimulant therapy.

Some studies point to estrogen aiding in the effectiveness of stimulants, but more research is definitely needed.

The good news is there are ways to manage your well-being. Some women find relief through doctor-monitored hormone treatment, others find reducing caffeine and making dietary and exercise adjustments are helpful.

For Andrea, adjusting her birth control prescription and stimulant medication made a big difference. She feels more even-keeled throughout the month.

“I know folks often talk about medication feeling like putting on glasses for the first time, but that’s exactly what happened when I adjusted my birth control pill and stimulants. I feel amazing!”

She says even though this has helped her, she still has sad days from time to time. She also says it’s always wise to work with a medical professional.

Some other suggestions to help gain control of your focus and well-being:

  1. Keep a diary of your menstrual cycle and highlight problem days
  2. Focus on getting enough sleep
  3. Reduce caffeine
  4. Speak with your doctor about your ADHD medication, it may be time for an adjustment
  5. Eat a well-balanced diet with plenty of fruit, vegetables and healthy proteins

Wherever you are on your ADHD discovery journey, it’s important to educate yourself and practice self-compassion.

ADHD in Women: What You Need to Know

  • Adult women with ADHD are more likely to be diagnosed later in life than men. This is because ADHD symptoms in women can be different from those in men and can be more easily overlooked.
  • Common symptoms of ADHD in adult women include difficulty organizing and planning, problems with time management, forgetfulness, and difficulty paying attention.
  • ADHD can significantly impact a woman’s life, including her work, relationships, and overall well-being.
  • If you are an adult woman concerned that you may have ADHD, it is important to talk to your doctor. They can assess your symptoms and refer you for further testing if necessary.

Managing ADHD in adult women

  • Get organized. Create systems and routines to help you stay on track. This may include using a to-do list, setting deadlines, and breaking down large tasks into smaller ones.
  • Delegate tasks. Don’t be afraid to ask for help from others. This could include delegating tasks at work or asking your partner or family members for help with household chores.
  • Take breaks. When you feel overwhelmed, take a short break to clear your head. Go for a walk, listen to music, or do something else that you enjoy.
  • Get enough sleep. When you’re well-rested, you’re better able to focus and manage your symptoms.
  • Exercise regularly. Exercise is a great way to reduce stress and improve your mood. It can also help to improve your focus and concentration.

If you are struggling to manage your ADHD symptoms, many treatments are available, including medication and therapy. Talk to our doctor about the best treatment options for you.