By Brian Wu, MD, MD, PhD
Clinically reviewed by Dr. Raafia Muhammad, MD, MPH
ADHD is often thought of as a “childhood” condition, but many people will continue to have symptoms of this disorder throughout their entire lifespan. The National Institutes of Health estimates that overall prevalence of ADHD is 4.4% for adults of both sexes. For women, the prevalence is 3.2%.
And for women negotiating both menopause and ADHD, the issues can be both complex and challenging. The good news? There are many options available to women to manage them both.
How Can Menopause Affect ADHD?
There are a number of things women entering menopause should be aware of if they also have ADHD:
Sex Hormones Affect the Brain Too
While most people think of estrogen as primarily a sex hormone, both estrogen and progesterone have been the topic of neurological research in recent decades, according to Frontiers in Neuroscience. A growing body of evidence shows these hormones — particularly estrogen in the form of estradiol — have an effect on various neurotransmitters, which are chemicals that act as messengers to different parts of the brain. Studies have found that during parts of a woman’s monthly cycle, when estrogen levels are high, there is an improvement in many cognitive functions, including working memory and impulse control.
The hormonal changes, such as the drop in estrogen levels, that occur before and during menopause can affect brain function. However, researchers in the journal Neurobiology of Aging note that this is not true for all women and that genetics can play a role in just how much of an effect menopause has on an individual woman’s cognition. However, Psych Central.com does note that the decreased estrogen has been shown to worsen symptoms of ADHD that are already present.
Some Symptoms of Menopause and ADHD can Overlap
Another issue that can muddy the waters for menopausal women with ADHD is that these two conditions can have some symptoms in common. These can include changes in sleep patterns, a decrease in sex drive, memory issues, decreased energy levels and increased anxiety or worrying, according to Psych Central.com. This overlap can leave women confused about just what is causing their symptoms.
What are the Treatment Options?
For women dealing with the challenges of both menopause and ADHD, there are several varied treatment options to consider. These can include any of the following:
Unfortunately, there is no one medication to treat both menopause and ADHD so these conditions will have to be treated separately. That does not mean, however, that women are without options. The gold standard treatment for ADHD remains stimulant medications. But there are also a number of nonstimulant treatments available for those who do not tolerate stimulant therapy. ADDitude Magazine notes that for women who have issues with depression or anxiety, selective serotonin reuptake inhibitors, or SSRIs, can help reduce these issues. A dietary supplement called S-adenonsylmethonine, or SAMe, can be used as an alternative if SSRIs are not tolerated. SAMe is a naturally occurring compound in the body; the supplement contains a synthetic version.
Hormone Replacement Therapy
Healthline.com reports that hormone replacement therapy — HRT for short — can help women deal with menopausal symptoms stemming from drops in estrogen levels. HRT may also help ADHD symptoms that have been made worse by these hormonal fluctuations. ADDitude Magazine notes that estrogen-only replacement therapy is often used to alleviate symptoms that stem from the falling estrogen levels occurring during menopause.
Medications and hormone replacement are not the only options available. According to ADDitude Magazine, there are several different kinds of psychotherapy that can help to reduce some of the overlapping symptoms of ADHD and menopause. For example, cognitive behavioral therapy, or CBT, can improve cognitive functions and make it easier to manage a schedule, plan ahead and remember things. CBT helps people learn how to identify and change negative thought patterns that influence their behavior and emotions. A type of cognitive behavioral therapy called dialectical therapy can make it easier to deal with the mood swings or changes in emotions that menopausal women can experience.
Psych Central.com notes that women can be greatly helped if their therapist is willing to communicate and work with their gynecologist. That way, a team approach can serve a woman’s complex needs.
The non-profit organization Children and Adults with ADHD, or CHADD, recommends that women with ADHD who are also going through menopause keep a journal to track any symptoms that they are concerned about. This can help you and your doctor discover possible patterns — and it can also give valuable information that can inform what kind of treatment plan to pursue.
A Healthy Lifestyle
ADDitude and Healthline agree that an overall healthy lifestyle can also help women who are dealing with menopause and ADHD. Getting adequate rest, exercising regularly and managing stress can, along with other appropriate therapies, help alleviate symptoms. CHADD also recommends a healthy diet for both treatment of symptoms and the balancing of hormones. A 2021 review of current knowledge of nutrition in menopause, published in the journal Nutrients, found that a Mediterranean-style diet (with an emphasis on fresh fruits and vegetables, whole grains, and healthy fats like olive oils) was most beneficial for menopausal women.
In summary, the changes in a woman’s body during menopause can be more challenging if that woman also has ADHD. Hormonal fluctuations, particularly the drop in estrogen levels, can make ADHD symptoms harder to deal with.
But a variety of treatment options — from traditional medication therapy with stimulants or non-stimulant drugs to hormone replacement to lifestyle changes — can help women manage both menopause and ADHD.