Guest Blog: ADHD and Perimenopause
By ADHD Coach Caroline Ross
ADHD during perimenopause is something I’m seeing more and more in clinical practice. For many women, this stage brings a noticeable shift in focus, emotional regulation, and overall capacity.
I asked ADHD coach Caroline Ross to share her perspective and practical strategies for women navigating this stage.
Is your ADHD becoming more challenging or obvious during the perimenopause?
You’re not alone. Many women first discover they have ADHD at this stage of life when new symptoms appear or previously tolerated symptoms become unmanageable.
One of the key reasons for this is hormonal. Fluctuations and overall decreases in oestrogen and progesterone, our key female hormones, directly impact focus, memory and mood.
Oestrogen helps to produce dopamine and serotonin, two key neurotransmitters known to be deficient in people with ADHD. Progesterone helps to reduce anxiety and supports sleep. So it makes sense that women with ADHD notice these midlife changes much more than neurotypical women do.
Other contributing factors
But there are also other reasons. Women with a late diagnosis may have spent their whole lives overworking to compensate for difficulties or people-pleasing to fit in and to reduce Rejection Sensitive Dysphoria (RSD).
This masking potentially takes a huge toll on the body and nervous system, and eventually becomes unsustainable, leading to chronic fatigue and burnout.
Practical strategies to support ADHD during perimenopause
The good news is that with awareness, knowledge and support, we can establish habits and strategies to better weather the storm. Here are a few things that can help:
Nutrition
Many of our neurotransmitters including dopamine and serotonin are made in the gut. Therefore, by eating the right foods, we can stimulate their production to support our ADHD.
Eating protein with every meal, plenty of fibre, healthy fats as well as fruit and vegetables in the colours of the rainbow is a great place to start.
Adding in goodness first before reducing alcohol, sugar and ultra processed food is usually a better strategy when you have ADHD.
Movement
Exercise is great at every age because it supports both the body and the brain. Moving our bodies releases several feel-good hormones that support our ADHD.
Don’t worry too much about the type, timing, or duration of exercise; instead tap into the ADHD brain’s interest-based nervous system and move your body in a way that feels good, is fun and enjoyable.
This could be bouldering, rollerblading or joining an outdoor fitness class with a friend. Strength training is highly beneficial during the perimenopause and beyond so if you can incorporate it, even better.
Sleep
A good night’s sleep helps reduce ADHD symptoms. People with ADHD often have a delayed circadian rhythm meaning they wake up later and go to bed later. We can influence this by getting daylight first thing in the morning. This will make it easier to go to bed earlier.
Eating well, moving our bodies and reducing stress also promote better sleep. Another helpful tip is to do a brain dump before bed – this could be in a journal, on a whiteboard or dictating into your phone – in order to find a home for the thousands of ideas that often circulate inside our ADHD minds.
Stress
When oestrogen is high, cortisol – a key stress hormone – is kept at bay. But as oestrogen declines during the perimenopause, frequent rises in cortisol are usually felt more intensely, and we may struggle to relax.
Taking frequent breaks, spending time in nature and with animals, and making time for creative hobbies will help the ADHD brain unwind. Incorporating breathwork, tapping and moving meditation are highly beneficial in the moment as well as a preventative practice.
If you have a stressful job or work environment, speaking to your manager about reasonable adjustments may also help. Paying attention to and reducing other sensory stressors as much as possible also reduces stress levels. Chronic stress may eventually lead to burnout so it’s worth investing time now to reduce yours wherever you can.
Connection
Connection with others is a fundamental human need which releases oxytocin – another key neurotransmitter involved in social bonding. For those of us with ADHD, we perhaps need this connection even more because it energises us and really gets us going. Think of it as starting the engine of a car. And all of a sudden you’re able to tackle that to-do list.
I always recommend my clients schedule some connection first thing in the morning (perhaps going for a power walk in the park with a friend) so they can focus and feel good for the rest of the day.
Building supportive habits
As you can see, many of the tools that support ADHD don’t cost a fortune or even take up much time. They do, however, require some intention, action and consistency to become firm habits.
Once these habits are ingrained, we can incorporate other helpful strategies. One of those is mindset. Adopting a healthy and helpful mindset towards your own ADHD – talking to yourself with curiosity and compassion the same way you would a dear friend – will work wonders for how you experience and manage your ADHD. And once you manage it well, you’ll be able to finally thrive and make use of all your wonderful strengths and unique qualities.