Part 1: How Hormonal Fluctuations Can Affect a Female’s ADHD Symptoms

Part 1: How Hormonal Fluctuations Can Affect a Female’s ADHD Symptoms

Part 1: How Hormonal Fluctuations Can Affect a Female’s ADHD Symptoms

Adapted from the CHAAD Weekly ADHD Weekly Newsletter August 2017

Part I: Is It PMS or ADHD?

Most women I know experience the symptoms of premenstrual syndrome to varying degrees. One question I think is very important to ask is:

Are women with ADHD especially vulnerable to PMS symptoms?

Recent studies show that sex hormones play a role in regulating communications between brain cells and can negatively affect executive function. To understand the role of hormones in ADHD, experts are now calling for new research focusing on the subtle fluctuations and combinations of hormones that influence emotions and executive function.

Researchers Ronit Haimov-Kochman, MD, and Itai Berger, MD believe the investigation of the role of hormones could generate new and improved diagnostic and treatment strategies that could change the course of cognitive-behavioral disorders like ADHD.

So what’s Going On In Your Brain?

  • On the first day menstruation starts, estrogen levels begin to increase. This is the beginning of the menstrual cycle, and sometimes results in an increased sense of wellbeing.
  • When ovulation occurs (10-17 days after the first day of menstruation), estrogen levels take a dive and progesterone levels increase. Moods can take a turn, with increased irritability and lower energy levels.
  • In the last days of the monthly cycle, both estrogen and progesterone drop, causing a significant shift in mood and energy for most women.
  • When estrogen drops, so do dopamine levels, which are already low in the brain affected by ADHD. Symptoms of ADHD are magnified at this time; and you may experience:
    • Sadness and mood swings
    • Difficulty sleeping
    • Irritability
    • Anxiety
    • Confusion
    • Fatigue

According to Patricia Quinn, MD, a developmental pediatrician, ADHD symptoms usually worsen a few days before the start of the menstrual cycle,.

The First Step: Recognizing the Symptoms

Simply recognizing your periodically changing hormones can have a significant effect on your ADHD symptoms. Recognize that ADHD is a brain-based disorder with increasing evidence that it is strongly impacted by hormones. Take the time to educate yourself and find good healthcare providers who will listen and help you find the best treatment options for your unique symptoms.

“The majority of clinicians don’t understand the impact of hormones on ADHD symptoms,” says Terry Matlan, MSW, ACSW, a psychotherapist and ADHD coach who specializes in ADHD in adults, with a special focus on women. “If a girl or woman is undiagnosed, she sees herself as lacking or less-than, rather than understanding it is part of a disorder. That leads to shame, which impacts all aspects of her life.”

Tools and Strategies

In order to identify the influence of hormones on your ADHD, you should keep a log of your menstrual cycles along with a daily log of your ADHD symptoms and share the data with your doctor, to support an optimized treatment regime. Your doctor may adjust your medicine accordingly.

You should also educate yourself on this topic as much as you can, focus on self-care, engage in mindfulness training and learn behavioral therapy techniques (see Part II of this article for details).

Perhaps most importantly, Terry Matlan urges women and girls to learn to embrace the difficulties of ADHD. “If you pretend it doesn’t exist, you won’t be a whole person,” she says.

Do you think you can benefit from hiring a professional ADHD coach? Are you ready to hire a coach that can help you manage your ADHD symptoms and thrive? Contact Kimberly at or to schedule a consultation to learn more about ADHD coaching with KPC.

NOTE: Discover additional tools and strategies in Part II of this series: How We Can Help Our Daughters with ADHD