Women, Hormones, and ADHD

The severity of ADHD symptoms will change during the course of a woman’s cycle. Here’s what you need to know to manage them.

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ADHD and Childbirth

Diagnosed with ADD at age 29, Becca Keeton, of Lomita, California, took stimulation medication for a year before she tried to become pregnant. "I went off ADD medication in my thirties, when I was pregnant with and nursing my three children," says Keeton. "During the first month of each pregnancy, my ADD symptoms worsened. During my second pregnancy, I was in three minor car accidents — all my fault — in the first month. As time went on, my ADD symptoms improved, and I felt better while nursing my babies, too." Now, in her mid-forties, with her childbearing years behind her, Keeton takes Adderall daily, and says that upping her dose in the days before her period helps control her ADHD symptoms, which typically worsen at that time.

Hormonal Effects on ADHD

Virtually all hormone levels change during pregnancy, mostly because the placenta produces hormones itself and stimulates other glands — like the adrenals and the thyroid — to produce more hormones, as well. As hormone levels rise in the first months of pregnancy, moms-to-be with ADD experience fatigue, mood swings, and anxiety. But as estrogen levels rise as pregnancy progresses, many women with ADD say they feel better.

"Some research shows that panic disorder improves with each trimester of pregnancy, and relapses after delivery," says Quinn. "It’s possible that a similar pattern occurs with ADD."

Quinn points out that, while there are no studies showing that ADD symptoms improve during pregnancy, there is anecdotal evidence that they do. “I get letters and case summaries from women, saying how much better they felt during pregnancy,” she says.

In the weeks after childbirth, hormone levels drop. While these hormone drops can lead to mood swings, sometimes called “the baby blues,” and to postpartum depression in all new moms, women with ADD may be more prone to depression.

Solutions: You and your doctor should re-evaluate your ADD treatment during your pregnancy and when you are breastfeeding. Studies show that some stimulants used to treat ADD may lead to heart defects and other problems in developing fetuses. Breastfed babies may develop addiction problems later in life if their moms took stimulant medication while nursing.

Certain antidepressant medications appear to be safe to take during pregnancy and breastfeeding, but you and your doctor should discuss all of your options and determine what’s best for you. Due to the hormonal changes discussed above, many women find that going off ADHD medications allows them to function better.

“Beyond medication, it’s important to get help during pregnancy and after the baby is born,” says Nadeau. “Although hormonal changes may improve ADHD symptoms, the stress of work, pregnancy, caring for other young children at home, and the anxiety of getting ready for a new baby may counterbalance any hormonal benefits.”

Next: The Change and ADHD

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