You’re “of a certain age” and suddenly your memory has so many holes you call it “swiss-cheese brain.” You lose things more frequently, and your get lost in your thoughts, distracted in a heartbeat. Women who have been diagnosed with attention deficit hyperactivity disorder (ADD/ADHD) sometimes panic, worrying about their worsening symptoms. Women who have not yet been diagnosed with ADD/ADHD who experience these sometimes-debilitating symptoms ask their doctor, “What’s happening? Do I have ADD/ADHD ... or Alzheimer’s?”
Regardless of whether you have ADD/ADHD or not, menopause influences everything! After “the change,” women’s estrogen levels drop about 65 percent, which affects the uptake of dopamine and other neurotransmitters. Less estrogen means lower dopamine and serotonin levels, causing the onset of ADD/ADHD-like symptoms: increased difficulty concentrating, memory dysfunction and cognitive problems, and less mental clarity. If you have ADD/ADHD, the further decrease of dopamine, from your already-low levels, means that existing symptoms get worse and new ones pop up.
Are These Symptoms of Menopause or ADD/ADHD?
Some women who have had undiagnosed ADD/ADHD all of their lives find that worsening symptoms send them to their doctor’s office looking for answers. But ADD/ADHD-like symptoms do not always indicate the presence of the condition. If you have only recently developed symptoms (and they haven’t been present since childhood), then menopause is probably the culprit. Talk with your doctor about symptom relief.
If you’ve been diagnosed with ADD/ADHD, menopause’s effects on the condition often require treatment adjustments. Work with your doctor to increase medication dosage, or to try an extended-release med, get more exercise (which can sharpen focus and, in the process, reduce the odds of developing osteoporosis), and consider hormone therapy. For many women, the best course of treatment is estrogen, for three to four months, followed by 10 days of progesterone.
Complicating matters is the fact that about 85 percent of women experience some sexual dysfunction after menopause. Just when you could use humor and support from your partner to cope with “swiss-cheese brain,” you may find that your relationship becomes more strained.
Treat Your Symptoms
It is important, at every stage of your life, to keep ADD/ADHD symptoms under control. This may mean working with several professionals -- a psychologist, an internist, and a gynecologist. Educate yourself about ADD/ADHD and what’s going on with your body, keep lists of medications, and chart your symptoms. Doctors rarely consider hormonal fluctuations when developing a treatment plan.
If you have problems with paying attention, getting organized, and keeping your life on a steady keel, a professional may prescribe a stimulant, even in the absence of an ADD/ADHD diagnosis. But this should be done in the context of a comprehensive, multi-modal plan that includes everything from nutritional changes and exercise to psychotherapy and hormone-replacement therapy. As for those problematic sexual changes, helping your partner understand that they are normal is a good place to start.
More on Women and ADD/ADHD
This article appears in the Winter issue of ADDitude.
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