ADHD in Women

Is it ADHD or Menopause?

Menopause affects memory, attention, and relationships as women get older — but that doesn’t mean it’s ADHD. Here, how to diagnose and treat your symptoms.

Doctor and patient discuss the overlapping symptoms between ADHD and menopause.
Doctor and patient discuss the overlapping symptoms between ADHD and menopause.

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 (ADHD) sometimes panic, worrying about their worsening symptoms. Women who have not yet been diagnosed with ADHD who experience these sometimes-debilitating symptoms ask their doctor, “What’s happening? Do I have ADHD … or Alzheimer’s?”

Regardless of whether you have 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 ADHD-like symptoms: increased difficulty concentrating, memory dysfunction and cognitive problems, and less mental clarity. If you have ADHD, the further decrease of dopamine, from your already-low levels, means that existing symptoms get worse and new ones pop up.

[Free Screener: Is It ADHD? The Symptom Test for Women & Girls]

Are These Symptoms of Menopause or ADHD?

Some women who have had undiagnosed ADHD all of their lives find that worsening symptoms send them to their doctor’s office looking for answers. But 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 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 ADHD symptoms under control. This may mean working with several professionals—a psychologist, an internist, and a gynecologist. Educate yourself about 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.

[Everything You Need to Know About Women, Hormones & ADHD]

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 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.

12 Comments & Reviews

  1. I’m on this website because I HAVE ADHD and I don’t need to be re-introduced to ADHD. It’s too bad we can’t get past the ADHD introduction phase.
    I’m also experiencing menopause which is like double ADHD. I have already been taking Adderall XR for a few years, but with the onset of menopause, my meds have ceased to be effective.
    When my medication stopped working, my GP doctor made the mistake of increasing it from 20 mg to 30 mg without addressing the decrease in estrogen that comes with menopause. This has made my symptoms much worse.
    In a better world I could talk to my doctor about medication adjustments, and hormone replacement therapy, but my doctor is not a psychiatrist, and I don’t have access to one who is qualified to work with a patient who has ADHD Combined with menopause, or one who understands how to adjust Adderall. I’m afraid she will stop my adderall prescription for lack of a better idea.
    Everyone needs to get real and understand what ADHD patients deal with. There’s no help like the kind described in these articles.

    1. You’re so right – esp in Canada! I was fortunate to find an ADD/ADHD GP who only treats “us” and is also an addiction specialist, so he really understands the issues. My regular GP is very progressive, thank goodness and I also see a naturopath, who is very successfully treating my premenopausal symptoms. It takes patience and persistence to find the right balance.

      If possible, I highly recommend seeing a NP to address the hormonal imbalance. A bio-identical estrogen cream paired with progesterone capsules is really helping me. I also take Concerta, which you may want tinask your doc about, because it has better efficacy, time-wise, than most other ADD/ADHD meds. Good luck with your quest! ☺

      1. Concerta. Do yourself a favor, take a hammer, smash the pill, look at the metal and ask yourself why are you ingesting a stimulant that has metal in it.
        This is about a drug causing serious side effects because of the “stuff” added to make it tamper proof for the general public.
        There are better, safer slow release stimulants.

  2. Ur right. It then becomes the patient’s responsibility to explain, remind and/or make the connections during conversations with each professional in each specialty: psychiatrist, gynocologist, an even your GP because every time you have any kind of a med change, he/she has to know about it as well. It is time consuming, scary and hard to do. If we aren’t educated and pushing for ourselves and our needs within each discipline, most of us wouldn’t even have an ADHD dx. in the first place!!!

  3. I agree totally to the above fionagrape, we are looking for help and not an introduction.

    Sadly there are many pages in the net about ADD / ADHD in kids, but nothing about Women and Menopause.
    ADD/ADHD Girls grow up, doesn’t anyone feel the need to study in depth how hormone (puberty / menopause) effect us?

    I was an ADHD child, and got diagnosed in 2001 as ADD / ADHD at the age of 40.
    Prior to the menopause I was able to function ok, trying to keep concentrated, double checking every action, everything I planned and worked on.

    Since Menopause started 4 years ago (I am 56 now) I noticed gradually being unable to control my concentration level. At first I thought it is this interrupted sleep these days, night sweats, never getting through a night with deep sleep, the REM phase (the reboot of one’s brain) missing. I wake up as if I had run a marathon, drag myself to work and lately I cant complete one task without error. I am desperately searching for answers on how to deal with this.

    In 2008 Ritalin, Methylphenidate etc in tablet form was too strong for me, as even a tiny quarter of a tablet was too much, and made me drowsy and lethargic (that was Pre-menopause). Besides I noticed hair loss, braking nails, loss of appetite and gnawing of teeth at night.

    My doc then prescribed me Amphetamine Sulfat D 2 mg – which is prepared by the pharmacist. A Liquid, which has the advantage of taking only a few drops.
    They said, start with 6 drops and go to 12 then later 18 and the 20 ect… EVERY DAY, or maybe several times a day, I cant remember.
    My experience Three drops taken on a Monday keep my attention focused for a week!

    I took them in 2009 and 2010, but stopped as the effect it had on my teeth (again grinding heavy at night) was so bad, that my jaw suffered. (Due to an accident in which my jaw was fractured in two places, I have problems because one temporomandibular joint (Jaw joint) has disappeared ). Also I felt cold never mind if it was 39 C outside.

    However, I am now without medication, (because of the jaw grinding) and find no solution as in what hormones may be able to help menopausal ADD / ADHD women?!
    It cant be that since 2010 there is nothing other than still only above mentioned Ritaline, Methylphenidate, Amphetamine Sulfat D?

    WHAT can ADD / ADHD women do?

    1. For you, thyroid check. Demand the whole panel. Even if your TSH is “normal” free T4 levels that are slightly above or even at bottom of range (.79) can lead to some nasty symptoms. I still had symptoms with a free T4 of 1.00. (Current doc keeps it at 1.50, and I no longer sleep 14hrs a day.) If your free T4 isn’t above 1.00, ask your doctor for treatment. If your doctor babbles on about TSH and doesn’t want to address free T4 (and free T3 for that matter, although it’s not as reliable a metric) then go to another doctor. If your TSH and free T4 are both good, you’ve ruled something out. If you want good info on thyroid disease, check out

      1. Hi Geo,
        thank you for your advice.
        Meanwhile I had my blood checked and the result was (as you said) all is ok.
        I will print whatyou wrote and present it to the doc. She is normal practicioner, not a specialist.

        Last week I have been looking at DHEA. DHEA sulfate are produced by the adrenal glands.

        (WIKIPEDIA says: Prasterone, also known as dehydroepiandrosterone (DHEA), is a naturally occurring steroid which is used as a supplement and medication. It is an androstane derivative and a precursor of steroid hormones like testosterone and estradiol. Prasterone has weak androgenic activity, weak estrogenic activity, and neurosteroid activity, and acts as a prohormone of androgens and estrogens depending on its dosage and route of administration. As a medication, prasterone may be used to restore or increase DHEA levels in deficiency or old age, for menopausal women as a weak androgen or to treat vaginal atrophy, and, in its sulfate form, for cervical dilation during childbirth.)

        Do you, Geo, or anyone else know if that may help with women ADD and Menopause?

        Thanks again for your imput, Geo.

      2. Hi Behrens I’m also on same meds as you. My husband is going to install a fire detector now because im so easly distracted. Im forgetting to turn off the gas or forgetting to close the lid of the kettles whistle. What is the strength of your concerts please and does it make a difference.

  4. I agree with the other commenters that this article is dumbed down and doesn’t provide much useful info beyond ADHD basics.
    This would be useful:
    1) This piece needs to be dated. I’m guessing that this was written more than a decade ago.
    2) the specific recommendation about harmone therapy needs a source.
    3) define your terms. Menopause is 12 months after a woman’s last period. But what about perimenopause, which is characterized by a decrease in progesterone and greatly fluctuating levels of estrogen?
    4) if you’re going to give a specific recommendation for harmone therapy you need to cite your source.

  5. Ned Hallowell those of us PAST menopause are a forgotten demographic. I was not diagnosed until the age of 61, 10 long years after damaging my career and my social life due to being prescribed anti-depressants and anti-anxiety meds (sound familiar?). We were not recommended to get HRT as it used to be considered dangerous not even 10 years ago. Now I am too old for HRT – but that is the standard answer given to my questions about what can be done to help me.
    Psychiatrists, psychologists, doctors and GYN’s are not trained for post menopause, and there is NO research on any mental or physical health for the post menopause generation. And we could live another 30 years, what does that tell you about an abandoned demographic. Every single book on ADHD stops at per menopause, so you and every other ADHD specialist have ignored us. I have yet to find ANYONE who understands and has the ability / capacity to diagnose and medically treat what I am going through. Can you refer me to anyone in the DC area?
    Until per-menopause I was always a quick study, and 100% accountable, and was able to cover over all my deficiencies. Then I was hit with such extensive loss in working memory, emotional control and time blindness that I lost every job I had after 18 months for the past 15 years, even after starting medication, so clearly it was not the right medication. I had to “retire” after losing my last job until I could find the right treatment, or combination of treatments, but alas in 2 years I have found no one, In Network or Out of Network, with any answers. And 99% of all Out of Network specialists DO NOT TAKE MEDICARE, isn’t that a true sign we are being ignored?
    As for what you cite as sexual limitations I discovered that after diagnosis my sexual interest grew and expanded in the most wonderful ways – maybe the knowledge that I was not crazy or had nothing to be shamed for was liberating.
    I hope you read these comments from this lost demographic, we need you to please spread our concerns to all you know in the industry!! Melissa Bennett

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