ADHD in Women

PMS and ADHD: How the Menstrual Cycle Intensifies Symptoms

“As an OB-GYN nurse, I can tell you that when progesterone levels are high, dopamine levels drop. So, for women with ADHD, the week leading up to menstruation is an awful time to try and get anything done.”

female, PMS, menstrual cycle, emotions
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PMS and ADHD share a volatile relationship. Due to hormonal fluctuations during the menstrual cycle, an individual may see their productivity and focus climb in lockstep with her estrogen during the second week of her cycle. Then, the humming motor comes grinding to a halt as estrogen plummets and PMS kicks in following ovulation. During the week before menstruation begins, increasing progesterone and declining dopamine can provoke and exasperate ADHD symptoms such as irritability, forgetfulness, and impulsivity (often at the same time) and heighten emotional dysregulation.

Recently, ADDitude readers told us how the menstrual cycle impacts their ADHD symptoms in ways that are both pleasant and painful during a typical 30-day cycle. Do your ADHD symptoms worsen or improve at certain times of the month? We’d love to hear from you! Share your thoughts in the Comment section below.

My working memory is most severely affected three days before my period. I can’t remember what I’m doing, and I’ll walk into the kitchen 100 times. I’m terrified that when my estrogen drops during perimenopause and menopause, I won’t be able to hide my symptoms at work anymore, and it will impact my ability to have a career.” — Kay, Scotland

“I definitely notice a difference in my ability to regulate my attention as I move through my cycle. I find it easier to be mindful when I am in the middle of my cycle (before ovulation). I am much more likely to forget everyday things or have lapses in attention as I get closer to my period.” — Ryland

“My ADHD symptoms become more intrusive the week leading up to my period. My executive functioning dips, my distractibility increases, and my energy levels are lower. First, I’ll be completely unfocused at work. Then I’ll look at my calendar and realize where I’m at in my cycle, and it’ll click.” — Chloe B

[Self-Test: What Does ADHD Look Like in Women?]

“I find that as my first week (flow) subsides, my ADHD symptoms are so much better — I get so much more done on those days. I’m more stable, motivated, focused, and mentally competent. The closer ovulation gets, though, the worse my symptoms become. I am more agitated and struggle to focus. Then the symptoms drop miserably right before my flow, where I can barely concentrate. I am even more forgetful, and I struggle significantly with emotional dysregulation and motivation. I feel terrible for my kids and husband, who have to tolerate my unpredictability. Learning about hormonal fluctuations throughout a woman’s cycle has helped me understand what I experience. However, I’m still trying to figure out how to work with my body and lessen my symptoms. I hope more studies will be conducted to help women like me thrive — not just scrape by — based on hormonal patterns!” — An ADDitude Reader

I’m more anxious and have trouble sleeping in the week leading up to my period. It’s also more challenging to articulate my thoughts, concentrate, and stick to a routine. I also react more emotionally at work. I feel out of control. Over the years, I’ve gotten a better handle on my symptoms, but one week out of the month, I feel like my old self — not in a good way.” — An ADDitude Reader

“My hormone cycle and ADHD have always been cumbersome. At peak ovulation, I think I am a superhero and over-estimate everything that I want to do and can do. Then it wanes as I get closer to my period. My emotional dysregulation gets the best of me, and I am a basket case with no focus. I do irrational things like quit my job and a week later think, ‘That job wasn’t so bad.’” — Michelle, New York

“The day or two before I get my period, I have difficulty regulating my emotions and impulse control. This creates situations where I binge eat and struggle to keep my opinions to myself, leading to arguments at home. As an OB-GYN nurse, I can tell you that when progesterone levels are high, dopamine levels drop. So, for women with ADHD, the week leading up to menstruation is an awful time to try and get anything done.” — Emily, Minnesota

[How Your Hormones Affect — and Worsen — Your ADHD]

“Just before my cycle, I experience mood dysregulation and pinchy headaches. Also, for a few days after my period, I experience low arousal and a severe lack of motivation.” — Kami, Washington

“The week before my period, my ADHD would be so bad that I couldn’t perform certain parts of my job, like correcting tests and calculating students’ grades. Thank goodness I’m post-menopausal!— An ADDitude Reader

“A week before I am due for my period, my brain goes to complete peanut butter. It is an utter mission to focus and stay on task. Sensory overload is at its peak. Impatience rules the days, and I get so overwhelmed.” — Charlie, Australia

“My ADHD symptoms worsen a week before my period starts. I’m more stressed and scatter-brained. I can’t remember anything! My anxiety can get out of hand. I feel like after my period ends, I’m more clear-headed. I can get things done easier and faster, and I’m more ‘with it.’”— An ADDitude Reader

“Oh, my word, YES! Common ADHD symptoms like being easily distracted and sensitive to noise and touch are amplified during PMS. I become extremely irritated by dishes lying around, the cats meowing, and my partner touching me.” — Tina

“Right before and at the beginning of my cycle, I stumble over my words or can’t think of the right one. I am more forgetful and much more emotional. Once, I cried when I forgot why I walked into the kitchen. I never really noticed how my mind changes so drastically during my menstrual cycle until I read about it, and now, I can’t not notice it.” — An ADDitude Reader

PMS and ADHD: Next Steps

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3 Comments & Reviews

  1. Not a woman, strictly, do get periods. (Yes hi hello queer people do exist outside of Pride month!)

    My first sign of it coming up is my anxiety worsening – it’ll slip back almost to where it was before I started treating it.

    The second is the focus. Being anxious worsens it, but in those few days around my period starting, it’ll be like my head got filled with bees. If I’m not on medication, that’s it. Work happens at a snail’s pace. I can hardly get my hobbies going at home or even read the random online crap I’m relegated to skimming through. On meds (Adderall anyways), it’ll be like a meh unmedicated day. Not ideal, but so much better than going without.

  2. I had to switch doctors because mine moved away. The new doctor is great except when I told him that there’s a connection between my ADHD and PMS/PMDD. I explained that when I’m ovulating, I feel like I have all my sh!t together. Leading up to my period, it’s like I’m slowly losing my mind, and slowly driving my family, friends, and coworkers crazy. A few days into my period, and the clouds start to part, and I slowly start to feel like myself again. My doctor dismissed the connection as coincidental and wouldn’t even consider it. My husband complains that I’m only useful (for lack of better term) for about 2 1/2 – 3 wks per month. He also doesn’t understand female hormones or adhd in general, so that doesn’t help. But it would be helpful if my doctor at least understood.

  3. I know this is unrelated, but I can’t seem to find anyone talking anywhere about how trying to conceive affects women with ADHD. What was anyone else’s experience like? I’m currently trying to conceive, I’m 8 months in and I am so stressed, worried, obsessive at times. I’m worried that all my worrying is actually hindering me. I decided not to start my medication again as I was concerned that it could have an affect on the baby or my eggs. I know I’d be handling things a lot better if I was on meds right now. Things are really pilling on top of me and I’m trying my best not to drown right now. I’m 37 and I really worry about my age too…. I’ve been checked at the doctors and he said there’s no reason why I shouldn’t be able to get pregnant naturally. Every month now feels like a roller-coaster… analysing every symptom and getting my hopes up… its awful. I’m over emotional anyway and this is sending me over the edge! I can’t focus on much else atm, I’m completely consumed by it.
    Does anyone have any advice on how to chill the [email protected]%k out?

    I’m going to post this comment on a few of the female related articles in the hope that someone will reply and can help…. or that Additude may have advice on this and do an article to help. As there is little advice of what a female with ADHD should do about meds when TTC or how to manage the stress etc.

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