If you are a woman living with or think you may have ADHD read this!

by Dr. Christina Harrington

Are you a woman with ADHD? Have you ever noticed that during the second half of your cycle, the pre-menstrual phase, you feel like your ADHD symptoms are worse and your mood is in the dumps?

Recent studies are actually finding this to be a pattern for many women with ADHD. Women report experiencing worsening of their ADHD symptoms such as: decreased ability to concentrate and focus; more emotionally reactive and harder to regulate emotions; increased depressive symptoms and, even suicidality.

The portion of your cycle from ovulation to menstruation is referred to as a luteal phase. Several studies have now show that many women with ADHD experience these increased challenges in the second half of their cycle.

Those with ADHD are understood to have lower levels of dopamine (one of the feel-good chemicals in our brain) or deficiencies in how the brain is using dopamine. Many of the medications used to treat ADHD help to stimulate dopamine.

There is a growing understanding that estrogen levels also play an important role for women. Estrogen is related to the production of dopamine as well. In the first half of a woman’s cycle estrogen levels are higher and she is more likely to feel more creative and better able to manage ADHD symptoms and mood. Estrogen levels drop in the second half of the cycle thus reducing dopamine. The theory is that this affects, and can worsen, ADHD symptoms for women.

Treatments trialed have included the use of combined pill contraceptives (estrogen and progesterone) and taking the pill packs continuously, skipping over the week of ‘sugar pills’. This is intended to maintain consistency in estrogen levels, so this drop is not occurring and impacting dopamine further. The other approach being explored, with promising results, is increasing ADHD medication (or psychostimulants) during the phase of the cycle when women are having more difficulties.

If you think this might be a pattern might hold true for you,  it may be beneficial to have this conversation with your family physician and explore options available to you. Below are links to several of the articles/links exploring this new and promising research.

Research & Awareness – ADHD and Women (adhd-women.eu)

de Jong, M., Wynchank, D. S. M. R., van Andel, E., Beekman, A. T. F., & Kooij, J. J. S. (2023). Female-specific pharmacotherapy in ADHD: premenstrual adjustment of psychostimulant dosage. Frontiers in Psychiatry14, 1306194–1306194. https://doi.org/10.3389/fpsyt.2023.1306194

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