Perimenopause/menopause and ADHD

Latest figures show that women spend almost one third of their life in perimenopause and menopause. The average age for the onset of perimenopause is now earlier, with most women over 40 experiencing some form of discomfort or symptoms. Non-ageing causes of menopause can mean that women in their 20s and 30s can also experience sudden onset menopause with the same range of mild to debilitating symptoms as their older peers.

While menopause is a natural part of ageing for women and gender diverse individuals, it is still a misunderstood, poorly managed, and taboo subject. There are other causes besides nature too: Post-cancer treatment; surgically induced; primary ovarian insufficiency as some examples.

Impact

The personal experiences many women face include issues such as:

Cognitive symptoms

Brain fog

Difficulty recalling information

Extreme mood swings

Depression

Anxiety

Social issues

Family conflict and breakdown

Mental health issues

Involuntary childlessness

Unemployment

Homelessness

Poverty

Lack of social support

Self-esteem and self-worth issues

Treatment and management of menopause, whether through therapy, medication, surgery or generalised wellbeing care is costly and can be difficult to access regularly, leading to financial strain.

Untreated or mismanaged menopause increases women’s risk for other co-morbidities including osteoporosis; cardiovascular disease; urinary incontinence; weight gain and stroke. These conditions further impede a woman’s ability to function at full capacity, reducing wellbeing and capacity to engage in the workplace.

Complex Menopause

Women who are neurodivergent, whether diagnosed or not, are at higher risk of complex menopause issues. Many of the symptoms can cross over and are likely to be considered ‘normal’ in menopause. Research and anecdotal evidence now clearly shows that the hormonal changes related to perimenopause can exacerbate ADHD symptoms, particularly in women who are undiagnosed for ADHD. There is a notable influx of women in their 50s being diagnosed with ADHD as a result, who may have pushed through until that point with learnt coping mechanisms and masking.

The reason for these changes is a drop in estrogen during menopause. Estrogen is important in dopamine synthesis; it enhances dopamine effects and transmission. Lowered estrogen levels in menopause and perimenopause leads to lower dopamine levels which can contribute to mood changes and other neurological issues. This can be a rollercoaster ride! Dopamine is crucial for working memory, pleasure, focus, regulation and mood, fatigue, motivation.

Dopamine dysregulation is a key factor in ADHD. Research suggests disruption of dopamine may play a role in the development of depression which is also common in perimenopause and menopause. The overlap of symptoms and experiences in ADHD and menopause can make it difficult for treating professionals to differentiate. The recency of the clear links are still not commonly known among health professionals who may not be neuro-affirming. This can lead to misunderstanding of symptoms and challenges, lack of accurate diagnosis and management for both issues, and women left feeling they are not being heard or like there is no help for them.

The Good News

There are many options for managing perimenopause, menopause and ADHD! These can range from lifestyle changes, to therapy, to medications and hormone replacement. The choices are dependent on each individual’s needs and wishes. Ideally a combination of therapies would be employed, with a collaborative approach by professionals. There are a few gynaecologists who specialise in complex menopause also, and if you are not happy with your current health team, it’s ok to seek elsewhere.

At Cocoon we are so lucky to have access to a number of practitioners versed in the complexities of perimenopause and menopause. It’s a one-stop shop for most of your perimenopause and menopause needs. Some of the many options for management include but are not limited to: education, lifestyle changes, acupuncture, Chinese medicine, counselling, coaching (ADHD + menopause specific, ADHD + other medication, hormone replacement, supplements, pelvic pod.

Many of these can be accessed through Cocoon, with your GP and other external professionals assisting. The options that work for you may take some time to fine-tune, but I promise you, once you find the right balance, things will improve dramatically and you will claim back your confidence, feel more empowered, and feel motivated to enjoy your life to the fullest.