Female Hormones and ADHD

Female Hormones and ADHD
Here I discuss a very important review paper just published this week (December 5, 2023) in the journal, Hormones and behavior, on the possible role that female hormones and their fluctuations across female reproductive life may have on ADHD symptoms, executive functioning, and comorbid mood symptoms.
The abstract of the paper I discuss is shown below:
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that exhibits striking sex differences in symptoms, prevalence, and associated problems across development. Etiological factors and mechanisms underlying these sex differencesremain one of the most understudied aspects of this disorder. The current paper seeks to provide a novel theoretical framework for understanding this phenomenon by reviewing evidence that females with ADHD may experience a “double whammy” of organizational and activational pubertal hormonal effects. We propose a novel theory of activational effects of cyclical circulating ovarian hormones on ADHD with increasing risk at times of rapid declines in estrogen. These declines may decrease executive function and trait control at two points of the cycle characterized by biphasic affective risk: (1) increases in approach/risk-taking behaviors at mid-cycle (periovulatory) and (2) increases in avoidance/negative affect perimenstrually. Low estrogen and control may then interact with increases in positive and negative affect, respectively, to increase hyperactivity-impulsivity symptoms post-ovulation and inattention symptoms perimenstrually. These interactions may be exacerbated by organizational pubertal effects on relatively overdeveloped limbic circuitry and adolescent-specific social pressures magnified in females with ADHD.
Research Discussed
Attention-deficit/hyperactivity disorder and the menstrual cycle: Theory and evidence
AG Eng, U Nirjar, AR Elkins, YJ Sizemore… - Hormones and Behavior, 2024
www.sciencedirect.com/science...
doi.org/10.1016/j.yhbeh.2023....

[@mrwormtester]

Perimenopause has been the nail in the coffin for my brain. Looking back, I realize I had been coping one way or another for decades and the loss of estrogen put me over the edge into dysfunction.

[@ZannaRussell]

Same.

[@jimwilliams3816]

Same with my mother.

[@maphillips1979]

Here too. That combined with trauma made it VERY apparent.

[@AuntieAlexandra]

Holy cow, so this!!!

[@frandavis7727]

Same here.

[@justbeegreen]

Helping women with ADHD and hormones moves at such a snail’s pace.

[@SomethingStrange910]

4:07 When I first suspected that I had ADHD 2 years ago, I did a DSM survey but I didn't "qualify" because I honestly don't recall much symptoms before my puberty. There were some, sure, but not significant enough to impair my life. I was always the best student in the class. Then I got my period at 13. I became an emotional mess at the age of 14. Had my first panic attack, stopped turning in homework, and fell into my first depression at 16.

[@3dchick]

They absolutely need to change the diagnostics! It's criminal how skewed the DSM is toward the old view of ADHD, that's its always about the same throughout lifespan as well as being more male centered.

[@drrodopszin]

This very research can show that ADHD can develop later at well established new life events.

[@tknows470]

Hugs for you ❤

[@pipwhitefeather5768]

I can relate to that. I suspect I am ADHD and am awaiting assessment. Started menstruating at 13 and had my first panic anxiety moment where I couldn't get out of the car. Also developed 'crushes' but more like mini obsessions. Got disruptive in school and got 'put on report' where all the teachers had to record on a sheet of paper how I had behaved in class for that lesson. Got into fights, not of my own making. I don't think I have any doubts anymore as subsequent years show incredible risk taking and impulsivity and generally not knowing where I was going or what I was doing. Which I suppose is a troubled executive function..? Post menopause now and I'm depressed with very little support, but relieved I have worked out 'what is wrong' with me. Best wishes and loves to all of us struggling with messy brains 🙏 💖

[@drrodopszin]

I have a growing horrible feeling, that many of the male-female stereotypes have a ton to do with how different hormones change expressions of a range of frequently occurring psychiatric disorders.

[@tuftela]

This is already well established, so your hunch is spot on. Seeing the impact on changing research is taking a long, long time though.

[@sharonaumani8827]

An old song comes to mind: "It's More Than A Feeling" [Boston, I think :)]

[@kimbalina28]

This is so exciting! I just had a very bad experience with my doctor when I told her my ADHD meds weren't working as well and I suspected it was a drop in estrogen because of menopause (I also listed a ton of other symptoms, too.) She told me that wasn't a thing and there was no research that showed that. I so badly want to send this to her and say I told you so! It's so hard advocating for your health and getting appropriate care as a women because there is so little research on women's health issues, especially in post-childbearing years.

[@wonderwend1]

Send it to her. The doctors need to be up to date

[@itaintright]

Yes! Absolutely send it. Hope she actually watches

[@SchwarzesSchweigen]

I am so sorry you are going through this with your doctor. Every patient deserves to be heard and every option should be considered until proven otherwise, especially such a reasonable one.

[@sonja7halcyon]

Send it but leave out the "I told you so!" ;)

[@pipwhitefeather5768]

Do it, take her the research or email the link. I think doctors that dismiss their patients testimony about their experience need to know they don't know everything! How could they? They have never been much help to me tbh.

[@MarielQueenPenguin]

I wonder how this impacts women who have both ADHD and PCOS, as the latter is a hormone dysregulation. Hopefully this is the first step of many of understanding ADHD in women.

[@K.Arashi]

for me, it's a mess. my hormone levels need regulation with some sort of birth control, and the type of birth control i'm on affects the severity of my adhd

[@acutejessdisorder_]

oh my god i literally just typed this comment, i have adhd and pcos. i think my pcos makes my adhd SO MUCH WORSE especially the extra testosterone/androgens i have which cause mood swings. which in turn makes my emotional dysregulation from the adhd like 10x worse. it's hell if im being honest.

[@charliechristie9916]

I went to first diagnosis appointment two weeks ago, and doc said PCOS was irrelevant to his criteria. Which is exactly what I was expecting, because why should any research should be done on female hormones and comorbidities, but still.

[@allstarconnie]

Yep, add PMDD to the mix because of the PCOS, and it's extra spicy during that time of the month.

[@aaheemas]

I hope this studied, including other hormonal problems and their effects on adhd

[@ceri-sandford]

Is there anything we can do to advocate for more research and studies? I feel that there are enough women out there who could push for change and an increase in scientific attention on this vital topic.

[@Maevelikeschampagne]

Yes please. Sign me up. Study me all day and night. At least my struggles won’t be entirely in vain

[@alexwelts2553]

​@@MaevelikeschampagneI have learned that the studying and research doesn't necessarily mean that they are focused on an outcome favorable to help us. But more like simulating as many conditions and variables and fluctuations and recording data and pressing limits. Dissecting down to the smallest division and sticking flags in it. They aren't necessarily invested in all this just to find a way to improve the quality of life for women or humanity. And also we end up being the "game pieces" and don't necessarily know why everything goes to extremes and downhill without ever getting a grip on our own trajectory. It's because they already are studying us. At our expense.

[@LiMaking]

I'm a woman and I'm participating in a study in sweden right now as someone who was diagnosed later in life and seem to fall in the "middle" of ADHD people. The study unfortunetely doesn't focus on only women though, but I've already shared my first experiences with my medication, and part of those being that it seems to work differently during the month and that it seems to be connected to my period. They already know the effects can be different thanks to hormones, but my doctor seemed interested in this particular info from me.

[@stevennguyen4993]

It depends, this is a remarkable study with a lot of possible confounding factors, that I'm surprised that the authors even dare make connections between hormone levels and ADHD. I've read other studies like these, and have fallen curious about general lack of considerations on other topics related to neurochemistry, behavior, and sociocultural factors. A study like this should never be "easy to read". I expect it to read like Chapter 1 of "The Principles of Surgery" where they start talking about hormones and cellular signaling. Especially since a study like these want to mention hormones. So much we don't know about, that a review is not a good start. Most research can't even comprehend hormone signaling at a cellular level. Especially with ADHD having a larger sociological component than a biochemical one. You take a young kid in his/her teens, at an age when they're supposed to be exploratory, energetic, and rambunctious (like a destructive, bitey, and stinky 18-month-old adolescent raccoon who is preparing to be an independent adult; or a young parakeet that is hyperactive in their search of a mate), and dose him/her with Adderall so he/she can sit in a classroom watching a lecturer 4 days a week for a total of 6 hours of each of that day before sitting down and doing more hours of reading and homework.

[@alexwelts2553]

@@LiMaking hmm, I haven't consented to be part of any studies, and then find myself in a situation where I'm being studied under the pretenses that I'm not being studied. And handlers who aren't necessarily who they present themselves to be, who aren't exactly invested in what one would think their family is unspoken and invested in. And as I find streams of my own research and life experiences according to my own genetic predisposition and abilities being published by doctors and authors, and my daughter has been obviously competitive pheromone and energetic and even metaphysically, and psychosocially, and ritualistically and chemically involved in changing my hormones, cycles, health stress, wellbeing, life force and quality of being. Trying to rubix cube askew my fertility and pheromone potency and energetic levels and viability. Even causing injuries, and spiritual means from hernia spirits and lightning and sigils. Hormones and ADHD and the effects of prolonged extreme stress on the non consumptive prey body and inducing menopause and even illness, Burst fibroids, etc. It's like I'm trapped in study conditions suited not in my favor and the fact I'm trapped is denied and gaslit.

[@3dchick]

This couldn't have come at a better time. I hope the medical community pays attention. I hit menopause and my adhd went off the charts.

[@sharonaumani8827]

"Snails pace" !

[@joeofoysterbay7197]

I'm a male trying to convince my oncologist that the hormone chemo treatments he's giving me to reduce testosterone production are really effing with my emotions and executive function. I guess no one has taken this into account so much so that I might as well be speaking Martian. I'm frustrated and you can bet I'll be bringing it up again at my next appointment. I'll turn some of that dysfunction on hm.

[@BlackMarilynMonroe33]

My Dad takes treatments to stave off prostate cancer. He has hot flashes and currently is suffering with bursitis-like hip pains, another menopausal symptom. The doctors are proud of themselves for depleting the testosterone levels, but they don’t realize how much this imbalance of hormones impacts one’s quality of life.

[@3dchick]

Watch out for bone loss with those treatments. They wotk pretty well, but especially long term use in men, in particular, can cause seriously brittle bones. Lupron is the one I'm thinking of. I guess it's a trade off for cancer, but people nred to be aware.

[@joeofoysterbay7197]

@@BlackMarilynMonroe33 The hot flashes really blow. Every night at least twice , I have to towel off and turn on the fan I got just for them. I oddly have hip pain when I sleep and that's the only time but I should look into it Thanks. I hope things get better for your dad. Take care!

[@BlackMarilynMonroe33]

@@joeofoysterbay7197 try sleeping with a knee pillow. Good luck 👍🏾

[@MiffoKarin]

Female hormones definitely affect my ADHD! It didn't really become a problem until I hit puberty. I went from a top student to barely scraping by in the course of a couple of years. I was diagnosed with depression and anxiety at 17, but my ADHD went undetected until my mid 30's when I stumbled upon it myself and all the pieces fell into place. Starting birth control made it even worse.

[@nk-dc5gc]

wouldn't starting birth control make it better? since it's a stable source of female hormons? so less cycle-related ups and downs?

[@MiffoKarin]

@@nk-dc5gc It's a stable source, sure, but it's also more hormones than what my body produces naturally, which I think is the main problem in my case.

[@lebambale]

Very interesting because I also found myself struggling from the year 17. And I've been on hormones, on and off, till now I'm in my early thirties. I observed that the symptoms attributable to ADHD also depend on the formulation - bioidentical estradiol can recover short-term memory in a few months' time! Whereas other formulations usually contain ethinyl estradiol and it affects the liver quite heavily (so if there are other risk factors, it's not going to work as well!). Can't really pinpoint the effect of progestins, whether they have any cognitive activity. But the quality of estrogens certainly matters a lot!!!! (I'm comparing Zoely vs. Yasmin, there are different adverse effects on both.)

[@sonyaosullivan69]

As a female psychologist, when working with female clients across the lifespan, regardless of the presentation, we work together to identify the influence of their hormonal cycle not only on their physical symptoms, but also on their mood, thoughts, feelings and behaviour and medication effectiveness. Their reports undoubtabley show observable changes in their cognition, executive functioning, level of emotional responses and effectiveness of their medication (stimulants medication less effective 2-3 days prior to onset of mensus). Additionally, as identified in this research paper, there are clearly identifiable points across the lifespan where changes in female hormones play a significant role in their presenting symptomology and unfortunately many women continue to be misdiagnosed as these factor are not taken into account. The scientific field has often excluded female participants in many of it's research trials for numerous reasons and has only recently started to consider the female biological profile. We have a long road ahead but it appears we are moving in the right direction and hopefuly in the not too distant future, female biology will be better understood and treatments will emerge to better support womens mental and physical health and overall wellbeing.

[@rachaelrifkin8843]

Can you go into more detail about how you address hormonal fluctuations with your female clients? Do you recommend any specific tools for recording symptoms and then addressing those symptoms?

[@vexhia6792]

I have seen some trans people with ADHD who take estrogen and progesterone hormone therapy on the internet talking about this because they suddenly begin experiencing this phenomenon after beginning treatment and discuss online while seeking information. Thank you for talking about this! It’s unfortunate how little attention there seems to be on research about women’s bodies and experiences and ADHD

[@Me-ei8yd]

It's ok. There's lots of research on how to make a man a woman. So we really aren't needed anymore, no research needed.

[@TylinaVespart]

This is such an important topic! My psychiatrist (the one I see for adhd) and I talk about it all the time because he’s interested in what I have to say. I can literally feel where I am in my cycle based on what my mood and symptoms of adhd do. Didn’t really notice prior to being successfully diagnosed and prescribed, but with the improved self awareness the pattern is incredibly clear. (For the curious, day after ovulation I feel awful, upset, low. Couple days prior to menses (up to a week) I get steadily more anxious, brain foggy, and difficult to focus on things. Day one of menses I’m suddenly able to focus, function, and feel pretty good. Insomnia is bad during the fertile window, I sleep best in the week or two prior to period. It’s clockwork.)

[@katzrantz]

That's really interesting. My brain fog was worst during menstruation, but then I was also in a lot of pain too which was pretty distracting.

[@pipwhitefeather5768]

I can relate to that - I would be so happy when it arrived! The shift in my mood was huge! As I approached menopause the misery prior would start days after ovulation, I would cry every morning for no apparent reason. It was awful.

[@SchwarzesSchweigen]

@TylinaVespart Oh, my God! I have the exact same experience. Right. To. The. Dot. Everyone I've ever shared those observations with has told me it's just my looking too hard into things, making things up, and making excuses for myself. But I knew it was a thing! I knew I could not be the only woman who experienced this very precise and constant pattern every month.

[@CarenMagill]

This is such an important topic! I was diagnosed with ADHD at 51, when all my life long coping strategies stopped working. That's also when I decided to become an ADHD Coach. My diagnosis and training have changed my life. Thank you, Dr. Barkley, for your tireless efforts to advocate for ADHD'ers! I admire your work so much. You're a good egg.

[@healthylife4eva]

Hi Caren , I watch your channel everyday. Just got diagnosed and your videos helping me alot understand my lifetime struggles. Thank you for great videos! ❤️

[@3dchick]

Hi Caren!! Love your channel! ❤❤❤

[@soniatee8458]

yes, this too. my lifelong coping strategies, like lots of coffee and staying up late, i can no longer handle in middle age. this eventually led to my diagnosis.

[@petrahoggarth1437]

Thank you for pointing out this article. A lot of my adult ADHD clients have issues with premenstrual dysphoria and many of my clients say their doctors are not aware of any ADHD/hormone link and don't appear to put much effort into finding treatments. This will be a great resource.

[@rdklkje13]

You may want to check out Sandra Kooij’s work. She’s been researching this for decades. The “Women, ADHD and Hormones Webinar” here on YT, from October 2020, is a good place to start. ADDitude also has some webinars on this topic.

[@petrahoggarth1437]

@@rdklkje13 ADDitude had been my mainstay for resources on hormones and ADHD for my clients. It's good to have this article that clients might be able to point their GPs to.

[@elizabethmarie96]

I have ADHD and PMDD. Once I was put on the FDA approved birth control treatment for PMDD, I *almost* felt like I didn't even have ADHD anymore. I finally feel "normal" (with some added quirks haha).

[@pixiwix]

I'm in the early stages of perimenopause (also with PCOS) and my ADHD has never been worse. Distractions are overwhelming and everywhere now to the point that I'm really struggling to cope in daily life. I feel like my brain is stuck in a bag of thick fog, which is stuck in a vice grip that everyone keeps throwing things at. I don't even recognize myself since (with hindsight) my hormones started shifting.

[@karladolman9664]

You're not picking up the little girls, they're not suddenly developing ADHD as a teen. My ADHD was clear from early childhood, my symptoms were all attributed to personality type and character flaws...very small children are socialised differently from infancy, boys behaviour tends to make an impact on those around them so are noticed younger, girls symptoms mostly affect ourselves so nobody is motivated to address it, when you add in the hormonal effects of menstruation on girls, their behaviour starts to get to affect adults in their lives more, around the same time that expectations on teens executive functioning are also growing as the enter secondary education etc.

[@bethb5915]

It's so true - I was diagnosed at 54 because things really went off the rails as I hit menopause, but now that I know more about it, it's clear I've had ADHD my whole life.

[@martinamontecinos953]

You did not listen at all. It is not that little girls don’t have ADHD before puberty. There are many girls whose sintoms started since a young age and were dismissed by adults, under the idea of adhd is pretty much hiperactivity and bad grades. However, there is people like me who did not have many sintoms of Adhd before puberty. I was at worse very talkative in class and as I look back, more hiperactive than a comon kid for sure. Had very good grades because I was able of concentrate for hours at home and planed my study for any test by weeks before (all of this by my own since i was 6 years old, grew in a very disfunctional home so my parents didnt help me at all). The only inattention problem I can recall, was with basic math operations like 5+3=9. And yet I was the best lf my class at math. This means: I had hiperactivity but almost no symtom of inattention, emotional desregulation or ejecutive function. As a kid I was much better at mental math and memorizing. I had for sure way better atention and ejecutive function at 12. I am 18 today, and i would have better grades at med school if i had the abilities i had until 13-14. Since 15 I did not ever understood why i suddenly had a “mental fog” and felt so lethargic. Now i know it was because the onset of my adhd symptoms. I did have some symptoms. Yet the ADHD as such started at 12 with a worsen attention yet fierce ejecutive function. I was able to do everything I proponed to my self. He did not say that women do not have ADHD as kids. He explained why the 1girl/3boys ratio, changes to 1girl/1,5boys due to this hipothesys. This does not mean girls with ADHD symptoms at a young age don’t get diagnosed later due to adults disesteeming their symptoms. Those girls exist, and also do those who worsened due to their hormones. This explains why so many women say they dont remember having strong symptoms as a kid; meaning they were not troubled by their almost nonexistent levels of inattention, hiperactivity, executive function and memory. We all had the predisposition to have adhd, yet for people like me it was (at least hipothetically) puberty that onset the changes in my body (genes) that caused my neurodevelopment to get so much worse. So please do not comen with that discourse, almost as it were a feminist complaint. Here is scientific proof that there is women whose ADHD symptoms are related to hormones; that cientific aspect has nothing to do with the social predisposition to dismiss adhd symptoms on girls. (Inglish is not my native language, and I do not want to expend time translating every word so there is most probably many gramatical errors. And the ‘ takes too much time.)

[@BanjoPixelSnack]

I’m 41 and my ADHD is pretty bad. Thankfully I have lots of support. But I’m honestly pretty scared of what menopause might do to make it even worse :(

[@chernagast6754]

This is absolutely my experience through my cycle. I was diagnosed with PMDD at the time. This was also the case with my pregnancies. I'm currently going into perimenopause and that's when everything got worse. This paper is dead on.

[@jamie3039]

Yes! Yes! A thousand times, yes! I was also diagnosed with PMDD (and Generalized Anxiety Disorder) as a teen. My symptoms of ADHD have been there my whole life, but ramped up after puberty. By high school, I was having debilitating hormone-induced mood swings. Those issues got better for a while after my hysterectomy (Adenomyosis), but are coming back with a vengeance, along with all ADHD symptoms being exacerbated and even depressive episodes now that I am in my late 30s (perimenopause? I learned it can be an 8-10 year process!). Thank you from the bottom of my heart, Dr. Barkley, for making this video! It has confirmed everything I have suspected about my PMDD actually being related to my ADHD, and your description of the different symptoms during different hormone levels accurately describes what I go through every month. It was helpful to hear the symptoms laid out in a timeline like that so my husband and I (and daughters!) can be more aware of what to expect. I hope more research and awareness about this topic is coming in the future so girls and women like us can get better help, and sooner in life!

[@murderyourlawn]

PMDD has ruined my life. I'm starting chemical menopause soon with the hopes of getting approved for surgery next year.

[@mandyvanzanen]

We need to acknowledge too what is going on for women externally during these phases. So many women are now having kids in their mid-late 30s, which means that we are in the absolute thick of it all with little ones, school, family activities and obligations, RIGHT when perimenopause starts. The cognitive load to do what is expected of us on all fronts breaks even typical women. I’m damn impressed with all of us for managing anything.

[@raisinettesareliketinygods4016]

Dr. Barkley, I found this information not only useful, but incredibly eye opening. I am a female with fairly severe ADHD (combined type), and although my own ADHD symptoms have been very obvious and in no way sub-clinical for my entire life, this has given me some insight into how symptoms have presented in my children. My youngest, who has been diagnosed with both Autism and ADHD (Also, she has full mutation Fragile X Syndrome, of which I’m the carrier) has always presented with symptoms that were very apparent. Since she hit puberty a few years ago, both her Autism and ADHD have seemed to become more of a challenge. I’ve read a few studies that have linked an increase in Autism severity to hormone fluctuations, but was unaware, until now, of any studies on this pertaining to ADHD. My oldest, born female but recently came out as a transgender male/non-binary, was always the one in our household who I thought dodged all of our fun family genetics. They were always the most cool-headed, most organized, socially adept one. Granted, I realize that I was comparing them to the rest of my family and I, who can only be described as pure chaos, but most importantly, I never suspected ADHD. They were an anxious child, yes, but that was about it. When puberty hit, around the same time that they entered middle school, the change was significant. Over the next few years they developed Bipolar, Tourette’s, and symptoms of ADHD became apparent. They were actually just recently diagnosed with ADHD. Also, as a side thought, I wonder how and if hormone therapy plays into ADHD symptoms. Have there been any studies particular to transgender individuals, ADHD, and the effects hormone treatments such as testosterone or estrogen therapy?

[@nk-dc5gc]

all the best to you and your family & thanks for sharing. :)

[@s.m.4948]

THANK YOU! I'm one of the many females who has asked you to address this topic. In one podcast I listened to, a prominent ADHD doctor spoke of the positive impact he's seen for many of his perimenopausal ADHD patients when they go on even a super-low dose of HRT. (However, he's the same doctor who said in another podcast that he guessed that the average ADHD patient has an IQ of around 128 and, even before you created your video about ADHD and IQ, this struck me as highly unlikely... and as a result I now find myself questioning everything he says). I only received my diagnosis in middle age so I really hope that we'll soon see a lot more research about hormones, ADHD and older women -- aren't we one of the fastest-growing cohorts when it comes to new ADHD diagnoses, these days!? -- but I'm not holding my breath; we're not a very trendy, "sexy" demographic to study, alas.

[@sfstucco]

I have been trying to figure out why I have major CHANGES in my ADHD SYMPTOMS since the onset of MENOPAUSE (age 50). I used to NOT have hyperactivity. Now (age 62) it is PROMINENT! I used to be able to stick to a task F O R E V E R. (if no interruptions). Now I cannot. These symptoms have been worsening, which I have associated with a decrease of physical activity/an increase of sedentariness. Maybe there’s a connection between the physical inaction and hormones? Very grateful for reporting on this neglected subject.

[@katereeez]

Thank you for sharing this paper Dr Barkley! The preliminary findings explain so much. I hope more research will be done on this very important topic - 65 comments and 1471 views in just 10 hours says a lot about the need for exploring more about how hormones in women impact their symptoms. Thanks for all that you do and have done to support the ADHD community!

[@Princess_Peach_84]

Finally, someone is paying attention to us! THANK YOU!

[@jaygee6447]

Attention is great

[@weaviejeebies]

Y'know, lately I've been struggling. I'm 49. I was reflecting sadly this week on how I'm losing ground in so many areas, but maybe I'm just going through a particularly rough time in life. I tend to have drunk society's kool-aid about being able to control and dominate every aspect of ADHD. I forget very easily that some of this is really out of my hands.

[@anessacheza3372]

great!!!! I always tell my doctor that my meds does not work when I am on PMS. it's awful, Because I can't literally function. I have a very foggy brain, my mental math calculation is terrible during this time. After my pms, my meds just work perfectly. So one thing that is helping is eating a lot of vegetables before and during this time (it helps a LOT with brain fog. I also started eating cured salmon with bread every morning 1week before my pms week and I don't know if is the omega 3 from fish. But I also felt a big improvement and less bad symptoms during my pms. If I have a bad diet like eating cereal everyday. and food based mostly in carbs etc. My adhd symptoms get really bad. I would like to see more research about the impact of food and nutrition in adhd! I do believe that this also has a big impact as well. (sorry for grammatical mistakes, english is not my first language, but I am always trying to improve) I do think that food has an impact in female hormones, which also has impact in adhd symptoms. But hopefully people research more about it!

[@basiabarbara3365]

You are 💯% right about the connection between nutrition and adhd/hormonal imbalances symptoms! I’m Nutritional Therapist, and this is exactly what I see and I also see the improvements in symptoms related to not only adhd but overall wellbeing with individual nutritional therapy. Thank you for sharing you own experience! This is fundamental and it should be always the first line therapy!

[@JH-lz4dh]

Great topic! Hormones absolutely affect ADHD in women!

[@lauraraquel513]

This is 100% my experience!! Thanks so much for sharing and normalizing/validating. I blamed myself and felt trapped in a monthly cycle of ever changing symptoms. I’d be interested to know what medications some are using to help at the two phases in the cycle.

[@Maevelikeschampagne]

This real. I’ve been living it my entire life. Omg at least I know I’m not losing it. Menopause wrecked my adhd. It was very well managed from diagnosis at 36 until perimenopause kicked in. Thank you! ❤struggling now big time and it’s been so hard to find a dr that listens much less cares

[@Trammiliin]

Very interesting. Also would be interesting to hear how hormone replacement therapies and different female hormonal medications relate to this. I asked about this topic from my doctor and he said there’s no connection between female hormones and ADHD symptoms. 😊

[@caitiecatcreates]

That's so weird. My doctor said there is a connection between female hormones and ADHD symptoms.

[@sookibeulah9331]

It doesn’t sound like he knows very much about either ADHD or female hormones. It’s also possible he knows little about both of them. Look up Louise Newsom and ADHD. I’ve found DRs in the U.K. who specialise in ADHD & (peri) menopause because it such a complicated interaction.

[@kaiyakershaw1028]

Not surprised. A) male doctors often don’t take women’s symptoms as seriously and B) MDs don’t get adequate training in either mental health or ob/gyn care.

[@sharonaumani8827]

@@caitiecatcreates Send your doctor this information and request your doctor pass it on.

[@sharonaumani8827]

@@kaiyakershaw1028 Not just males! Younger, not so smart, gaslighting females, too!

[@allysonkendall2457]

Gosh I wish I had someone like you to talk with about my situation... 38 just diagnosed and have been struggling my whole life but no one to sort it all out with :( goodness it's very hard

[@zandrazentio5290]

Same for me ❤

[@littlebumgorf]

@@zandrazentio5290 i highly recommend the workbook "radical guide for women with adhd" i think it saved my life

[@DLT111]

I actually do adjust my meds up 2.5mg during the few days around ovulation and up 2.5mg twice a day in the lead up to my period. Surprisingly my first doctor was the one to hear me talk about my meds not working during my period and suggesting it and he was a stereotypical old white dude who still called it ADD (just diagnosed three years ago as an adult). He was the best! As we tinkered with it we found the perfect amounts to counter the fluctuations after I started wearing my nuvaring for four weeks to even out the estrogen fluctuations since I am way more sensitive to even small changes than normal people (and since I don't care for the monthly migraines when we do allow me to have a period). Just keep that in mind if you also have serious periods. It may be a thing you work out with your psychiatrist and general/gyno doctor.

[@Herfinnur]

How are you able to adjust them that little? My pills are 20mg each. I'm a man btw, but it would be interesting to know

[@katzrantz]

​@@Herfinnur2.5mg is half a Dexamfetamine tablet

[@DLT111]

​@@HerfinnurMy doctor gave me a normal 15mg instant release twice a day and he specifically gave me a 10mg script of 30 pills to break apart with a pill cutter as needed and that supply lasts me 3 months roughly.

[@katzrantz]

Starting HRT patches a few months ago has seen a massive reduction in impulsiveness and improved memory, executive function, and emotional regulation for me. I'm not much looking forward to when I have to stop using them, but that's up to 5 years away. There'll have been more research done by then, so maybe there'll be alternative treatments.

[@shannigans8]

My meds also do not work as well the week before and of my cycle.

[@lagomorphia9]

I noticed exactly this too. I was only on meds for a couple years before menopause but there was a distinct shift in how well it worked that also completely matched the week before and during that were completely out of control for me most of my life. Hard to have a reasonable life with bad ADHD never mind when about two weeks out of every four were, for me, not only useless but downright destructive at times. Two weeks self sabotage, two weeks to try to climb back out of the hole, only to repeat ad nauseum.

[@shannigans8]

@@lagomorphia9 it’s also not helpful to have studies on this topic because it doesn’t help the pharmaceutical industry to say hey our sh*t will only work 2 weeks out of the month. My provider gave me extra Adderall for the times I needed it, but I stopped taking Adderall all together because it caused anxiety and I worked at the time as a psych nurse. So dealing with that AND my psych clients was too much to handle. I eventually quit that job (even though I loved it and my clients) because of it. I am usually emotionally unwell and just hide it and try to remind myself it will pass. Since middle school it’s been a challenge to want to remain on this earth at times. It’s not that I don’t want to live, it’s that I don’t want to live like this. I’m sorry you experienced this and I have hope for others in the future it won’t have to be like this anymore. I know I’m learning everything I can so my two kids don’t have to experience what I did growing up. I would LOVE some natural alternatives for ADHD or someone to just figure out how to “cure” it.

[@sfstucco]

@@lagomorphia9- Oh boy, that’s rotten. I have a question for you about symptoms POST-menopause. Do you notice anything different compared to pre-menopause (besides the cyclic symptom pattern pre-menopause)? Of course, maybe it would be hard to tell if you’re on ADHD meds.

[@user-tr6xq9ri5d]

I was dx PMDD in 2016, and ADHD/ASD this year. For two weeks after ovulation I would be a completely different person, which got worse after having my kids. I work with humans just like me and some have been in crisis multiple times. This needs to be researched, can you pls do whatever you can to get this louder and known!

[@user-tr6xq9ri5d]

@@charlie5115oh gosh I got put on hormonal birth control and it made me worse. I’ve since learnt that antihistamines help - I’ve also looked a bit at my diet and cut sugar and gluten as this made it worse but some months I’ve just gotta accommodate myself… sleep in, lay in bed, do the bare minimum. It’s so hard. I’m glad more are talking about it but if you have to work with someone Telehealth because they understand then do it - it’s soooo important!

[@Visitor1234]

I'm 31 and my adhd is quite bad.. the worst for me are memory loss and executive dysfunction. And now I'm utterly afraid of menopause..

[@lebambale]

Same!

[@Finkeldinken]

Thank you! I have had the misfortune that my skin can't tolerate methylphenidate at all and the non stimulant meds didn't work at all, so I was unmedicated for 10+ years post diagnosis. I had made my peace with not being able to get medical help, but about five years ago I was prescribed mini pills for myigraines because I noticed there was a very clear connection to my hormonal fluctuations - and Lo and behold! Within a couple of months, my ADHD symptoms and chronically lowered mood I got noticably better - people around me could tell too. The P-pill never did that, maybe because of the way they work or maybe the weeks pause in them was enough to mess everything up, idk. The one psychiatrist (a friend, not someone I go see professionally) I've told completely brushed me off, so that's fun. This was heartening, as was one of the episodes from ADHD Broadcasting Europe (or something like that, the channel name is hard to remember) where they had a psychiatrist on talking about women and hormones and ADHD. Very assuring. Thank you, fellow flannel fiend, for sharing - this one gives me hope that people with wonky hormones in general might get a bit more love in the research and following that, in treatment. But dang. It's hard when our own reports are not taken into account in daily treatment.

[@rdklkje13]

That’s the “Women, ADHD and Hormones Webinar” by Dr Sandra Kooij, from October 2020 on the Broadcasting ADHD Europe channel! She’s been researching ADHD in adults since the mid-1990s, specialising in (older) women once she noticed differences like these, and many more, and the dearth of information about them. By now she’s one of the leading experts on ADHD in (older) women internationally. If you google “Sandra Kooij ADHD” you should be able to find the sites of several projects she’s involved with, which have (links to) a number of resources especially for and about women with (undiagnosed) ADHD. One of these is the EU-funded “The ADHD Women Project”, which is available in English and German.

[@healthylife4eva]

Hi, Can you please share what mini pills for migraine?

[@flawlix]

I knew this anecdotally, both from myself and other ADHD women in my life. But it’s nice to see it laid out in a way that clearly tracks with my experience. Plus, now that I’m having some issues with my hormone levels separate from my normal cycle, I’m experiencing a lot more fluctuation in the severity of my symptoms from day to day.

[@mnmlst1]

I'm undergoing perimenopause and as an autistic person with ADHD my executive disorder is skyrocketing.

[@mimishandle]

Absolutely phenomenal video and information. I’m a late diagnoses and I myself have discussed this with my partner who sees me struggling every single month and the patterns are there. It’s incredibly challenging to deal with at age 29, and I’ve struggled since I was 11- when my cycle started and hair growth as well as rage, inattentiveness and excitability only around certain things and activities that I obsess over but my period will make suddenly debilitating for me. The anxiety and sensitivity is there before my cycle, feels relieving the days during and afterwards I feel I could take on the world for about a week- then I cry for days. But atleast my closet is the most organized it’s ever been (it won’t last guys I never do laundry regularly). I never struggled during school but a few times under the radar…as an adult it was impossible to “fly under” anyone’s radar. I was always late, forgetful and a crying mess. I just felt so sick always. I saw a psychiatrist. Prozac has helped tremendously as well as far as depression and panic attacks. They started around 19 but weren’t regular until 25-27 and with years of medication I have far less anxiety but it’s still prominent and unwilling during PMS

[@antivyris]

I would love to see a study on if transitioning in trans women affects ADHD symptoms.

[@KVVUZRSCHK]

Me too, I've definitely noticed that my ADHD feels different since I've started HRT but It feels too intricate and complicated to pin down what's going on as a laywoman

[@jimwilliams3816]

Thank you! I will check out the paper. It’s important to me because my mother had clear executive functioning issues, severe dysregulation at the perimenstrual phrase of her cycle (what was then called PMS), and I think never really recovered from menopausal dysregulation. I know she “chased dopamine” and became a massive hoarder by late in life, but unlike me she was not hyperactive, and inattention was not obvious to me, so I still am undecided if she had ADHD as such. This is relevant to me in part because I am struggling to avoid certain downward spirals that vexed her late in life, in particular worsening irritability. Watching myself, I’ve come to suspect that variation in levels of my own hormones play a role in my own issues, but lacking a woman’s reproductive cycle, it’s hard to know if that might be. And needless to say, there’s likely no research on ADHD and hormones in men.

[@typical_snowflake]

I have medicated adhd and I want to share that taking vitamins ( a complex of all that is needed) AND vitamin A has really improved my mentrual cycle. It's less painful, the flow is normal instead of catastrophic and I'm less tired. I really advise to be supplemented in vitamins even if your diet is good. And also, my pms is insanely shorter. I had a pms of 15 days before, now with medication + vitamins it's 2/3 days before ( really tired) and the D day ( can't get out of my bed) and that's it. It's really worth a try.

[@StellaLeeThreads]

THANK YOU. Your ability to collate and present the available research into a short presentation is second to none.

[@blastypowpow]

Thank you for this extremely interesting video! I’m glad I found your channel recently. I’d be interested to know what my hormone levels are like right now. I’m just perimenopausal at 44, but I can feel a significant difference, because the older I get, the more I speak awkwardly because I have the concept in my minds eye, but can’t think of the related word. I never had kids because I have awful taste in men and had a narcissist waste my prime baby making years. I lose my train of thought far easier. If someone interrupts me, the thought is gone. At puberty my symptoms got way worse. I went from talented and gifted classes to barely getting by in my junior and senior year. I still don’t have my degree despite knowing I’m pretty intelligent. I’m anxious about taking the GED because I’m scared I will fail. I want to go to college so badly so I’m not homeless living in a box when my parents pass away. I’m great at space science and physics(they’re a hyperfocus of mine) so I want to be an astronomer or astrophysicist. I know I could probably get my masters if I just knew where to start to solve this issue. I’m stuck in “waiting mode” all the time. Paralyzed because no one will tell me how to gain confidence to take back my life and take my GED and manage my ADHD/Autism(I think I’m a bit on the spectrum.) I’m going to be asking my gyno to check my hormone levels. I just had my yearly, but I’ll call and leave her a message. See what she thinks. It could be life changing for some of us.

[@sallyunderwood66]

During/after menopause, my symptoms got completely out of control. I was pretty nuts. I only got diagnoses earlier this year - at the age of 56. I always wondered what hormones had to do with it and why no therapists or doctors ever seemed to see things from this perspective.

[@rdklkje13]

Same here! Menopause brought ADHD to the surface as the lack of estrogen made compensating for it impossible. You may find Sandra Kooij’s work interesting, she’s been researching this for decades.

[@sallyunderwood66]

@@rdklkje13 thank you! I'll have a look at Sandra's work.

[@StVesta]

PMDD! Thank you so much for bringing more awareness to this!

[@user-mp4gp7po4w]

Thank you so much for this. We need so much more research and therapies to help females with adhd.

[@nicolebea9764]

Thank you so much for presenting this! ❤ I have PMDD and ADHD. It’s hard to know where to start with getting them both effectively treated. This information is very helpful.

[@elinek5470]

I certainly have pms, but my rage - when triggered - was/sometimes still is very bad the days before my period starts. It is like i am another human being 😮 but it is worst when i am stressed. Nowadays i know what it is, and i keep track of my cycle. Before that i did not know what made me so depressed. When my period starts it is like a fog is going away and i can think more clearly again. Now i warn my environment and try to take extra care of myself😅

[@nicolebea9764]

@@elinek5470 Yes! I had the same experience before I got the diagnosis. I was often confused-and after a rage episode, embarrassed. My behavior was completely out of character; someone else was driving. 😅 Knowing what it is and knowing my limitations has certainly helped. 😊 I have to slow down; I can’t operate at full capacity. I try to keep my premenstrual days as low-stress as humanly possible.

[@elinek5470]

Exercise helps me a lot i noticed, and not eating things with white flour and sugar (not even much fruits), and eating more protein. My blood sugar is very sensitively balanced and especially around my period 🥲 Do you have other things you like to do around that time?

[@nicolebea9764]

@@elinek5470 ⛅️ During the day, Midol boosts my mood better than tea/coffee. I actually feel happy and upbeat, not just wired. I have fewer caffeinated beverages since the Midol is plenty. Don’t want to overdo it since it can make anxiety worse. ⭐️ For evening and night, I drink lavender tea to calm me. I sometimes use my MZOO sleep mask for a short meditation or to help me refocus…and I listen to Alan Watts recordings on KZbin 😄 while deep-breathing.

[@luslab]

I am nearly 100% certain that I got diagnosed late in life with ADHD because I was suffering from some hormonal problems/fluctuations and my ADHD symptoms became unbearable. I was quickly diagnosed with ADHD but it would take me nearly two years to realize that my problems stemmed from my hormones. Once my hormonal problems were addressed, my ADHD symptoms became so much more manageable. My doctor was convinced that it was anxiety or even bipolar disorder because of the cyclical ups and downs I would have. I am now realizing that my depression was due to hormonal problems, the anxiety my psychiatrist thought I had was actually hormonal problems, my overwhelming ADHD symptoms were due to my hormonal problems. I obviously still have ADHD but it is manageable now with medication and therapy, along with consistently developing skills and establishing routines. It frustrates me that there is so little research on this topic. It shows how little thought is given to women in ADHD research. To add to this, pregnancy for me was a very stable time mentally. I felt so focused and energetic. I would just get things done and would not feel down or lethargic. I wish I could feel like that again.

[@healthylife4eva]

What medication helped you?

[@luslab]

@@healthylife4eva I was first put on clonidine and had an amazingly good reaction to it. I think my psychiatrist tried it to see if I had ADHD, because when I told her how stable and "normal" I felt on it, she said "I think you have ADHD" and I laughed because I thought she was joking. I thought my inability to read and focus was due to depression or something. I thought she was treating my depression. I knew nothing about ADHD. I then got officially diagnosed through evaluation/testing. I had been taking Wellbutrin before I got diagnosed, it was the only antidepressant that worked and then I learned that it's used for ADHD. I honestly think that most of my symptoms were ADHD related and very minimally related to depression. I am currently taking Concerta ER and Stattera, clonidine and Wellbutrin for my ADHD. I was previously taking Adderall but I switched over to Concerta because I felt it wasn't working as well as it initially did. I feel like I am in a sweet spot in terms of my ADHD meds. Concerta and Stattera address my focus, and clonidine and Wellbutrin address my mood stability/emotional regulation. In terms of hormones, I stopped taking the pill two months ago after being on it to stabilize my hormones. My hormones got messed up from getting an IUD (Mirena). I am very sensitive to hormones and I'm not sure if that is an ADHD thing or what, you know, because there is no research on it. I got the Depo shot many years ago and that made me an emotional and unfocused wreck, screwed up my cycle and I had to go to the pill to stabilize my cycle. Just remember that everyone is different. What works for me can not work at all for others.

[@kelliodell9686]

Perhaps you are aware of Dr. Louise Newson, but I was really helped to listen to this podcast that provides a huge education on why some women love how they feel during pregnancy; it's often all about progesterone sensitivity--in pregnancy you have what you need, and afterwards, not so much: kzbin.info/www/bejne/fnyvpWpjoNuJr5I

[@alternativetentacles1760]

I definitely feel the changes throughout my cycle.

[@sharonaumani8827]

I didn't as much when I was younger. However, the closer I got into perimenopause, the more I started to notice changes to my executive functions and mood. It got to the point I felt crummy nearly half the month [the week before starting, and up to a few days after completing my menses].

[@brandywindham4248]

Dr. Barkley, thank you for sharing this! I was formally diagnosed at 36 and I'm now 40. I have noticed how sensitive and irritable I am while on my cycle. Not just with feelings but also touch. I will go change an entire outfit because I feel so overwhelmed by the fabric or the fit of the fabric. Things I normally wear drive me insane to the point of tears. I also just realized my medicine doesn't seem to kick in. No matter how much sleep Ive had or how good my nutrition is. When I mentioned it to my psychiatrist last week, he told me it was PMDD. He assured me it does not correlate with ADHD.

[@redrovermedia964]

Dr. Barkley, you have been such a wonderful help to me since I was diagnosed at 32 a little over a year ago as I learn to accept that yes, I do have a disability but once I know my limits, I can create a succesful plan. My life makes sense, now, and I have hope I can find paths through life that work for me. Recently I realized I may have PMDD, just a couple days ago actually when I hit a very hard, hard bottom emotionally due to difficult circumstances in my life that made the symptoms that much worse. Maybe if I had known it was even a thing, I couldve prevented such intense suffering and trouble in my life. Its hard to describe the spiritual level of pain I have felt twice now, the last two months, only barely making the connection to my irregular menstrual cycle. I shudder to speculate that PMDD couldve had an even worse effect on my life with how traumatic it has been for me lately, if I didnt catch it. I only just saw this video, and I havent even watched it yet but I just find it so serendipitous that Doctor KZbin Grandfather Barkley might have some studies to show me about that, as well, so I can be my own advocate. Thank you, sir!

[@didemkilinc]

I’m 46 and peri-menopausal. I have never felt so dysfunctional in my life. I can’t get anything done, can’t focus on anything, find myself disengaged from everything and also find myself very irritable. When I read or listen to something words don’t register. I’m so easily stressed out. Life is a bigger struggle now. What’s going on with me?

[@christied3645]

Thank you for your time in making this content!

[@CJBintheHouse]

I love your videos. They’ve helped me communicate my disorder so much better, thank you ❤

[@rdklkje13]

Dr Barkley, like many others, I wasn’t diagnosed until menopause made it almost impossible for me to do anything at all. In hindsight, however, it’s not that I was sub-clinical before. It was 1) that my symptoms weren’t recognised as being ADHD, i.e. misdiagnosis, and 2) that high intelligence compensated for a lot, but at a very high price for me mentally and physically as I was hanging on by the skin of my teeth for decades. I recently found medication which makes a big difference, but unfortunately I’ll have to stop using this soon because it turns out that it works by re-starting estrogen production, something not listed as a known side effect of this medicine although other cycle-related effects have been registered.

[@ursulamoney203]

I was the same: menopause was the last straw and I am now medicated, More importantly, after reading a lot about oestrogen I finally - age 63! - lobbied for hormone patches and they have made a bigger difference than the medication. Would you please share which drug re-starts oestrogen production? That would be useful/interesting?

[@rdklkje13]

I didn't include the name before, because these things work differently for different people. I also have some neurological damage, I should add. This means that even before menopause there were many things I couldn’t do and it may affect how the medications work. But with this caveat, it's Bupropion. And I do find that to be interesting because even though this medicine was first registered in 1985 (I forget whether as an antidepressant or help to stop smoking), it’s still unknown how it works. My main therapeutic needs were/are for improved task initiation and completion, sustained attention, focus - basically the executive functions you need just to be able to eat, dress, move around and other basic aspects of daily life. (While I used to have emotional dysregulation, depression, anxiety and such, these haven’t been an issue for about a decade at this point.) I started off with methylphenidate XL which gave me bad, known, side effects even at low doses, and only slight benefits. Then I changed to Elvanse (Vyvanse) which was much better. No real side effects other than decreased appetite, and quite noticeable benefits. This worked up to 50 mg, but I couldn't tolerate more than this, unfortunately. Since more benefits would be very helpful we added Bupropion (off-label for EFs). 150 XL at first which led to a bit more improvement but still seemed far off a potential ceiling. So we increased the dose to 300 XL, and this made an immediate difference. I could suddenly do things I hadn't been able to do since menopause even with the Elvanse. At this point I decided to stay at this level of medication, cos it seemed sufficient for me to be able to do something about diet, sleep, exercise (as opposed to being happy if I managed to eat anything at all, for example). And then once these things had improved, assess whether more/different medicine might still be relevant. That was about two months ago, but yeah, it’s turned out that my hormone levels are not post-menopausal anymore, with the change from 150 to 300 XL Bupropion the apparent culprit. We’re still looking into this, so I don’t know yet if I can continue with 150 mg, but even so, it didn’t make the same difference. Which make sense, if what actually makes the difference is the estrogen. I hope you don’t mind the long reply, I prefer to mention such things in the proper context (which may be more expansive for my ADHD brain than for many other people 🙃). I’m also curious about your patches - for how long can you keep using those? I thought only a few years. I also asked my GP whether I might try HRT first, as the waiting lists for ADHD diagnosis are considerably longer here, generally. But in the end I was able to get the ADHD assessment more quickly after all.

[@mixedmedialife7916]

​@@rdklkje13I'm very grateful for your initial comment and this detailed follow-up. I can relate to so much of your story. Will talk to my doc abt bupropion amongst other Rxs. Thank you so much 💐

[@bethb5915]

Hi, I can't find anything online about Bupropion / Wellbutrin restarting estrogen production. But because it works with norepinephrine levels (it's an SNRI not SSRI) it can apparently increase testosterone a bit. Also, our hormone levels fluctuate a lot day to day and even hourly, so you can't know for certain what your levels are like you can if you get a blood test for other things. So good doctors treat your symptoms, and it can be a process of trial and error to see what best addresses your symptoms.

[@bethb5915]

​​@@ursulamoney203- Same for me with menopause. FYI, you can research Bupropion online (called Wellbutrin in the US) - there's tons of info. I tried it and it did nothing for me, positive or negative, so that's just an example of how drugs work differently in different people. 🤷🏼‍♀️

[@lanas.3116]

Your videos bring me so much hope and relief. All this information is wonderful and validating. Thank you for your succinct and timely messages.

[@brendahobday]

To paraphrase Spike Milligan 'I told you there was something wrong' Perimenopause made my previously undiagnosed ADHD so much more apparent but I was dismissed everytime I went to the doctors. We need so much more research, acknowledgement and co-ordination of results.

[@zandrazentio5290]

This is describing just how my life has been. So importent ❤

[@ambertheanxious]

This is all so mind blowing for me. It just makes so much sense, how much more I struggled through school when I first started my period. I got diagnosed with PMDD a few years ago and now ADHD just a year ago. In my PMDD groups, it is seeming SO common to have both

[@notso3031]

Thankyou Thankyou Thankyou this is so helpful!! Finally some recognition ❤

[@cameronwilliams8161]

Thank you for reviewing this article Dr. Barkley!!

[@annaeliasson952]

Estrogen patches gave me my brain back.

[@MarieMuscat-eg1xw]

Can I ask how old you were when you started?

[@annaeliasson952]

I was 51.

[@sharonaumani8827]

Indeed! It just needs to be in the right FORM!

[@sharonaumani8827]

Thank you so much! I just forwarded this link to my therapist/physician and encouraged they also share with GP's [and GYN doc's]. In hindsight, I clearly had ADHD before the age of 7, but I still held an outdated definition of ADHD. I have worked in mental health for many years, as a nurse, both inpatient & outpatient, but I didn't figure out my own ADHD until perimenopause, when my lifelong self-compensatory mechanisms started to fail [along with memory, more than usual]. Since I never worked with kids, nor had any of my own, I never had a reason to find out more about ADHD or autism [I thought!]. Everything started falling apart [and mostly resolved with HRT]. I even started to suffer from parasomnias that were correlated with the first day of my monthly cycle, or when it would have been, if it had skipped. My B/P was all over the place, [often too elevated], but that also resolved with HRT. I basically went back to my previous baseline [where I needed further treatment for the ADHD and comorbid depression, but back to "my normal"]. Also, I was careful to use an Estradial patch [not oral Estrogen OR Progesterone], so as to bypass the liver, which would only negate the beneficial effects]. I was afraid to get off hormones, but Menopuase is a much more tolerable adjustment!

[@K.Arashi]

thank you for this! this pretty much confirms the suspicions i've been having that i need to get back on the combination birth control pill. my adhd symptoms and depression both got harder to deal with when i switched to the mirena iud a few years ago. the "not having to remember to take one more pill everyday" part isn't worth the "not being able to deal with anything else" part.

[@kellyalsaleh3032]

I got my ADHD diagnosis late (age 46) and benefited from my medication. Once the perimenopause gathered force in the last year (age 48-49), I noticed brain fog and poor working memory but it felt different to the kind I have always struggled with (with ADHD). this felt much more foggy, and vague, dopey than ADHD brain fog. I've just started HRT (hope I can remember to stick to the cyclic regimen!). Sadly, we are experiencing a worldwide supply issue with ADHD meds so my ADHD prescription keeps being delayed at the pharmacy as they try to source similar alternatives.

[@melindar.cordell8775]

Try getting your meds through a local mom and pop pharmacy. Oddly, they're able to source meds that the big suppliers can't get. They can't get everything, but they'll work with you at any rate.

[@julyol119]

Thank you for that information, it's really interesting. I csn definitely say, that I tend to slide into deoressive states around my period, even though I usually have my depression well under control.

[@user-zf9ho3wk1b]

Really appreciate your content and expertise. You are one of the few sources I trust implicitly as we know there is SO MUCH misinformation and stigma out there regarding ADHD, especially when it comes to women. I hope you will also examine and comment on the growing research behind menopause and ADHD. I am 64, diagnosed at age 37 and some of my ADHD symptoms are nearly unmanageable at this point in my life, in spite of continued stimulant medication and the later addition of clonodine. Symptoms such as disorganization and emotional dysregulation have increased in my post-menopausal years, whereas symptoms such as risk-taking have decreased.

[@LiMaking]

This is interesting. I've just started my medication journey, and one of the first things I felt was that I felt the effects of my medication more during/later during my period, and almost no help 2 weeks before my period. I've just started taking a higher dose, so we'll see how it went in about a month. Edit, also when I told this to my doctor she said this is the first time she heard anyone trying the medication say this (in an interested and positive way though). There should be more women like me who feel this way about their medication but might not feel like it's important to share to their doctor. These women should share it.

[@elizabethmarie96]

I'm a 28 year old female, and I have ADHD and PMDD. As soon as I went on the FDA approved pill for PMDD (.02mg estrogen and 3mg progestin), I became very productive and slept a lot better; I don't need sleep aids nor do I need to listen to ASMR to wind down, I just go to sleep as soon as I lay down. I love how on top of my day to day activities I am with my elevated productivity. My mood is much more uplifted, stress is completely manageable, and I don't feel my usual phobias. I feel so much more "present" in life; I'm not living in a cloud anymore. I wish I started the pill sooner, I feel like a "normal" person for the first time. It blows my mind that just supplementing hormones has been infinitely more effective than taking amphetamines (which I haven't taken for over a decade due to their debilitating side effects).

[@pattyw9543]

Thank you so much for this informative video! Dbl whammy here!

[@kayaykay7381]

Thank you and i hope to see more of this from your channel. I was diagnosed a year ago and I started my meds right before my cycle and they worked great. When my cycle started i told my psychiatrist they were not working but didnt even think of the connection, so now i am trying something else. I feel like adhd is a neverending puzzle.

[@catherinehoward7012]

I am 55 and have been recently diagnosed with combined ADHD. This video makes so much sense to me now and looking back over my life. Thank you

[@takiyaazrin7562]

Great study!

[@peachykeen7634]

I’ve been pregnant and post-partum 4x. My symptoms are COMPLETELY UNMANAGEABLE without medication during pregnancy and nursing. The catch-22 is that Docs don’t want to RX meds while women are pregnant/nursing.

[@drgillykahn]

Thanks for posting this. 5 studies? That's insane

[@heatherrosa7966]

This has been a long journey for me to figure out, I just recently got diagnosed with adhd at 33. I began therapy when I suspected I had it and I told her how I felt like my monthly cycle was greatly affecting my behavior and she diagnosed me with bipolar 2. I had already learned that therapists will go through a cycle of diagnosing other disorders before landing on adhd, and I had already been diagnosed with anxiety, depression now bipolar and ptsd. I saw a psychiatrist (recommended by my therapist for bipolar) and the psychiatrist diagnosed me with adhd. I will also be getting a neuropsych exam because I’m getting conflicting diagnoses from 2 different professionals. I think it is adhd that varies during the time of my cycle, and mood changes go along with that. The second half of my cycle I am much more lethargic, very distracted, inattentive, hard to concentrate, more prone to want to drink alcohol, more crying/emotional disruption but during the first 2 weeks I feel pretty good, energetic and happy. I am prescribed focalin and I would like to talk to my psychiatrist about using it just during the second half of my cycle when I need the most help.

[@kasia199213]

This is a very important video and study!

[@mirandak1773]

I shockingly was diagnosed as a female by the time I was 13 and what ended up doing me in where I felt like I couldn't tread water anymore was pregnancy and postpartum. The hormonal shifts at the time, i feel, permanently affected me 😢

[@ghostapi874]

Thank you very much for the video. Would it be possible to make a video regarding pregnancy and whether you should stop your stimulant medication during pregnancy?

[@caitiecatcreates]

^ my OBGYN told me to take it because he could see I was stressing and worse off without it. But now that I hit the third trimester, it doesn't even work. I'd love a video on this topic.

[@tatianakholiavko9727]

Wow! This is so important. Thank you so much for your explanation of this scientific article!

[@leilap2495]

The last week of the cycle was so awful for me. I had to add on an SNRI and birth control mainly because the hormone fluctuations in PMS interfered with my ADHD medication feeling like it was working at all. During pregnancy, I recall feeling dumbed down and sluggish, but happy after an initial surge in anxiety.

[@noseehere]

44 and perimenopausal here. I'm not okay. Barely functioning at all. Mood swings, irritability, agitation, hot flashes, rage. Absolutely zero help or support available here. Medical gaslighting and abuse only. 😣

[@alannah8891]

Hi Dr. Barkley. Thank you very much for this KZbin channel and all of your research and advocacy for people with ADHD. I’m curious if you have knowledge on ADHD, stimulant medications, and women’s reproductive health - especially as it relates to women trying to conceive or during pregnancy. There isn’t a lot of research, but there’s so many differing opinions on the safety of stimulant meds prescribed for ADHD and pregnancy. Thank you very much!

[@CrowsinthePark]

So...why? What is the relationship between estrogen, progesterone and the prefrontal cortex, neurotransmitters like dopamine, etc? What is the mechanism of this effect?

[@Lakshyam9]

Estrogen in women has the same effect as DOPAMINE

[@katzrantz]

I can't remember where I read it, but oestrogen receptor .. beta? can slow down dopamine reuptake. I'm gonna have to go back down that rabbit hole or I won't sleep.

[@nk-dc5gc]

share your results please, once you found the study :)

[@divergentmind2023]

when i was pregnant with girls i felt the most normal but pregnant with a boy it was not as easy i will be 46 this month, these last years i felt like a huge handicap, someone came and erase my memory, it scares me how little i can understand of the world around me

[@elizabethangelo4190]

Thank you thank you. Signed dx at 43 after my daughter now at 49 perimenopause brought it all crashing down.

[@jophillips1909]

Well that is certainly my experience too 😢

[@helencharnock3436]

I have adhd and aspergers, i found it impossible to cope with my time of the month and eventually had a fuĺ hysterectomy, best thing i ever did.

[@shatha8908]

I can predict my menstrual period day and evolution day without looking at the calendar, just by my ability to regulate my emotions, And Executive functioning, I believe this is having tremendous impact on my ability to succeed at work/ study and even keeping up with healthy eating or home chores, despite all my attempts😢 Thank you for this valuable resource, Now the question is my daughter is 9 years old, she only got her diagnosis last year, my psychiatrist said it’s not advisable to start medications now, as this might affect her hight growth, especially she is on the 3% hight on growth charts, but if this is going to be so limiting for her during puberty years, shall I start medication for her now ?

[@studiosvpd]

More research!

[@llareia]

This also undoubtedly makes it more difficult for women to get diagnosed; the diagnostic criteria rely on you having had similar symptoms your whole life, and doctors tend to leap to other conclusions if you had a change in symptoms at life stage changes.

[@caitiecatcreates]

Im pregnant, and my medication is not working. We dropped me to a 15 mg Adderall and it worked but now im in third trimester, and it seems to not work at all. ! This video def makes sense.

[@epicindy]

I would love to hear about how you interpret this data for those of us who take hormones (the pill, or in my case progesterone only as treatment for endometriosis) and thus don't have a natural cycle?

[@lambs5258]

I'm so glad you're covering this. Amazing video. Got a question: If someone is on hormonal birth control and doesn't have a period, would that protect against the impact of their cycle/hormones on ADHD symptoms? In those cases does it just remain stable?

[@katereeez]

Wondering the same thing!

[@carlagraca2729]

My personal experience with ADHD and being on and off of HBC indicates that yes, being on the pill stabilizes the ADHD symptoms. Right before the period, I can barely function, even with increased dosage of stimulants. When I'm using a HBC, the symproms remain stable and I don't go crazy... But of course, this is a personal experience, not a general response.

[@Tiffany-lo6hc]

Dr. Barkley, can you speak about what other practitioners are prescribing at different points in a woman's cycle? I'm on 300 mg pf Wellbutrin and its amazing - but it doesnt work at ALL in the progesterone days leading up to menstruation. It gets real rough. Thank you!

[@desereetouchet9294]

I sought out a diagnosis at 39 years old. I'm pretty sure I'm in perimenopause early (apparently if you've ever smoked this can happen) and I (with the permission of my Dr.) take birth control without taking the week of pills that don't have hormones. That helps both the perimenopause symptoms and keeps the estrogen levels up so that helps my ADHD meds work better.

[@user-zq5jy9ds7v]

What are the recommended medications to control for symptoms for women particularly regarding emotional dysregulation that may be increased? What are your thoughts on the impact of hormonal birth control on Women with ADHD?