Evidence-based supplements to support ADHD during perimenopause and menopause

7 Nov

Navigating perimenopause or menopause when you also have ADHD can feel like being hit from both sides. Hormonal fluctuations, particularly declining and erratic levels of oestrogen, progesterone, and testosterone, can significantly affect cognitive function, mood, sleep, and executive functioning.

For women with ADHD, these hormonal shifts can be particularly challenging. Oestrogen plays a key role in modulating dopamine and serotonin pathways, both of which influence attention, focus, and emotional regulation (BMC Psychiatry, 2020; My Menopause Centre, 2023). When oestrogen levels fluctuate, the symptoms of ADHD—such as overwhelm, forgetfulness, emotional sensitivity, and poor concentration—can worsen noticeably.

While hormone replacement therapy (HRT) is often a key part of managing menopausal symptoms (NICE, 2024), some women also explore supplements to provide additional support. Certain nutrients and herbal compounds can help regulate the nervous system, stabilise mood, support gut–brain health, and optimise hormone metabolism. However, supplements are not a replacement for evidence-based medical treatments such as HRT or prescribed ADHD medication, and should always be discussed with a qualified clinician to ensure safety and suitability (NHS, 2024a).

What the NHS and NICE say

Current UK guidelines emphasise that most supplements and complementary medicines for menopause lack robust evidence and regulation, and some can interact with prescribed medications (NHS, 2024b). The NICE Menopause Guideline (NG23) highlights that HRT remains the most effective evidence-based treatment for menopausal symptoms, and that complementary therapies should only be considered when adequate safety data exists (NICE, 2024).

For adults with ADHD, the NHS (2024c) recognises lifestyle interventions, behavioural strategies, and medication as core treatments. Supplements are not currently part of standard ADHD management recommendations. Therefore, any supplementation should be considered an adjunct, not an alternative, to established treatment approaches.

Evidence-based supplements

Below are some supplements that have been explored in relation to both ADHD and perimenopause. Each shows potential benefits but should be considered with appropriate caution.

Magnesium (especially glycinate or threonate)

Magnesium supports sleep, mood regulation, and nervous system function. Magnesium L-threonate in particular has been linked to improved cognitive performance and reduced anxiety in small studies, though evidence in ADHD populations is limited (Harris, 2023). The NHS advises prioritising dietary sources first, such as leafy greens, nuts, seeds, and whole grains (NHS, 2025a).

Caution: High doses can cause digestive upset and may interact with antibiotics.

Omega-3 fatty acids (EPA and DHA)

Omega-3s are essential for brain health, reducing inflammation, and regulating mood. Research suggests modest improvements in ADHD symptoms when supplements are high in EPA (Sinn and Bryan, 2010; Breen et al., 2017). The NHS encourages regular consumption of oily fish for its benefits to brain and heart health (NHS, 2025b).

Caution: Choose high-quality, sustainably sourced fish oil supplements.

Vitamin D3 (with K2)

Vitamin D supports hormone production, bone strength, and mood regulation. Deficiency is widespread in the UK, particularly during the winter months (NHS, 2024d). While research on ADHD-specific benefits is limited, low vitamin D levels have been associated with fatigue and low mood, which can exacerbate both ADHD and perimenopausal symptoms (Medical News Today, 2024).

Caution: Avoid high doses without medical advice or blood testing.

B-complex vitamins (B6, B9, B12)

These vitamins are crucial for energy production and neurotransmitter synthesis. Deficiency can contribute to fatigue and emotional instability (NHS, 2025a). While research on ADHD-specific benefits is mixed, maintaining healthy B-vitamin levels supports general cognitive and emotional wellbeing (Verywell Mind, 2016).

Caution: Excessive supplementation may cause nerve irritation; food sources are preferable.

Zinc

Zinc supports dopamine regulation, immunity, and hormone balance. Low zinc levels have been associated with inattentiveness and impulsivity in ADHD (Verywell Health, 2016). Foods rich in zinc include beans, lentils, seeds, and seafood.

Caution: Too much zinc can cause nausea and deplete copper levels.

Ashwagandha (Withania somnifera)

An adaptogenic herb traditionally used to reduce stress and anxiety, ashwagandha has been shown to improve sleep and reduce climacteric symptoms in perimenopausal women (Gopal et al., 2021). It may also help with emotional regulation in ADHD, though further research is needed.

Caution: May interact with thyroid medication, HRT, or stimulant medication.

Iron (only if deficient)

Iron is essential for dopamine function and energy. Low ferritin levels have been linked to cognitive fatigue and poor attention in ADHD (Konofal et al., 2020). Women experiencing heavy bleeding during perimenopause are especially at risk of deficiency.

Caution: Never supplement iron without a blood test, as excess can be harmful.

L-Tyrosine

A precursor to dopamine, tyrosine may support focus and alertness under stress (Benton, 2021).

Caution: Can raise blood pressure or anxiety in some individuals and should not be taken alongside stimulant medication without clinical guidance.

Rhodiola rosea

Another adaptogen, Rhodiola may help improve resilience to stress and reduce fatigue, though evidence is mixed (Panossian et al., 2021).

Caution: Avoid if taking antidepressants or stimulant medication.

N-acetylcysteine (NAC)

NAC has shown promise in supporting emotional regulation and impulse control in adults with ADHD (Zhou et al., 2022).

Caution: Possible interactions with nitroglycerin or psychiatric medications.

Probiotics and fibre supplements

The gut–brain axis plays a key role in mood and cognition. Certain probiotic strains, such as Lactobacillus rhamnosus and Bifidobacterium longum, have been associated with improved stress resilience (Bagga et al., 2018). Fibre-rich prebiotics such as psyllium husk and inulin support gut and hormone health (British Dietetic Association, 2024).

Caution: Introduce gradually to avoid bloating or discomfort.

Key considerations before supplementing

Always test for deficiencies (iron, vitamin D, B12, folate, thyroid) before starting any supplement.
Some supplements (especially adaptogens and amino acids) can interact with ADHD medication or HRT, always seek clinical guidance first.
Use reputable, third-party tested products to ensure quality and safety.
Supplements can complement, but not replace, medical treatments such as HRT or ADHD medication.
Foundational lifestyle strategies like adequate sleep, balanced nutrition, regular movement, and effective stress management, remain essential for managing both ADHD and perimenopause (NHS, 2024a).

Final thoughts

For women navigating ADHD during perimenopause or menopause, finding the right balance between medical treatment, nutrition, and lifestyle can make a profound difference. Evidence-based supplements can sometimes offer valuable support, but they should always be used with care, professional supervision, and a clear understanding that every woman’s needs are unique.

If you’d like to learn more about managing ADHD during perimenopause and menopause, or explore personalised strategies through ADHD coaching, you can visit my website [insert link] or sign up for my monthly newsletter for more evidence-based insights.

References

Bagga, D., Reichert, J.L., Koschutnig, K., Aigner, C.S., Holzer, P., Koskinen, K., Moissl-Eichinger, C. and Schöpf, V. (2018) ‘Probiotics drive gut microbiome triggering brain connectivity changes in healthy humans’, Nature Microbiology, 3(1), pp. 64–73.

Benton, D. (2021) ‘Tyrosine, stress and cognitive performance’, Nutrients, 13(2), pp. 1–10.

Breen, C., Cooney, J. and Dempsey, S. (2017) ‘Omega-3 benefits to ADHD brains: fish oil for focus’, ADDitude Magazine, 23(2), pp. 12–15.

British Dietetic Association (BDA) (2024) Fibre fact sheet. Available at: https://www.bda.uk.com/resource/fibre.html (Accessed: 5 November 2025).

Cooper, B., Stevenson, C. and Allen, D. (2015) ‘Omega-3 supplements for ADHD: current research findings’, Canadian Learning Society Journal, 11(4), pp. 35–42.

Gopal, N., Johnson, L. and Wiley, A. (2021) ‘Effect of an ashwagandha root extract on climacteric symptoms in perimenopausal women: randomised, double-blind, placebo-controlled study’, Journal of Obstetrics and Gynaecology, 41(7), pp. 1093–1101.

Harris, M. (2023) ‘Should you take magnesium L-threonate? Benefits, dosage and risks’, Health.com, 17 June.

Johnson, L., Gopal, N. and Wiley, A. (2021) ‘Effect of ashwagandha root extract on climacteric symptoms in perimenopausal women’, Wiley Online Library, 40(6), pp. 875–882.

Konofal, E., Lecendreux, M. and Cortese, S. (2020) ‘Iron deficiency in attention-deficit/hyperactivity disorder’, Pediatric Neurology, 111, pp. 14–20.

Medical News Today (2024) ‘Vitamin D and mood: What’s the link?’, Medical News Today, 15 February.

My Menopause Centre (2023) Attention-deficit/hyperactivity disorder (ADHD) and the menopause transition. Available at: https://www.mymenopausecentre.com (Accessed: 5 November 2025).

National Institute for Health and Care Excellence (NICE) (2024) Menopause: diagnosis and management (NG23). Available at: https://www.nice.org.uk/guidance/ng23 (Accessed: 5 November 2025).

National Health Service (NHS) (2024a) Menopause: things you can do. Available at: https://www.nhs.uk/conditions/menopause/things-you-can-do (Accessed: 5 November 2025).

National Health Service (NHS) (2024b) Herbal remedies and complementary medicines for menopause symptoms. Available at: https://www.nhs.uk/medicines/hormone-replacement-therapy-hrt/alternatives-to-hormone-replacement-therapy-hrt/herbal-remedies-and-complementary-medicines-for-menopause-symptoms (Accessed: 5 November 2025).

National Health Service (NHS) (2024c) ADHD in adults. Available at: https://www.nhs.uk/conditions/adhd-adults (Accessed: 5 November 2025).

National Health Service (NHS) (2024d) Vitamins, minerals and nutrients. Available at: https://www.nhs.uk/conditions/vitamins-and-minerals (Accessed: 5 November 2025).

National Health Service (NHS) (2025a) Vitamins and minerals: others. Available at: https://www.nhs.uk/conditions/vitamins-and-minerals/others (Accessed: 5 November 2025).

National Health Service (NHS) (2025b) Fish and shellfish nutrition advice. Available at: https://www.nhs.uk/live-well/eat-well/fish-and-shellfish-nutrition (Accessed: 5 November 2025).

Panossian, A., Seo, E.J. and Efferth, T. (2021) ‘Rhodiola rosea: a phytomedicinal overview’, Pharmaceuticals, 14(6), p. 579.

Sinn, N. and Bryan, J. (2010) ‘Effect of supplementation with polyunsaturated fatty acids and micronutrients on learning and behaviour problems associated with ADHD’, British Journal of Nutrition, 103(8), pp. 1160–1166.

Verywell Health (2016) Zinc for ADHD: what the research says. Available at: https://www.verywellhealth.com (Accessed: 5 November 2025).

Verywell Mind (2016) Natural remedies for ADHD. Available at: https://www.verywellmind.com (Accessed: 5 November 2025).

Zhou, Y., Zheng, W. and Wang, C. (2022) ‘Efficacy of N-acetylcysteine in adults with ADHD: a systematic review and meta-analysis’, Frontiers in Psychiatry, 13, 865142.

Sarah West