Is the overlap between ADHD and perimenopause one of the most overlooked areas in women’s health?
October marks both ADHD Awareness Month and World Menopause Awareness Month, yet the connection between the two continues to be missed by so many healthcare professionals.
Countless women reach perimenopause and suddenly find themselves struggling with focus, motivation, memory, and emotional regulation. For some, these symptoms are new. For others, they’ve been there all along, just mistaken and misdiagnosed with other conditions.
Many women are diagnosed with anxiety or depression, when the underlying cause may actually be ADHD made worse by hormonal changes. Oestrogen plays a crucial role in regulating dopamine, a key neurotransmitter involved in attention, motivation, and emotional balance. When oestrogen levels fall during perimenopause, ADHD traits can intensify dramatically (Medical News Today, 2024; Biedermann et al., 2023; Quinn and Madhoo, 2025).
Instead of recognising this pattern, too many women are prescribed antidepressants or told they’re simply “not coping”. Their lived experience is dismissed, and the real picture remains unseen. It’s not a lack of resilience, but a lack of recognition.
What support looks like
Understanding the overlap between ADHD and perimenopause is only the first step. The next challenge is creating the right support which is compassionate, informed, and tailored to each woman’s needs.
For many, the most effective approach combines medical, psychological, and lifestyle support within a neuro-affirming framework. Body-identical hormone replacement therapy (HRT), prescribed in line with NICE guidelines, can help stabilise fluctuating oestrogen levels, improving cognitive function and mood regulation. For those already on ADHD medication, stabilising hormones can make medication more effective and reduce emotional volatility (PMCID: PMC12145478, 2025).
Equally important is access to neuro-affirming coaching, therapy, or counselling. These approaches recognise the individual’s unique brain wiring rather than focusing on “fixing” perceived deficits. They help women understand how their ADHD traits interact with hormonal changes, and how to create strategies that work with their brains rather than against them.
Many women, myself included, have spent years, even decades, in therapy that was not neuro-affirming, and therefore never truly felt understood and it never really helped. Only once I began working with professionals who understood ADHD and neurodivergence did things begin to make sense. Without that understanding, therapy and CBT can unintentionally reinforce shame or self-blame, leaving women feeling as though they are failing to “get better”. Sadly, I know my experience reflects that of so many others.
Neuro-affirming support focuses on self-compassion, realistic expectations, and building systems that honour how the brain actually works. It helps women prioritise rest, manage overwhelm, and rediscover their strengths, particularly when perimenopause adds another layer of emotional and cognitive change.
Recent research highlights the importance of this approach: neurodivergent clients who receive identity-affirming support report significantly better mental health outcomes compared with those receiving conventional interventions (Kroll et al., 2024). This reinforces that understanding and validating neurodivergence is not just an optional extra, but is essential for effective care and support.
Peer connection also plays an important role. Many women describe finding enormous relief through communities of others who share similar experiences. Being seen and validated by others who understand can reduce the isolation that so often accompanies both ADHD and menopause.
Workplace adjustments can make a significant difference too. Recognising fluctuating concentration, emotional sensitivity, or time-management challenges as part of this intersection can help employers offer flexibility, realistic deadlines, and supportive communication. Small adjustments can prevent burnout and allow women to continue thriving professionally. However, while reasonable adjustments are a legal requirement under the Equality Act 2010 (UK), the reality can be very mixed. Some employers embrace this responsibility with genuine understanding and compassion, while others approach it as a tick-box exercise, offering little meaningful support in practice.
Why awareness matters
We need far greater awareness, better education for clinicians, and more integrated pathways that acknowledge how hormones and neurodivergence interact. Menopause care should routinely include screening questions about focus, motivation, and sensory sensitivity. Equally, ADHD assessments should include questions about menstrual cycles, perimenopause, and hormonal fluctuations.
Until that happens, thousands of women will continue to feel misunderstood and unsupported at a time when they most need compassion, clarity, and the correct support. Awareness and early intervention can transform lives, helping women not just to cope, but to understand themselves and thrive through this stage of life and beyond.
As I reflect on this overlap between ADHD and perimenopause, I can’t help but think about the generations of women before us who lived through this without understanding or support. So many were dismissed, invalidated, and made to feel that their struggles were a personal failing rather than the result of biology and neurodivergence. Some were even institutionalised in asylums, labelled as “hysterical” or “unstable” for symptoms we now understand as hormonal and neurological. Although not as extreme today, echoes of that stigma remain. Women are still too often dismissed, misdiagnosed, or told they are simply not coping. Remembering this history reinforces why awareness and compassion matter so deeply now, because what was once misunderstood and punished must never be repeated.
References
Biedermann, J., et al. (2023) ‘The impact of oestrogen on dopamine and ADHD symptom presentation in women’, Journal of Psychoneuroendocrinology, 150, p. 106176.
Kroll, E., et al. (2024) ‘The positive impact of identity-affirming mental health care for neurodivergent clients’, Frontiers in Psychology, 15, p. 1403129.
Medical News Today (2024) ‘How hormones affect ADHD symptoms in women’. Available at: https://www.medicalnewstoday.com/articles/hormones-and-adhd (Accessed: 29 October 2025).
PMCID: PMC12145478 (2025) ‘ADHD and sex hormones in females: a systematic review’, Journal of Neuroendocrinology. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC12145478 (Accessed: 29 October 2025).
Quinn, P.O. and Madhoo, M. (2025) ‘Research advances and future directions in female ADHD’, Frontiers in Global Women’s Health, 6, 1613628. Available at: https://www.frontiersin.org/articles/10.3389/fgwh.2025.1613628/full (Accessed: 29 October 2025).