The effects of ADHD and PMDD on women’s health
Premenstrual Dysphoric Disorder, or PMDD, is a severe hormone related condition that remains widely misunderstood. For many women it brings intense mood changes, anxiety, and physical symptoms which appear in a predictable monthly pattern but often remain unrecognised for years.
I was one of those women. Each month it caused significant mood shifts and an intense emotional impact, long before I knew there was a name for what I was experiencing. It affected every part of my life, from how I coped day to day to how I saw myself. It was only in recent years that I realised how closely these experiences aligned with ADHD, which suddenly made sense of why those weeks were so much harder to manage.
How PMDD affects the brain
PMDD symptoms peak in the late luteal phase of the menstrual cycle, the week or so between ovulation and the start of a period. During this time oestrogen drops and progesterone first peaks and then falls. For women with PMDD the brain becomes unusually sensitive to these fluctuations. A particular area of interest is allopregnanolone, a metabolite of progesterone, which affects the GABA and serotonin systems. These systems are central to mood regulation and emotional steadiness, and sensitivity to allopregnanolone can heighten irritability, anxiety, and emotional reactivity (Schiller et al 2016).
This biological sensitivity is not the same as a hormone imbalance. Instead, it reflects how the brain responds to otherwise normal hormonal changes. For many women this distinction is never explained, leaving them feeling confused, dismissed, or unsure whether what they are experiencing is “real”. Research over the last decade has helped to clarify the mechanisms involved, although awareness in clinical settings still lags behind.
The overlap between PMDD and ADHD
For women with ADHD this hormonal pattern often hits much harder. ADHD is fundamentally linked with dopamine regulation which affects focus, motivation, emotional regulation, and executive functioning. Oestrogen plays an important role in supporting dopamine production, release, and signalling, helping the brain utilise dopamine more effectively. When oestrogen falls sharply in the late luteal phase, this can destabilise dopamine availability and intensify ADHD traits such as emotional reactivity, reduced tolerance to stress, overwhelm, and poorer focus.
This means that women who already live with ADHD may experience a much steeper decline in coping capacity at this point in their cycle. Many describe this time as feeling as though their usual strategies stop working or that they temporarily lose access to their resilience. For some, this leads to misdiagnosis, with PMDD or severe premenstrual symptoms incorrectly attributed to mood disorders, personality disorders, or stress alone.
What the latest research shows
A new open access study published in the British Journal of Psychiatry offers some of the clearest evidence to date on the link between ADHD and PMDD. The researchers analysed data from 715 UK based participants aged 18 to 34 and found striking differences in PMDD rates depending on ADHD status (Broughton et al 2025). Provisional PMDD affected:
• 31.4 per cent of women with a self reported ADHD diagnosis
• 41.1 per cent of women who met ADHD criteria on the ASRS
• 9.8 per cent of women without ADHD
Risk was highest in women who had both ADHD and existing depression or anxiety.
Although the study authors highlight limitations, particularly around self reporting, the pattern strongly reflects what many women describe in real life. ADHD appears to increase vulnerability to severe premenstrual mood symptoms. Coexisting mental health conditions further amplify that risk, often leaving women with a complex mix of symptoms that are overlooked or misunderstood.
Why awareness matters
I spent years not knowing that PMDD existed, let alone that it had a clear pattern and recognised biological mechanisms behind it. So many women are left feeling as though they should simply cope better or that their symptoms reflect a personal failing. Research like this is vital not only for understanding the links between hormones, mood, and ADHD, but also for encouraging clinicians to ask about cyclical symptoms when supporting neurodivergent women.
For women themselves, having an explanation can be enormously validating. It can help them recognise patterns, seek appropriate support, and understand why certain weeks of the month feel overwhelming despite their best efforts. As more research emerges, particularly studies focusing on neurodivergent women, we can begin to create better pathways for assessment and support.
If these experiences resonate with you
If you recognise yourself in any of this, you are absolutely not alone. Many women live decades of their lives before they learn about PMDD or understand the role hormones play in ADHD. Awareness is increasing but there is still a long way to go in terms of clinical understanding, research, and appropriate support.
References
Broughton T, Lambert E, Wertz J, Agnew Blais J 2025, ‘Increased risk of provisional premenstrual dysphoric disorder PMDD among females with attention deficit hyperactivity disorder ADHD, cross sectional survey study’, British Journal of Psychiatry, vol. 226, no. 6, pp. 410–417, doi:10.1192/bjp.2025.104.
Schiller CE, Johnson SL, Rubinow DR 2016, ‘The role of ovarian hormones in mood disorders’, Biological Psychiatry, vol. 80, no. 6, pp. 479–489, doi:10.1016/j.biopsych.2016.05.007.