Is it ADHD or the perimenopause, or both?

19 Feb

Many women in perimenopause begin to notice changes in concentration, memory, emotional regulation, sleep, and their ability to manage everyday demands. With increasing awareness about ADHD, a common and entirely valid question can often follow, which is “is this ADHD, the perimenopause, or a combination of both?”

This is not always easy to untangle. ADHD and the perimenopause share a wide range of overlapping signs and symptoms, and for many women these experiences exist alongside one another. Understanding this overlap matters, because the support that helps hormonal change is not always the same as the support that helps ADHD, and many women need both to be recognised.

Overlapping symptoms of ADHD and the perimenopause

Both ADHD and the perimenopause can affect executive functioning, emotional regulation, sleep, stress tolerance, and mental clarity. Women often describe increased forgetfulness, difficulties sustaining attention, feeling emotionally overwhelmed, disrupted sleep, anxiety, irritability, and reduced capacity to cope with competing demands.

These experiences are recognised within menopause guidance, including that published by the National Institute for Health and Care Excellence, and they are also core features of adult ADHD. This overlap is one of the main reasons women can struggle to identify what is driving their symptoms.

Hormonal changes play an important role here, as fluctuating and declining oestrogen during perimenopause affects neurotransmitters such as dopamine and serotonin, which are already central in affecting ADHD. As hormone levels change, ADHD related difficulties can become more noticeable or harder to manage, particularly for women who have relied on coping strategies they have created without knowing it throughout their lives.

ADHD in women and late identification

Many women reach midlife without ever having been identified as ADHD. Diagnostic frameworks have historically focused on childhood behaviour, particularly in boys, meaning that many girls and women learned to mask, compensate, and push through difficulties without recognition or support.

Perimenopause can be the point at which these coping strategies no longer work. What looks like a sudden change can often be a combination of long standing neurodivergent traits and hormonal transition occurring at the same time.

Why symptoms are often misattributed

Women are frequently told that symptoms are either hormonal or psychological, when the reality is often more complex. Some women experience cognitive and emotional changes primarily driven by perimenopause. Others have ADHD that becomes more visible during hormonal change. Many experience both.

Historic support has been through the lens of a neurotypical, medical model and this often leaves women feeling that support has only partially helped, or that something is still missing. This can lead to frustration, self doubt, and delays in accessing appropriate care.

Why understanding the difference matters

Recognising whether symptoms relate to ADHD, perimenopause, or both is important because the pathways for support differ. In line with guidance from NICE and organisations such as the British Menopause Society, hormonal symptoms may be supported through HRT, lifestyle changes and psychological support

ADHD related difficulties may benefit from neuro-affirming therapy or coaching, workplace adjustments, structured support, and in some cases formal assessment and medical treatment. For many women, addressing both areas together leads to the most meaningful improvement.

Making sense of your own experiences

It can be helpful to reflect on patterns over time. Were some of these difficulties present earlier in life, even if they were better managed? Did symptoms intensify during your monthly cycle? Are there family patterns of ADHD or other forms of neurodivergence?

Structured reflection tools can support this process, helping women organise their thoughts, notice patterns, and prepare for conversations with healthcare professionals, employers, or support providers.

A more joined up approach

ADHD and the perimenopause are not competing explanations. They are often highly interconnected, and both deserve attention. When women are supported to understand this overlap, they are more likely to feel validated, informed, and able to access the right kind of help.

If you are navigating this space, your experience is real and understandable and with the right information and support, it is possible to move forward with greater clarity and confidence.

Free Downloads Link

Alongside the blog, I have created two free downloads, which offer clear, accessible information you can use at your own pace.

These guides can help you recognise patterns, organise symptoms in a clear and structured way, and prepare for appointments so you can access the right support. They can also help you explain what you are experiencing more confidently and clearly.

Sarah West