If you’re a woman with ADHD in your late 30s or early 40s and have noticed your symptoms worsening, there may be more to it than you realize. A new 2025 study found that those with ADHD had worse perimenopause symptoms and experienced perimenopause significantly earlier in life.
What the Research Found
A recent population-based study examined over 5,000 Icelandic women (~500 with ADHD, ~4,500 without) and found that 54% of women with ADHD experienced severe perimenopausal symptoms compared to just 30% of women without ADHD.
The study measured three categories of symptoms, and women with ADHD scored higher on all of them:
Psychological symptoms: Nearly 59% of women with ADHD experienced severe psychological symptoms, including depression, anxiety, irritability, and fatigue during perimenopause.
Physical symptoms: About 30% of women with ADHD experienced severe physical symptoms like hot flashes, heart palpitations, sleep problems, and joint pain, compared to 14% of women without ADHD.
Urogenital symptoms: These affected 43% of women with ADHD compared to 28% of women without the condition.
The connection with earlier perimenopause
The study found that women with ADHD reported their highest perimenopausal symptom levels between ages 35 and 39, while women without ADHD reported peak symptoms at ages 45 to 49. This finding is consistent with emerging genetic research suggesting women with ADHD may enter menopause earlier than other women.
The Role of Estrogen
The interaction between ADHD and earlier, more severe perimenopausal symptoms likely involves estrogen’s effects on both the brain and body function.
Estrogen does significantly more in the body than most people realise. It is connected to nearly every aspect of the female body: bones, neurotransmitters, the heart, skin, hair, bladder, the gut, the immune system—nearly everything.
Of note, it influences dopamine levels in the brain. During perimenopause, estrogen levels fluctuate and decline, which can make dopamine levels feel more erratic as well. This then can connect with worse attention, more brain fog, difficulty remembering things, challenges with motivation, etc. Estrogen and progesterone are also highly connected with the neurotransmitter GABA, which helps us with emotional stability and calming our nervous system.
For many people with ADHD who have periods, we experience worsened ADHD symptoms. Many people also experience something called PMDD, or Premenstrual Dysphoric Disorder. It is an abnormal reaction to fluctuations in hormones that make typical PMS symptoms nearly unbearable. If you have been curious about what the nutritional research says will help your PMDD, you can purchase my eBook on PMDD Nutrition HERE and listen to this episode I did on the subject HERE.
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Study Challenges
One challenge in this area is that ADHD and perimenopause share similar symptoms:
- Memory and concentration difficulties
- Executive function challenges
- Mood changes and irritability
- Sleep disturbances
- Fatigue
This overlap can make it difficult to determine which condition is driving which symptoms, or whether they’re interacting in more complex ways. However, as Dr. Leann Borneman said about this study: “ADHD care, especially in midlife, has to be individualized, contextual, and allowed to be complex.”
Considerations for Women with ADHD
If you have ADHD and are approaching or experiencing perimenopause, this research might feel scary or defeating. However, there are things you can do to lessen the severity of perimenopause.
- Communicate with your healthcare providers. Let them know you have or suspect ADHD and discuss whether your symptoms might be affected by hormonal changes. Your treatment plan may need adjustment during this time: more ADHD medication, a dietitian referral, or even hormone replacement therapy.
- Discuss hormone therapy. Menopausal hormone replacement therapy has been shown to reduce some health risks associated with early menopause. Talk with your doctor about whether this might be appropriate for your situation. One of my favorite experts on perimenopause and ADHD is Dr. Jolene Brighten. She discusses HRT and ADHD on her blog and podcast.
- Reduce your stress. Stress, especially chronic stress, is one of the greatest indicators of worsened ADHD symptoms. It is also a large indicator of worsened perimenopausal symptoms. Consider re-evaluating how you have been approaching life: is there anything you can do to live more slowly? More connected to your community? Talk therapy with a licensed therapist may be something to consider as well.
- Increase physical exercise, especially cardiovascular exercise. Research into both ADHD and perimenopause agree that cardiovascular exercise is great for reducing symptom severity. For ADHD, cognitive exercise is especially helpful: think dancing, rock climbing, Tai Chi, yoga, and mixed martial arts. However, even taking a walk is helpful.
- Focus on your diet. There are a few dietary changes that might help with reducing perimenopausal symptoms. You can learn more in this article.
This article summarizes the research from the aforementioned study and is for educational purposes only. Nothing in this article constitutes medical advice.
