What is ADHD?
Attention Deficit Hyperactivity Disorder (ADHD), once known as Attention Deficit Disorder (ADD), is a neurodevelopmental disorder defined by a consistent pattern of inattention and/or hyperactivity-impulsivity that interferes with daily functioning. Although it is not part of the formal diagnosis, emotional dysregulation is another recognized grouping of ADHD symptoms.
Globally, ADHD affects 2.5% – 6.7% of adults. Although it has long been seen as a disorder of childhood, one study found that 75% of adults with ADHD were not previously diagnosed in childhood.[1] [2]
The rates of ADHD are equal in men and women however women are significantly underdiagnosed. ADHD is perceived as a disorder affecting hyperactive boys, not girls or grown women.
However, ADHD in girls and women usually presents very differently from ADHD in boys and men.
For example, girls’ inattention shows up as daydreaming, and girls daydreaming is not a red flag for mental health. Boys’ inattention, however, shows up as not paying attention in class and is bothersome for both teachers and parents. These differences in symptom presentation is why boys get diagnosed with ADHD nine times more frequently than girls.
The sharp increase over the last few years in diagnosing ADHD in adult women is linked to women trying to get their children with ADHD help. As women walk their children through the diagnostic process, they may recognize symptoms as ones they have. The percentage of women newly diagnosed with ADHD between 23 – 49 years of age increased by almost 50% 2020 to 2022. [3]
Adult women with ADHD are more likely to get a diagnosis of Major Depressive Disorder or Bipolar Disorder instead of the correct ADHD diagnosis. These incorrect diagnoses are happening because doctors are not educated on ADHD symptoms in girls and women.
ADHD is caused by a combination of genetic, neurobiological, and environmental factors. Studies have shown that ADHD is highly inheritable, so that parents with ADHD have a 60% – 70% chance of passing ADHD onto their children. Environmental risk factors such as complications at birth or exposure to toxic materials in utero also play a role. Brain scans indicate that the prefrontal cortex is underdeveloped in men and women with ADHD helping to explain the neurological basis of ADHD symptoms. [1]
ADHD and Perimenopause
ADHD and perimenopause are connected because both conditions are strongly influenced by estrogen levels. Estrogen and dopamine, one of the neurotransmitters involved in ADHD, have a regular cycle, where dopamine increases when estrogen increases because estrogen stimulates new dopamine production.
When estrogen starts to decline in perimenopause, dopamine also declines. For women with ADHD, this makes both their perimenopause and their ADHD symptoms worse.
For example, a recent study indicates that women with ADHD suffer a 2 – 3 times increase in frequency and severity of mood changes during the menopause transition.
For women without ADHD, the decrease in dopamine can actually cause behaviours that mimic the symptoms that are seen in women with ADHD.
What Are ADHD Symptoms?
Women with ADHD may find it hard to focus and remember events causing challenges in all domains of life. Unfortunately, many women with ADHD are completely unaware and do not understand that their symptoms are based in their brain chemistry, not in personal flaws such as being lazy or weak-willed. This often leads to severe self-criticism, self-hatred, depression, and anxiety.
People with untreated ADHD have a higher risk of substance use, car accidents, unintentional injuries, depression, anxiety, and suicide or self-harming behaviours. In other words, underdiagnosis has significant implications, far beyond inability to focus.[4][5]
If you are experiencing any of these symptoms, talk to trusted people around you to see if they have noticed any symptoms in your behaviours (like being impulsive or overly emotional). Then talk to your healthcare provider so you can first name and then start assessing your symptoms to find solutions that work for you.
Female ADHD symptoms may include:
▢ anxiety
▢ depression
▢ impulsiveness
▢ disorganization
▢ strong reactive emotions
▢ excessive daydreaming
▢ being very loud
▢ interrupting
▢ poor time management skills
▢ problems focusing on a task
▢ poor working memory
▢ trouble multitasking
▢ excessive activity or restlessness, physical and mental
▢ use of harmful substances
▢ poor planning
▢ easily frustrated and irritated
▢ frequent mood swings
▢ problems following through and completing tasks
▢ extreme sensitivity to perceived rejection
Did you know?
Self-Care & Natural Remedies for Symptoms of ADHD
Women with ADHD often blame themselves for their shortcomings, because they do not understand that their brains are ‘neurodivergent’ and work differently from ‘neurotypical’ brains. This can lead to harmful substance use, low-self esteem, self-hatred, self-harm, social isolation, and negative self-talk.
If you know or suspect that you (or a loved one) may have ADHD, being kind to yourself (or them) as you learn to accept your symptoms is key to managing your symptoms. Talk to your healthcare provider about getting a proper diagnosis and to access ADHD resources near you.
Positive Self-Talk
Positive Self-Talk
Many women who have ADHD live with negative self-talk, including statements to oneself like: ‘I’ll never be able to do that task; every time I try that I fail; I never remember things; I’m lazy; I’m crazy; etc.
Working to become aware of your negative self-talk is the first step. Then, start the process of exchanging positive self-talk for your negative self-talk. For example, replace ‘every time I try that I fail’ with ‘I’m so proud you keep trying. This is important to do and you are capable. Keep trying till you get it right!’
Remind yourself constantly that you are not crazy, and you are not stupid. Actively work to soften your self-talk and be compassionate with yourself. Coping with ADHD symptoms requires acceptance of being neurodivergent – where your brain works differently than most people (neurotypicals), even though it may be uncomfortable to process this different way of being.
Share Your Experiences
Share Your Experiences
Talk to someone you trust and share your symptoms. Women with ADHD have been masking their symptoms for their whole lives, causing tremendous shame. Sometimes just sharing your experiences provides perspective and can help.
Build a Strong Foundation
Build a Strong Foundation
Coping with ADHD symptoms requires a strong foundation built through good nutrition, adequate exercise, and good quality sleep. Not only will you feel better but you will also be better able to handle the stress and the frustrations of living with ADHD.
Body Doubling & Accountability
Body Doubling & Accountability
Practice a technique called ‘body doubling’, where you connect with others who are also concentrating in order to support your focus. Zoom with a friend and both do work at the same time. Exercise with friends. Make connections with people that share your interests and arrange to do things simultaneously. This is not social time, rather this technique keeps you focused and accountable for getting things done.
Mindfulness & Meditation
Mindfulness & Meditation
Practice meditation and/or breathing exercises. Daily practices like “box breathing” help calm your mind and give you a smart tool for reducing the strength of mood swings, anger, depression or other behavioural symptoms in the moment they happen.
Journal
Journal
Journal your thoughts and feelings. Keeping a journal is a proven way to self-reflect and practice self-care, and it can also help you track your symptoms. You may start to see patterns and identify situations that trigger uncharacteristic feelings and behaviours. Take the time to journal things that are good as well! This can be a boost when you are feeling down or irritated.
Groups
Groups
Join a support group or a peer group available virtually or in person near you. There are many ADHD support and discussion groups online or your healthcare provider can give you a recommendation for a support group or point you to a specialty care organization dedicated to coping with ADHD.
Wellness
Wellness
Practice Mind Body Wellness therapies and explore options for alternative and complementary treatments that may help you. Yoga, biofeedback and relaxation therapy, hypnosis, aromatherapy, meditative movement such as Tai Chi or Qigong. Get inspired to try one or more of these and see if it helps any of your symptoms and/or helps you calm your mind. [6]
Therapies & Treatments for ADHD and Menopause
If you’re experiencing ADHD symptoms (with or without a diagnosis), seek help and referrals from your healthcare provider. A diagnosis is required to get medications, but there are many other treatments and therapies that are part of a regular ADHD treatment plan.
Cognitive Behavioural Therapy (CBT)
Cognitive Behavioural Therapy (CBT)
One of the most common approaches to overcoming ADHD symptoms is a talk therapy called cognitive behavioural therapy (CBT). Most adults with ADHD experience ongoing impairments including procrastination, disorganization, poor time management, emotional dysregulation, impulsivity, and problems completing tasks. These persistent issues can make it even more challenging for adults with ADHD to regulate their emotions and behaviors. The result is increased self-criticism, pessimism, and distorted thinking and beliefs. [7]
CBT is used to improve the challenges that interfere with daily functioning, such as poor planning, disorganization, or intense emotional outbursts. It is not used to treat the underlying core symptoms that come from brain and neurotransmitter functioning. [7]
Women with ADHD will often say “I know what to do, I just don’t do it.” CBT is effective for ADHD because it focuses on developing coping strategies, managing negative expectations and emotions, and then implementing the strategies.
With a therapist using CBT, you will:
- identify specific symptoms impairing your daily life.
- increase your awareness of negative thought patterns and how they can impact your functioning.
- identify negative thinking and reframe it in a way that changes how you feel.
- learn new behaviors and put them into practice. [8]
Dialectical Behaviour Therapy
Dialectical Behaviour Therapy
Dialectical behavior therapy (DBT) is a type of talk therapy based on cognitive behavioral therapy (CBT), which looks at how thoughts impact behaviours. DBT teaches four core skills – mindfulness, acceptance & distress tolerance, emotional regulation, and interpersonal effectiveness.
Dialectical means ‘opposites’, and comes from combining two key ideas – change and acceptance. DBT helps people accept the reality of their behaviors and helps teach them how to effectively change unhelpful behaviours.
Menopausal Hormone Therapy (MHT)
Menopausal Hormone Therapy (MHT)
If you have started to notice ADHD symptoms starting after you are in peri-menopause, these could be indirectly caused by decreasing estrogen. There is a clear link between estrogen and dopamine, the neurotransmitter involved in ADHD symptoms. Estrogen drives the production of dopamine so when estrogen starts to decrease, dopamine starts to decrease. Depending on your dopamine levels, this may result in the appearance of ADHD symptoms even though you do not have the condition.
Talk to your healthcare provider, as MHT will increase your estrogen levels that should, in turn, increase your dopamine levels.
Stimulant Medications
Stimulant Medications
If you have received a diagnosis of ADHD, your healthcare provider may prescribe a stimulant medication for you. Stimulants can help manage ADHD directly by increasing the production of the neurotransmitters dopamine and norepinephrine. Having low levels of these neurotransmitters in your brain is directly linked to ADHD symptoms. [9] [10]
Stimulant medications are typically the front-line medication used for ADHD treatment. However, they are controlled substances because they have the potential to be abused and cause addiction. As well, some women suffer significant side effects from taking stimulants, including agitation, upset stomach, mood swings and insomnia.
Non-Stimulant Medications
Non-Stimulant Medications
If you are unable to tolerate stimulants or are uncomfortable with taking a potentially addictive substance, new non-stimulant treatments are available. These typically act by increasing levels of norepinephrine in the brain. [11]
The Science
Research has shown that ADHD is associated with weaker function and structure of prefrontal cortex (PFC) circuits that form connections with other regions of the brain. One of these, the prefrontal association cortex, is critical for regulating attention, behavior, and emotion, and behavioral inhibition. Proper functioning of the prefrontal cortex also depends on access to the appropriate levels of the neurotransmitters dopamine, norepinephrine, and epinephrine. [9]
Estrogen and Dopamine
Estrogen is a steroid hormone that regulates reproduction and sexual development in females. Estrogen, however, also serves as a ‘master regulator’ because it impacts many other body systems and functions.
Dopamine is a neurotransmitter that is made in your brain. It is known as the ‘feel-good’ molecule, because it is part of the brain’s reward center. When you complete a positive task or behaviour, dopamine is released, producing feelings of pleasure, satisfaction and motivation. It also plays a role controlling memory, mood, sleep, learning, concentration, movement and other body functions. [12]
Estrogen directly impacts dopamine levels in the brain. It increases the amount of dopamine available for your brain to use by boosting the amount of dopamine that is made. At the same time, it reduces the amount of dopamine that gets removed from the system through natural breakdown, and the amount that gets recycled during the reuptake process.
This connection between dopamine and estrogen is the likely root cause of some menopause symptoms including mood changes. When estrogen levels decrease, usable dopamine levels decrease. In fact, data from a recent study shows that women with ADHD suffer a 2-3 fold increase in frequency and severity of mood changes during the menopause transition. [6] [10] [13]
No, although for many years boys received almost all of the ADHD diagnoses. This is because ADHD presents differently in boys and girls. For example, hyperactivity in boys is obvious – they can’t sit still or pay attention. Hyperactive girls, on the other hand, typically internalize their hyperactivity so it shows up as a chaotic mind (which they usually hide) and / or a hyperverbality where they talk all the time.
No it isn’t. Some people with ADHD also have learning challenges (including dyslexia), but those have no impact on IQ. People with ADHD are absolutely capable of being CEOs, surgeons, academics, and entrepreneurs, just like any other non-ADHD person.
ADHD is a neurological development condition, and to receive a diagnosis, symptoms have to have been present in childhood. However, estrogen is involved in the production of the neurotransmitters that can cause ADHD symptoms, so changes to your estrogen levels can affect whether or not you experience symptoms. The root cause is different, but the effects and the symptoms show up in the same way.
Yes absolutely. If you have been formally diagnosed with ADHD, you may be prescribed medications that will impact your brain chemistry and improve your symptoms. Medication is rarely enough on its own, however, so talk therapy, especially cognitive behavioural therapy (CBT) can be very helpful as well.
[1] Abdelnour E, Jansen MO, Gold JA. ADHD Diagnostic Trends: Increased Recognition or Overdiagnosis? Mo Med. 2022 Sep-Oct;119(5):467-473. PMID: 36337990; PMCID: PMC9616454.
[2] https://www.additudemag.com/adhd-symptoms-checklist/
[3] https://epicresearch.org/articles/number-of-adhd-patients-rising-especially-among-women
[4] https://www.mayoclinic.org/diseases-conditions/adult-adhd/symptoms-causes/syc-20350878
[5] www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd
[6] Kooij JS. Hormonal sensitivity of mood symptoms in women with ADHD across the lifespan. Eur Psychiatry. 2023 Jul 19;66(Suppl 1):S23. doi: 10.1192/j.eurpsy.2023.92. PMCID: PMC10417850.]
[7] https://www.additudemag.com/cognitive-behavioral-therapy-for-adhd
[8] https://www.healthline.com/health/cbt-techniques
[9] Arnsten AF. The Emerging Neurobiology of Attention Deficit Hyperactivity Disorder: The Key Role of the Prefrontal Association Cortex. J Pediatr. 2009 May 1;154(5):I-S43. doi: 10.1016/j.jpeds.2009.01.018. PMID: 20596295; PMCID: PMC2894421.
[10] https://www.absoluteadvocacy.org/dopamine-and-estrogen-a-surprising-relationship
[11] https://www.webmd.com/add-adhd/adhd-nonstimulant-drugs-therapy
[12] https://my.clevelandclinic.org/health/articles/22581-dopamine
[13] Del Rio JP, et. al. Frontiers of Public Health, 23 May 2018, Volume 6 – 2018 | https://doi.org/10.3389/fpubh.2018.00141
Original content, last updated February 17, 2025.
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