How Hormones Impact the Mental Health of Women with ADHD

Article written by Denver therapist, Shelby Aronoff

To fully navigate the challenges that come with being a woman born biologically female with ADHD, it is essential also to recognize and understand how hormonal changes interact with female bodies and minds.

The impact that hormones have on women’s mental health as they go through life has not often been encouraged to discuss openly.

From a young age, it can feel as if a layer of shame, discomfort, or disregard has been placed on this topic.

Being hormonal as a woman has historically been considered to be viewed as a weakness and is often the cause for women to be seen as emotionally weak or unpredictable.

Because of this, society tells women that talking about things such as our menstrual cycles or menopause should be kept private.

Until more recently, ADHD has also been a topic surrounded primarily by avoidance and invalidation, causing those with ADHD to feel as if they are fending for themselves.

Individuals with ADHD may be called lazy or disruptive or told that if they just tried harder, they would succeed.

However, in order to create and maintain balance and mental wellness with ADHD, it is important to be aware of a person’s whole self.

Read More: “ADHD: A Difference, Not A Deficit”

Learning about how hormones interact with ADHD symptoms allows women to gain a broader understanding and picture for themselves.

It also empowers women with ADHD to work with their bodies and symptoms rather than against them when managing ADHD symptoms day to day.

This article will cover the role hormones play in the female body, discuss how hormones may affect symptoms of ADHD, and provide strategies that encourage women to learn more about this part of themselves in order to make changes that promote mental and physical well-being.

The Role of Hormones in Mental Health

It is important to understand how hormones influence our bodies and our mental health.

Estrogen:

Estrogen is a hormone that promotes sexual and reproductive health.

Levels of estrogen fluctuate in our bodies during events such as menstruation, pregnancy, postpartum, and all phases of menopause.

Estrogen also regulates other essential processes in the body.It plays a role in maintaining cholesterol levels, blood sugar levels, circulation, muscle mass, and moisture levels in your skin.

Estrogen also helps promote our brain’s ability to function by supporting our ability to focus, stay on task, and regulate our emotions thus impacting our overall mental health.

Progesterone:

Like estrogen, progesterone is a hormone involved in reproductive health that supports our bodies during our menstrual cycles and in the early stages of pregnancy and menopause.

Progesterone is partially responsible for changes in our mood, energy levels, and how our body regulates our nervous system overall – all impacting our mental health.

Testosterone:

Testosterone is a hormone often affiliated with the male body.

However, it is also produced in small amounts in women’s ovaries and adrenal glands and supports functions such as sexual reproduction, sex drive, bone density, and muscle mass.

Testosterone is also involved in cognitive function. When raising or lowering, it can contribute to increases in symptoms of ADHD, depression, anxiety, irritability, and impulsivity.

How do Hormonal Fluctuations Affect Women with ADHD?

ADHD manifests differently in women. Hormones play a large role in this as they influence symptoms and affect mental health.

Read More: “Unlocking Your Full Potential: Strategies for Adulting with ADHD”

Each of these hormones not only plays a physiological role, but also influences things like executive function, impulsivity, motivation, and emotional regulation, which are all challenges that people with ADHD already face each day.

Because of this, women with ADHD may be more sensitive to hormonal fluctuations and susceptible to emotional dysregulation causing them to become more vulnerable to anxiety and depression than neurotypical individuals.

Menstrual Cycles and ADHD Symptoms

Because of our menstrual cycles, ADHD symptoms are also changing for women each month. ADHD symptoms are influenced by the week or phase of a woman’s cycle and may also influence how effective ADHD medication is.

Follicular phase:

Begins on the first day of your period and lasts for about two weeks.

Estrogen and Progesterone levels are initially low and gradually rise as this phase takes place. Because of this, mood may improve, and energy levels may increase.

Motivation and focus may increase by the end of this phase.

However, at the beginning of this phase, ADHD symptoms such as forgetfulness, trouble focusing, and working memory may be more severe.

Ovulation:

Occurs around day 14 of your cycle. Estrogen levels are at their peak when this phase begins and then begin to decrease significantly once this phase is complete.

This shift from high to low estrogen may cause an increase in severity of ADHD symptoms and anxiety as you approach the end of this phase.

Luteal Phase:

Begins after ovulation. ADHD symptoms may be most severe, can worsen, and medication might not work as effectively.

Estrogen and progesterone peak in the early stages of this phase and then drop as the body prepares for the early follicular phase again.

How Estrogen and Progesterone Impact Mental Health and ADHD

These hormones do not always have negative effects. High estrogen levels in the follicular phase of women’s cycles have the ability to improve things like energy and focus, lowering the intensity of ADHD symptoms overall.

Read More: “Finding Balance: Self Care and Stress Management Strategies for Individuals with ADHD”

This would be a good time to work on a big project, engage in social activities, or spend time doing something that is mentally or physically challenging.

When progesterone levels are higher after ovulation, this can promote feelings of relaxation and calmness, potentially lowering feelings of anxiety and stress.

However, during this time mood and energy may go drastically down, causing feelings of sluggishness, brain fog, and fatigue.

This would be a good time to recharge, practice self-care, and engage in activities that promote rest.

How Pregnancy and Menopause Affect ADHD

With pregnancy comes significant hormonal changes that can have various impacts on ADHD symptoms for women.

The first trimester of pregnancy can cause a noticeable increase in ADHD symptoms caused by the fast rise in both estrogen and progesterone.

At this time, pregnant women with ADHD may experience a higher difficulty in focusing, memory, mood swings, and energy levels.

By the second trimester, these hormone levels begin to lower, and symptoms may become more manageable.

Some women even report an abnormal increase in their ability to focus, motivation, and attention as hormone levels stabilize.

The severe drop in hormones after giving birth can potentially trigger extremely low levels of estrogen and progesterone in the body which can lead to intense mood swings, postpartum depression, and an overwhelming increase in ADHD symptoms.

The body is in the process of extreme hormonal changes so it would be beneficial to seek extra support and practice self-compassion.

Overall, menopause causes a specific decline in estrogen, worsening ADHD symptoms, reducing neurotransmitters like dopamine, and creating greater difficulty with organization, memory, mood regulation, and cognitive function.

The link between Dopamine and Hormones in Women

Our hormones also cause changes in the levels of dopamine and serotonin in the body.

When estrogen and progesterone levels change in the days leading up to a woman’s period, access to dopamine becomes more limited.

A major cause of ADHD symptoms in men and women is directly linked to dopamine.

It is the neurotransmitter that helps us feel motivated and emotionally regulated.

Dopamine is already negatively impacted by ADHD, and this is why women with ADHD may experience more severe symptoms and challenges during this time of their cycle.

This would be a good time to practice self-care and curate your environment to help support more severe ADHD symptoms.

Strategies for Managing Hormonal Impacts on ADHD

Now that we have identified and learned about the hormones that play a key part in ADHD and mental health, it can understandably feel overwhelming to recognize how much is seemingly out of one’s control.

However, there are strategies to help use this knowledge to create ways to support mental health while facing these obstacles and manage symptoms of ADHD.

Track Your Cycle and Symptoms

Keeping a journal or using an app to help track hormonal changes is a great tool to help you learn and understand how hormonal changes uniquely affect you each month.

It may be helpful to not only track your menstrual cycle but alongside this, track your ADHD symptoms to more clearly see how they relate to one another.

If you do not have a menstrual cycle, it is still useful to track your mood, focus, and energy levels each month to identify personal patterns and fluctuations with ADHD symptoms.

Use Your Findings to Your Advantage

Once you have a clearer picture of how your mental health and ADHD symptoms change each month, start to use this information in a useful way.

Read More: “Time Management Strategies to Support Individuals with ADHD”

You may learn that at certain times of the month, you tend to feel more energized and focused.

Recognizing this, you can plan for things that challenge you, engage in new experiences, or willingly add new goals into your life.

At other times in your cycle, you may notice that you experience increased fatigue, lack of focus, or low mood.

When possible, you can make sure to incorporate extra rest, support, and self-compassion in a way that is more preventative and may help you avoid symptoms of depression or burnout.

This self-awareness will help you to develop and maintain good mental health.

It may also help you to feel more connected to your body and mind, feel aligned with your needs, and feel better equipped to manage ADHD symptoms on the harder days.

Create Opportunity for Balance in Energy, Mood and Movement

Hormones are sensitive to and react to our lifestyle choices. The way one treats their body and mind each day will either lessen or heighten symptoms of ADHD.

Things you can put intention and awareness into that will help to combat the negative effects include:

• Practicing mindfulness through the use of meditation, journaling, deep breathing, and checking in with your body and mind without judgement
• Engaging in activities that reduce stress such as yoga, reading, taking a bath, or intentional rest
• Exercise and movement
• Balanced diet of nutritious foods
• Getting an appropriate amount of sleep
• Doing things that bring you joy
• Listening to your body to identify whether you need to rest, engage, eat, sleep, or recharge

All of the above improve mental health and reduce the chances of anxiety and depression, which in turn allow your hormones to function properly and your ADHD symptoms to become more manageable.

Hormones act as regulators in the body that will adapt and change in order to keep you healthy.

Therefore, the daily lifestyle choices that you make will in fact influence your hormone levels.

Medication Management

There are also times when our hormones may be experiencing or undergoing a chemical and physiological imbalance.

Things that may cause hormonal imbalances might be a medication you are taking, chronic stress, autoimmune conditions or other health conditions, allergies, dietary choices, exposure to toxins, etc.

Things that can cause hormonal imbalances in women are also events like puberty, menstruation, pregnancy, and menopause.

It may be beneficial to speak to a doctor or hormone specialist and get tested and assessed to determine if you have a hormonal imbalance and if there are additional resources to support you.

This knowledge can better provide you with the next steps needed.

Speak with your healthcare provider about whether some of these possible steps might be helpful for you:

• Hormonal therapy
• Adjustments to ADHD medication/medications
• Supplements and holistic supports
• Adjustments to your diet

Mental Health Support for Hormones and ADHD

It is clear that hormones affect more than just the body.

They can influence one’s tolerance to stress and change, intensify ADHD symptoms, and impact one’s ability to regulate emotions.

They increase susceptibility to anxiety, depression, and other mental health disorders.

If it feels like a lot to handle on your own, please remember that external support is always an option.

Connect with an ADHD therapist, ADHD coach, or contact friends and family for support.

Knowledge is Power!

Let this post be a gentle reminder that the more we set out to know and learn about ourselves, the better equipped we become to live our lives to the fullest!

Understanding the link between mental health and hormones is instrumental for women with ADHD.

When we acknowledge and recognize how hormonal changes impact our symptoms, we can then take intentional steps to manage our mental health more effectively.

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Denver Therapist, Shelby Aronoff

Shelby Aronoff is a Denver therapist who specializes in ADHD therapy for teen girls and adult females.

She has advanced training in working with ADHD and her curiosity in women’s health drives her passion for supporting women with ADHD.

In addition to being an ADHD therapist, Shelby also supports clients with Autism, trauma, anxiety and depression.

Shelby is a compassionate, thoughtful, encouraging, and well-informed therapist located in Denver, CO.

See Shelby’s bio to learn more about her and her approaches, or reach out to schedule a free consultation.