As a women’s health practitioner, when I received my diagnosis of combined type ADHD at age 41, my first thought was to understand how my hormones affected my traits. What I found astounded me – I knew the gender bias that exists in medical research was real, but nowhere have I seen it so starkly, as within the field of neurodiversity! Therefore, I have made it my mission to bridge this gap in service provision for ADHD women, to empower them to understand why it is vital that their hormonal health is considered in their ADHD treatment plans.

What is ADHD?

ADHD is an umbrella term for 3 subtypes – inattentive, hyper, and combined type.  The traits associated with this can vary but are linked to dopamine regulation and executive function. Interestingly traits can be quite different in females than the stereotypical “naughty little boy” bouncing around a classroom!! Whilst this view of ADHD contributes to delayed diagnosis in girls, our hormones also play a huge role in influencing our experience of ADHD as women.

ADHD in Females

Unlike males, females experience monthly hormonal fluctuations and life phase hormonal shifts such as menarche, pregnancy, and perimenopause. Sadly, these experiences are largely absent from the research on neurodiversity, which means the female experience is rarely considered in ADHD treatment plans.

As more women are diagnosed with ADHD there is a definite need for gender-specific interventions and treatment plans. A significant difference for women is their hormones’ impact on their traits, which is largely under-researched and understood. ADHD Interventions that women receive are based on what works for males, and therefore they are treated like small men, with little regard for the impact of their monthly and lifetime hormonal fluctuations.

What is the link with hormones? How do hormones affect traits?

It is incredible, that given what we know about the role hormones play in supporting our mental health and cognitive function, this is not a core part of every ADHD woman’s treatment plan!

In 2021 The Journal of Psychiatric Research study evidenced that ADHD women:

  • Have a higher risk of PMDD – 45.5% as opposed to 28.7% of the general population.
  • Higher risk of post-natal depression – 57.6% compared to 14-20% of the general population.
  • Were much more likely to experience intense symptoms during perimenopause.

This study alone evidences hormones’ significant impact on neurodivergent women and that more research is needed.

We know that the brain is covered in oestrogen & progesterone receptors. Oestrogen enhances the activity of neurotransmitters like dopamine, therefore impacting executive functioning, and for many women, making traits more manageable at certain times of their cycle.

However, when oestrogen declines and progesterone rises, we see that ADHD women are significantly more likely to experience a challenging luteal phase and even PMDD.  This combination of low oestrogen and high progesterone exacerbates symptoms tremendously and makes masking traits incredibly challenging.

For those women who choose medication, they may notice that progesterone dampens the effect of the medication that otherwise works well at other times of the cycle.

As you can see just from considering oestrogen & progesterone, the impact of hormones is significant for ADHD women.

How do hormones affect traits during different phases of an ADHD woman’s life?

Again, from a research perspective, data is limited. That said, we know that the significant hormonal shifts women experience can play havoc with ADHD traits.

A girl’s traits often flare up at puberty due to fluctuating hormones.

Pregnancy can also have a huge impact on ADHD traits both during gestation and after birth. For example, for some ADHD women, the high oestrogen during pregnancy can be supportive, but in contrast, as this drastically drops off after birth, this can be a vulnerable time for new mothers.

In the clinic, I am also seeing a link between ADHD & conditions like PMDD, endometriosis & PCOS, although there is no understanding of why at this stage.

Finally, one of the reasons we are currently seeing a rise in perimenopausal women receiving an ADHD diagnosis is due to the natural decline in hormones that begins at this time. The reduction in oestrogen means it is much harder to mask traits and life can become incredibly overwhelming without these yummy hormones supporting us!

Men simply do not experience these significant hormonal shifts, which is why the impact of these on women is barely considered in ADHD management due to the gender bias in the research.

Are other hormones affected?

Of course, we know that hormone imbalances do not exist in a vacuum, but the spotlight usually focuses on progesterone & oestrogen. However, if queen bees’ cortisol & insulin are out of balance our reproductive hormones will struggle.

In the ADHD community, I see significantly greater dysregulation with these queen bees, which in turn affects the thyroid. These imbalances must be addressed to firstly truly understand what symptoms are hormonal and which are ADHD traits and secondly to ensure the hormonal imbalances are not amplifying ADHD traits.

There also seems to be an association with PCOS, Endo and PMDD, but again research to support this is lacking.

What can we do?

It is fundamental to ADHD women that we are empowered to understand our hormones’ impact on our traits and then supported to address any identified hormone imbalances. Once our hormones are healthy, it creates a much clearer picture of the severity of our ADHD traits due to the overlap of some symptoms.

The first step is tracking traits against monthly ebb and flow. I love to teach women how to track their traits against their cycle, and to use this data to create an ADHD-friendly lifestyle.

Getting a DUTCH test also means that women can take an evidence-based approach to managing their hormones, rather than just chucking lots of resources at something in the hope something will work!

It is fundamental to ADHD women that we are empowered to understand our hormones’ impact on our traits and then supported to address any identified hormone imbalances. Once our hormones are healthy, it creates a much clearer picture of the severity of our ADHD traits due to the overlap of some symptoms.

The first step is tracking traits against monthly ebb and flow. I love to teach women how to track their traits against their cycle, and to use this data to create an ADHD-friendly lifestyle.

Getting a DUTCH test also means that women can take an evidence-based approach to managing their hormones, rather than just chucking lots of resources at something in the hope something will work!

I truly believe that incorporating hormone health into every woman’s ADHD plan is the future of treating ADHD women and am excited to see what the future holds!

Why not book in a discovery call with me to find out more.