If you have ADHD ( Attention-Deficit/Hyperactivity Disorder ) and you have monthly periods, you may have noticed that your ADHD symptoms change dramatically with your menstrual cycle. Sometimes, it may feel like the medication you take isn't working properly. Also, these medications can make your PMS (Premenstrual Syndrome) symptoms worse. But don't worry, there are things you can do to minimize these effects. Let's talk about that today.
What is the relationship between ADHD and hormones?
The exact cause of ADHD is still unclear, but doctors believe it is caused by a problem with the way the body processes chemicals in our brains called neurotransmitters, specifically dopamine and norepinephrine.
You may be taking stimulant medications for this. These medications work by increasing the levels of these chemicals. This makes it easier for nerve cells in the brain to communicate, which helps control ADHD symptoms.
Now let's see how this relates to the menstrual cycle. Estrogen, a major female hormone, also increases dopamine levels in the brain. Another female hormone, progesterone , also affects dopamine, but its effects are not yet fully understood.
Typically, estrogen levels rise during the first two weeks of the menstrual cycle. After ovulation, estrogen levels drop and progesterone levels rise. Levels of both hormones are at their lowest levels a few days before menstruation. This can also cause dopamine levels in the brain to drop.
So imagine, what happens when someone with ADHD has low dopamine levels and their dopamine levels drop even more due to hormonal changes before their period? It's like "a bull going after a man who fell from a tree." ADHD symptoms get worse, and PMS symptoms also appear.
How does your period affect ADHD?
Many women report that their ADHD symptoms worsen during the last part of their menstrual cycle, about a week before their period. Some also report that medication doesn't seem to work during those days. One study found that ADHD symptoms worsen when estrogen levels drop.
Scientifically, there is evidence that stimulants work best when combined with estrogen. So when estrogen levels drop before menopause, the effectiveness of the drugs may decrease and symptoms may increase.
The most common type of ADHD in girls and women is the predominantly inattentive type. This type of ADHD is characterized by problems with attention and concentration rather than hyperactivity. See if you have any of the following symptoms.
- Difficulty staying focused on something
- Inability to focus on one task at a time
- Having problems in social relationships
- Difficulty controlling emotions
- Difficulty organizing tasks
- Forgetting or losing belongings
Some of these symptoms are very similar to those of premenstrual syndrome (PMS). Regardless of whether or not you have ADHD, many women experience these emotional and behavioral problems before their period.
| ADHD (Inattentive) Symptoms | Symptoms of premenstrual syndrome (PMS) |
|---|---|
| Difficulty concentrating | Loss of concentration/difficulty paying attention |
| Difficulty controlling emotions | Irritability, anxiety, depression |
| Forgetfulness, difficulty organizing | Sleep problems and resulting fatigue |
Do ADHD medications affect your menstrual cycle?
This relationship can also work the other way around. That is, the medication you take to control ADHD could affect your menstrual cycle.
| Medication | Possible impact on the menstrual cycle |
|---|---|
| Non-stimulant medications such as atomoxetine (Strattera) and volixazine (Qelbree) | Heavy, irregular, or painful menstrual periods. These may go away once the body gets used to the medication. |
| Stimulants such as amphetamine/dextroamphetamine (Adderall, Mydayis) | Painful menstrual cramps may occur. |
| Stimulants such as Methylphenidate (Ritalin) | Menstrual bleeding may increase. Some animal studies have found that it may affect fertility, but further research is needed in humans. |
How to manage your menstrual cycle when you have ADHD?
Understanding these changes in your body is the best way to manage this condition. First, keep a journal or diary of how you feel and your symptoms every day for a few months. You can then see if there is a pattern to this for yourself.
The most important thing is to talk to your doctor about this. Discuss with him/her whether you need to adjust your medication dosage according to your menstrual cycle.
And there are a few things you can do yourself to make life a little easier during this time:
Plan your work in advance.
If you have a big project or presentation coming up in the days leading up to your period, try to start it a little earlier. That way, you won't feel as much pressure during the hardest days.
Getting good sleep is essential.
PMS can cause changes in sleep patterns, making sleep a big challenge during this time. Follow these habits to get a good night's sleep:
- Go to bed and wake up at the same time every day.
- Do not keep electronic devices such as phones and tablets in the bedroom.
- Avoid drinking alcohol and eating heavy meals before going to bed.
Eat a nutritious diet.
A balanced diet can help you stay energized and reduce both ADHD and PMS symptoms. Include fruits and vegetables, especially leafy greens, in your diet. These can help with both ADHD-related attention problems and PMS-related fatigue.
Don't forget to exercise.
Some studies have found that cardio exercise can help reduce the emotional and physical symptoms of PMS. Exercise has also been shown to help manage ADHD symptoms in children. While there is no large-scale research on adults, preliminary studies show promising results.
Get rid of stress.
Stress can make both your PMS and ADHD symptoms worse. Stress is especially prevalent in women with the "inattentive" type of ADHD. So, taking time to do things like mindfulness, deep breathing exercises, or yoga can help manage stress.
Take-Home Message
- There is a direct link between hormone levels in your body (especially estrogen) and ADHD symptoms.
- It is common for ADHD symptoms to worsen and medications to become less effective in the week before menstruation.
- Keeping a diary of your menstrual cycle and symptoms is the first step to understanding and managing the condition.
- Most importantly: Talk openly with your doctor about this. Never change or stop medication doses on your own.
- Lifestyle changes such as good sleep, a balanced diet, exercise, and stress management can provide you with great relief.
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