Navigating ADHD during perimenopause
“I don’t feel like myself anymore.”
Picture this: You’re in your 40s or early 50s. You’re juggling a demanding career, teens who need rides, aging parents who need extra support, and household tasks. You've been the family CEO, the problem-solver, and the dependable friend. But suddenly, it feels like your powers are gone.
*POOF*
You walk into the kitchen, forget why you went in. Deadlines slip by, typos go unnoticed, and you reread paragraphs because they don't sink in. You snap at your teenager over a simple question.
The woman who once colour-coded calendars and managed multiple projects now feels overwhelmed by sticky notes and forgotten commitments.
If this sounds familiar, you're facing a challenging, less discussed aspect of women's health: ADHD during perimenopause. The confusion is real, frustration understandable, and you're not alone—you're not losing your mind.
The perfect (shit)storm: When ADHD meets perimenopause
Understanding the hormonal chaos
Perimenopause, starting around ages 40–45 and lasting up to 10 years, involves hormonal fluctuations, especially in estrogen, progesterone, and testosterone, affecting fertility and brain function.
For those with ADHD, these shifts can worsen symptoms.
💡 Estrogen regulates dopamine, crucial for ADHD.
As estrogen drops during perimenopause and menopause, women with ADHD may face greater issues with focus, memory, and mood.
Estrogen influences dopamine production and brain response, so hormonal changes can intensify ADHD symptoms.
Progesterone affects GABA, a calming neurotransmitter. When progesterone declines, women often feel more anxious, have trouble sleeping, or become irritable, worsening ADHD symptoms.
I am one of those women who has been raging more.
The symptoms that make you question everything
The symptoms of perimenopause often mirror or magnify ADHD symptoms:
| Perimenopause Symptoms | ADHD Symptoms | The Combined Effect |
|---|---|---|
| Anxiety | Overstimulation, executive dysfunction | Paralyzed by simple decisions |
| Brain fog | Inattention and distractibility | Forgetting conversations mid-sentence |
| Forgetfulness | Sensory sensitivities | Overstimulation from normal daily activities |
| Hot flashes and physical discomfort | Working memory challenges | Missing appointments |
| Insomnia | Poor sleep, time dysregulation | Unable to maintain routines or schedules |
| Irritability | Emotional dysregulation | Explosive reactions to minor frustrations |
| Mood swings | Rejection sensitivity, low frustration tolerance | Snapping at people |
Perimenopause often becomes the tipping point that brings ADHD into focus.
“Is it me... or my hormones?”
Short answer: It’s both.
This disorienting life phase involves internal shifts—hormonal, neurological, emotional—while managing external responsibilities like work, family, and relationships.
You may start questioning:
Your competence at work
Your ability to parent or partner
Your capacity to handle what used to be “easy”
Many women with ADHD have overcompensated for years—being extra organized, hyper-responsible, or high-achieving—making this unravelling especially confusing.
Why high-functioning women face the greatest challenges
The masking phenomenon
Many women with ADHD have spent decades developing coping mechanisms—known as "masking." You might have become:
The over-organizer who plans everything months ahead
The people-pleaser who never says no to avoid disappointing others
The perfectionist who double-checks everything to avoid ADHD-related mistakes
The workaholic who compensates for perceived deficiencies with extra effort
I tend to be an over-organizer or not organize at all. A recovering people-pleaser, I’m also a perfectionist and workaholic. (Damn, I just realized that.)
These strategies can work really well—until perimenopause, when the mental energy needed to keep up those appearances is less available, and old systems crumble, bringing new challenges but also fresh opportunities to reconnect with yourself.
The late-diagnosis connection: when perimenopause reveals hidden ADHD
Why many women get diagnosed for the first time in midlife
Perimenopause doesn't cause ADHD, but it often highlights previously unrecognized symptoms. Here's why:
Increased demands: Midlife brings more responsibilities—career, teens, aging parents.
Hormonal unmasking: Lower estrogen levels make ADHD symptoms more visible.
Reduced coping capacity: Less mental bandwidth affects masking strategies.
Healthcare engagement: Women seeking relief from perimenopause often find providers who recognize ADHD patterns.
Red flags indicating ADHD
If you notice these symptoms in midlife, they could indicate ADHD:
Persistent brain fog not relieved by hormone therapy
Long-standing procrastination or time management issues that are now worse
Heightened sensitivity to criticism or rejection
Difficulty completing tasks despite skills and knowledge
Feeling constantly "behind" or trying to catch up
History of anxiety or depression that doesn't fully respond to traditional treatments
What helps: rebuilding from the inside out
You can’t fully control your hormones, but you can create a more ADHD- and hormone-friendly life.
Here’s how:
Much of this is part of the six-pillar PRIMED framework I developed in my late 30s during a severe ADHD flare-up.
1. Track your cycle, even if it’s irregular
Track your personal patterns - not just your period
Why it matters: Estrogen fluctuates daily, not just monthly. You may notice patterns in your attention, energy, and emotions that match your hormonal shifts. Understanding your unique hormonal rhythms helps you anticipate difficult days and plan accordingly.
How to do it: Use an app like Clue, Flo, or a calendar to track energy levels, focus, emotional intensity, sleep quality, and physical symptoms.
As I’m writing this, Clue says my period is 13 days later than my last cycle, which could be related to the increased acne on my face and the rage I felt earlier this week. Every few months, my period falls off schedule, and those late periods keep getting later. My current pattern suggests that my next one will be “on time”. And THIS is why I have to be careful when I have sex. A late period at this stage in life could mean pregnancy OR menopause (I’m not pregnant).
Pro tip: Observe patterns over 3-4 months. You might find that you have 2-3 "sparkling days" each month when your focus is sharp, and several "survival days" when basic tasks feel overwhelming.
2. Adjust expectations, not standards
Accept that your old systems might no longer work. This isn't failure; it's adaptation.
Energy-based planning:
Tackle demanding tasks when energy peaks.
Build buffer time between commitments.
Simpler routines with fewer steps. “Routine” is one of my six pillars.
Environmental modifications (the “E” in PRIMED):
Reduce visual clutter for a calming workspace
Use noise-cancelling headphones to manage sensory overload.
Set up stations for essentials like keys, medications, and paperwork to save time and reduce stress.
Communication strategies:
Let trusted colleagues and family know about your health journey for support.
Request agenda items before meetings to reduce stress.
Record voice memos instead of trying to remember instructions to track important details.
This is strategic energy protection, especially when hormonal shifts are compounding executive function challenges.
3. Rethink your relationship with productivity
ADHD skews your sense of “enough.” Perimenopause fatigue may make you feel like you’re underperforming.
Ask:
What am I measuring myself against?
Whose definition of productivity am I using?
What needs to be done, and what can wait?
This is a good time to unlearn hustle culture and build a life aligned with your body's and brain's needs.
4. Nutrition and supplements — what I call “Intake”
Part of my PRIMED framework, “intake”, refers to anything you put in your body. Remember to eat, especially if you’re on medication that suppresses your appetite. Stable blood sugar promotes steady mood and focus. Here are some ADHD + perimenopause brain boosters.
ADHD + Perimenopause power foods:
Protein in every meal to support dopamine production + blood sugar
Complex carbs: Sweet potatoes, quinoa, and oats for energy
Healthy fats: Avocados, nuts, and fatty fish support hormones and brain health
Magnesium-rich foods: Dark leafy greens, pumpkin seeds, and dark chocolate
Targeted supplements
(Always consult your healthcare provider):
Magnesium glycinate: for sleep and nervous system support
Omega-3 fatty acids: for brain health and inflammation
B-complex vitamins: Especially B6 and B12 for hormone + energy regulation
Vitamin D3: Many women are deficient, and it affects both mood and hormone function
Note: Everyone's needs vary. My insights reflect my research and experience as a Certified Transformational Nutritionist.
Omega-3s and healthy fats from foods like avocados and fish helped me when I discovered I might have ADHD. Some with ADHD swear by L-theanine for calming or L-glutamine for executive function. I’ve been taking L-glutamine, but can’t tell if it works for me.
5. Movement and physical activity — what I call “Physical”
Regular physical activity that boosts mood and focus is essential. That’s why it’s one of the six pillars of the PRIMED framework that I teach and base my coaching on.
Here are some ADHD-friendly ways to get moving:
Walking meetings: Combine work calls with movement or make them coffee meetings with a walk.
Dance or movement videos: 10-15 minutes of fun movement can boost your mood
Aerobic activity: Raises your heart rate, boosting focus and learning.
Yoga or tai chi: Help manage physical symptoms and emotional balance.
Strength training: 2-3 times weekly boosts mood and bones; I prefer 5-7 times, but choose what works for you.
Consistency is key. A 15-minute daily walk beats sporadic gym sessions. I coach people that the best exercise for them is often the one they like and will do.
6. Sleep strategies and rest
“Downtime” is also part of the PRIMED framework.
The challenge: Both ADHD and perimenopause disrupt sleep, creating a vicious cycle.
Evidence-based solutions:
Temperature regulation: Keep your bedroom cool (16-20°C / 65-68°F) and consider using cooling pajamas or fans for comfort.
Blue light management: Use blue light blocking glasses or apps after sunset to help wind down.
Consistent bedtime routine: Wind down 1-2 hours before bed to signal relaxation.
Magnesium supplements: May improve sleep and reduce hot flashes.
Mind dump journaling: Spend 5 minutes writing tomorrow's tasks to calm your mind and prepare for sleep.
7. Building your support network
Professional support:
Healthcare providers: Find hormone-literate doctors familiar with ADHD.
Therapists: Seek specialists in women's health and ADHD.
Employee Resource Groups: Also referred to as “affinity groups,” they can provide support in your workplace. My workplace has a Neurodiversity ERG. Yours might. If not, consider starting one!
ADHD coaches: Coaches like me can help develop systems and accountability
Personal support:
Online communities: Facebook groups and forums for women with ADHD
Local meetups: Search Meetup.com for ADHD or women's health groups
Trusted friends.
Michelle's Transformation
Michelle, a 48-year-old marketing executive and mother, prided herself on being "the organized one." She managed her family's schedule, led projects, and volunteered at school.
But suddenly, everything changed. "I started missing meetings I planned," she said. "I'd be overwhelmed in the grocery store by yogurt choices. My daughter asked me to sign a permission slip, and I snapped at her for bothering me with routine tasks."
The turning point was during a performance review when her supervisor expressed concerns about missed meetings and her "seeming distracted." Michelle, usually receiving positive feedback, felt devastated, embarrassed, and anxious. "I thought I was having a breakdown," she said. "I went to my doctor thinking I needed antidepressants or anti-anxiety meds, but she referred me to a women's health specialist who understands both ADHD and menopause." I then started googling and searching my social networks and found you.
Michelle's treatment plan included ADHD coaching for organization, hormone therapy to balance estrogen, magnesium and omega-3 supplements, and a modified schedule to match her energy.
Six months later, she said, "I've learned to work with my brain instead of against it. Some days are still hard, but I don't feel like I'm drowning anymore." She’s worried about returning to her open-concept office full-time, where distractions are more frequent and numerous. Working from home helps her control her environment. I mentioned she could get a doctor’s note for an exemption if needed.
Michelle's experience highlights common patterns many women face.
When to seek professional help
Don't wait until you're in crisis. Seek support if experiencing:
Persistent brain fog that affects your work or relationships
Unpredictable mood swings
Sleep problems lasting more than a few weeks
Anxiety disrupting daily life
Thoughts of self-harm or feeling like "everyone would be better off without me"
What to look for in healthcare providers
When seeking healthcare providers, choose those experienced with both ADHD and menopause, open to hormone testing, understanding how ADHD differs in women, and collaborative in treatment planning.
The science behind what you're experiencing
Recent research findings
A recent survey conducted by ADDitude magazine found 94% of women with ADHD experienced worse symptoms during perimenopause or menopause. Over half said their 40s and 50s were when ADHD became most disruptive, with issues like memory, time management, emotional regulation, and overwhelm. Hormonal changes during midlife may greatly affect women with ADHD.
What This Means for You
Understanding the science can be empowering. You're not imagining things, and you're not "weak" or "failing." You're experiencing real, measurable neurological changes that respond to targeted interventions.
From a coaching perspective, this reinforces the importance of personalized strategies that adapt to changing cognitive and emotional needs. What worked in your 30s may no longer be effective—and that’s not a failure. It’s an opportunity to reassess your rhythms, supports, and expectations with compassion and clarity. Tailoring tools to your current season of life can make all the difference.
Looking forward: redefining success in midlife
Letting go of outdated expectations
The woman who juggled 15 things in her 30s doesn't have to be the same now. Perimenopause and ADHD may slow you down, but that's not a bad thing.
Many women find that this challenging transition leads to better boundaries, authentic relationships, career clarity, and self-compassion.
They learn to say no to draining commitments, connect with accepting people, pursue aligned work, and treat themselves kindly.
Creating a new definition of productivity
Instead of comparing to external standards or your past, focus on:
Impact over activity: What matters most?
Quality over quantity: Can you do fewer things better?
Sustainability over speed: What pace is sustainable?
Growth over perfection: What are you learning about yourself?
Key takeaways
🧠 The connection is real. ADHD and perimenopause interact, potentially worsening symptoms affecting attention, memory, mood, and identity. Recognizing this link helps you feel better and seek support.
🔄 Your systems need updating. What worked in your 30s might not be as effective now, and that's okay. Embracing change is a sign of strength, not weakness.
⚖️ Hormones matter. Both estrogen and progesterone affect ADHD symptoms. Hormone-aware treatment can make a significant difference.
💪 Small changes, big impact. You don't need to overhaul your entire life. Small tweaks to your nutrition, sleep, movement, and support systems can make a big difference in how you feel every day.
👥 You're not alone in this. Millions of women face similar issues. Getting support and connecting with others can make the journey less lonely and more supported.
🌱 This Too Shall Pass. Perimenopause can last years, but your brain will adapt to hormone changes. The habits and strategies you develop now will benefit you long after this phase ends.
Take action: your next steps
Immediate actions (this week):
Start tracking your symptoms, energy, and cycle with an app or calendar
Schedule an appointment with a healthcare provider familiar with both ADHD and perimenopause
Join an online support community for women with ADHD. Find those offering helpful strategies, not just venting.
Short-term goals (next month):
Implement a new organizational system that accommodates brain fog. You may want to ask yourself which one will stick when executive function is compromised and how you’ll adapt it as symptoms change?.
Try one targeted supplement (with healthcare provider approval). It’s best to try one new supplement at a time, for four weeks.A nutritionist can help with that.
Establish a consistent sleep routine.
The challenge: Knowing what to do is only half the battle. Knowing how to personalize these strategies for your specific situation, track what's actually working, and adapt when your symptoms shift? That's where targeted guidance makes all the difference.
The reality: These steps sound straightforward, but personalizing them for your unique situation—knowing which patterns to track, which systems will actually stick, and how to adapt as your symptoms change—that's where guidance makes the difference.
You don't have to figure this complex puzzle out alone.
Ready for some relief?
If you're overwhelmed or need personalized guidance, I support women at the intersection of ADHD, hormones, and life transitions.
Let's have a 30-minute chat about your situation to see if this approach fits. We’ll talk through your specific situation, and you'll get clarity. Take what you need from it. If I’m not the one to support you, my online content is there for you.
If you already have a therapist, personal trainer, chiropractor, nutritionist, or other specialists, an ADHD coach is an essential addition to Team You.
Get in touch to explore personalized support.
For more insights on navigating ADHD, women's health, and midlife transitions, explore my other articles (click “learn’ above) or follow me and my articles on LinkedIn.
