ADHD and: Hormones

Picture this: As your menstrual cycle approaches, you notice a shift in your mood and focus. One moment you feel productive, clear-headed, and on top of your ADHD. The next moment your concentration slips away. 

Hormonal changes can turn everyday routines into huge challenges for women with ADHD. In this episode, listen as Dr. Monica Johnson explores how hormonal fluctuations can heighten ADHD symptoms. Learn key hormones that can impact mood and focus. And get tips on how to manage ADHD and hormonal changes effectively.

We love to hear from our listeners. Email us at podcast@understood.org.

Related resources 

• A guide to hormones and ADHD

• ADHD and hormones (Catie Osborn’s story)

• ADHD and women

Timestamps

(00:55) What are hormones?

(01:35) Does research show a connection between ADHD and hormones?

(02:38) How does ADHD impact the menstrual cycle?

(04:11) How to manage ADHD and hormonal changes effectively

(05:04) How diet and exercise play a role

Episode transcript

Dr. J: For many women with ADHD, hormonal changes can feel like an added storm in already turbulent waters. You've worked hard to build routines and strategies that manage your symptoms. But then every month, like clockwork, everything starts to unravel. Your focus wanes, your emotions run high, and the tools that typically help now feel almost useless.

This is "ADHD and," where we talk about everyday life and ADHD. I'm your host, Dr. J. I'm a licensed psychologist who works with those with ADHD. Today we're talking about ADHD and hormones.

This conversation can look a lot different depending on how you want to classify hormones.

(00:55) What are hormones?

Here is the official definition of a hormone: A regulatory substance produced in an organism and transported in tissue fluid such as blood or sap to stimulate specific cells or tissues into action. This means that some of the things that the social media space refers to as neurotransmitters are actually also hormones like dopamine. We talk about dopamine all the time, so that won't be the focus of today's episode.

I imagine that most people think about sex hormones when they think about this topic, and that includes testosterone, estrogen, and progesterone. I'll also add in a bonus hormone.

(01:35) Does research show a connection between ADHD and hormones?

The truth is that research doesn't draw a great conclusion between ADHD and hormones, except for dopamine, which is greatly involved in ADHD. But don't worry, I'm going to give you the lowdown on some relevant information related to your hormones and ADHD.

Testosterone has been linked with cognitive processes, including attention and executive functioning, which are often impaired in women with ADHD. However, the relationship is actually pretty complex, with some studies suggesting that optimal levels of testosterone might support cognitive functioning while too much or too little might be detrimental. For estrogen, it's vital for healthy functioning minds. And when estrogen levels fluctuate due to someone's menstrual cycle or pregnancy, for example, your cognitive functioning will fluctuate as well. And that's regardless of if you have ADHD or not.

So, symptoms may appear worse for any cognitive problem whenever there are issues related to the amount of estrogen that's available in your system.

(02:38) How does ADHD impact the menstrual cycle?

Women with ADHD often report that their symptoms worsened during certain phases of their menstrual cycle, particularly when progesterone levels are high, such as during the luteal phase or the second half of your menstrual cycle, for those of us who don't remember our sex ed class from 20 years ago.

This phase is characterized by increased progesterone and a decrease in estrogen. High levels of progesterone have been associated with mood changes, cognitive difficulties, and fatigue, which can exacerbate ADHD symptoms like inattention, impulsivity, and emotional dysregulation. Now for our bonus one, cortisol, otherwise known as the stress hormone. Abnormal cortisol levels have been associated with specific ADHD symptoms. Lower cortisol levels may be related to increased inattention, while altered cortisol reactivity might be associated with hyperactivity and impulsivity.

The exact nature of these relationships varies. It is important to mention that a lot of research needs to be done in this specific area. The shorthand of the situation is this: When you have ADHD, you already struggle with issues of emotion, regulation, impulsivity, negative self-talk, and for many, sensory issues as well. When you're a woman on your period with ADHD, it often can and will heighten all of those symptoms for you. So, what can we do about that?

(04:11) How to manage ADHD and hormonal changes effectively

The first thing I want to mention is tracking. Keep a symptom diary to track symptoms along your hormonal cycles. There are a lot of free period apps that you can use for this. Being aware of where you are in your hormonal cycles will provide you with valuable information on how to engage in self-care. For instance, you can be on the lookout for funky moods or decreased concentration and put extra support in place during those times when it's needed.

It's not quite the same, but I'm a person who lifts heavy weights, and depending on where I am in my menstrual cycle, my lifting can be straight garbage because hormonal changes also impact your fatigue and strain. Having this additional information keeps me from engaging in negative self-talk during these times. It also encourages me to implement more rest and to lift lighter waves without judgment if necessary.

(05:04) How diet and exercise play a role

Which brings me to my next point: Diet and exercise. My unwanted gift that keeps on giving. The benefits of it are actually enormous. In women, regular exercise helps maintain a healthy balance of estrogen and progesterone. This reduces symptoms associated with a hormonal imbalance like PMS and menopause. Exercise can also help to manage cortisol, while acute exercise temporarily increases cortisol levels, regular physical activity helps lower baseline cortisol levels. It also reduces your chronic stress and improves the body's overall stress response.

Consuming healthy fats like those found in avocados, nuts, seeds, and oily fish is essential for hormone production, especially sex hormones. A diet that's high in fiber, particularly from fruits, vegetables, and whole grains, is great for supporting hormone balance. It helps by promoting healthy digestion and also by removing excess hormones from your system like estrogen. This is why I keep reminding people that the fundamentals will get you so far in life.

Everything that I've mentioned here are probably things that you've heard before that you keep dismissing or that you've tried and given up on. If that sounds like you pick one health habit and focus on it until it becomes a part of your routine. You may get frustrated and think that you're not doing enough. But listen to me: If you developed and maintained one good habit every year of your life, you'd probably die one of the healthiest people on the planet.

Lastly, don't hesitate to speak to a health care provider about your hormone levels if you're worried that you're drastically outside of the recommended zones. I've worked with patients in the past who are exhibiting severe mental health symptoms and they went to get their levels checked and found out that they were super low on one or more parameters. Once they began engaging in hormone replacement therapy, they saw that their symptoms improved because that was a contributing factor to their poor mental health.

We're all learning how to take care of our bodies and minds, and that includes the hormonal changes that occur to us. It's normal to feel off, emotional, sensitive, or even out of control throughout various times of the month, especially if your hormones are potentially out of whack. What helps us to stabilize is understanding that these issues are common and that we need to focus on self-care.

For women that could be tracking our cycles, making small dietary changes, or even speaking to a doctor just to double-check that the issue isn't a little bit bigger than we can manage on our own. In all cases, I'm sure you're doing the best that you can, and I just need you to know that going step by step is A-OK, and it's probably best for you in the long run.

I appreciate you so much for joining me on this episode of "ADHD and," and I would love for you to subscribe to our channel for more.

This show is brought to you by Understood.org, a nonprofit organization dedicated to empowering people with learning and thinking differences like ADHD and dyslexia. Learn more at Understood.org.

"ADHD and" is produced by Tara Drinks and edited by Alyssa Shea. Our video producer is Calvin Knie. Ilana Millner is our supervising producer. Briana Berry is our production director. Neil Drumming is our editorial director. Our audio engineer and music composer is Justin D. Wright. Our executive directors are Laura Key, Scott Cocchiere, and Seth Melnick. And I'm your host, Dr. J.