Audio Version (09:11)
In recent years, more and more women have recognised signs of attention deficit hyperactivity disorder (ADHD) during their transition into perimenopause. It’s something that I definitely see in my coaching practice and have first-hand experience with.
This late-life revelation often comes as a surprise, as ADHD has historically been underdiagnosed and misunderstood, particularly in women.
The link between perimenopause and ADHD is complex, rooted in hormonal changes, societal expectations, and growing awareness of ADHD’s nuanced presentations.
In this article, I’ll be exploring the reasons why perimenopause often exposes undiagnosed ADHD and what it means for women navigating this life stage.
In the extended YouTube version, I discuss the role of hormones in ADHD and the benefits of a diagnosis in later life, and I provide strategies for navigating its complexities. You can watch it here.
Before we get into the details – full disclosure – as I’ve mentioned in previous articles, I was diagnosed with ADHD in January 2023 at the age of 53.
Subsequently, I have coached more than 30 individuals on a one-to-one basis who either suspected they were neurodivergent, had no idea they were neurodivergent but were struggling to understand their emotions and behaviour, or already had a diagnosis. I have also trained thousands of people in Neurodiversity Awareness.
So, this one is personal and an important topic for me.
Understanding ADHD in Women
ADHD is a neurodevelopmental condition that affects executive functioning, including skills such as attention regulation, impulse control, decision-making, emotional regulation, and organisation.
While ADHD is commonly associated with hyperactive boys in childhood, its presentation in girls and women often looks very different. Many women with ADHD experience symptoms such as:
Chronic forgetfulness and disorganisation
A tendency to procrastinate
Difficulty focusing, especially on tasks that don’t hold their interest
Emotional overwhelm or hypersensitivity and emotional dysregulation
Feeling perpetually overwhelmed by daily responsibilities
These symptoms often get dismissed or misattributed to personality traits, anxiety, or depression, leading to a lack of proper diagnosis in childhood, adolescence and adulthood. Women may develop elaborate coping mechanisms to manage their symptoms, masking their ADHD for decades.
Why Perimenopause is a Tipping Point
During perimenopause, which typically begins in a woman’s 40s or early 50s (although it can begin earlier), fluctuating estrogen levels can intensify ADHD symptoms.
Many women describe feeling as though they are “losing control” or “falling apart.” Tasks they once managed with ease suddenly feel insurmountable, and emotional overwhelm becomes a frequent experience.
Three key factors contribute to this tipping point:
1. Hormonal Chaos
Hormonal fluctuations significantly impact ADHD symptoms, particularly in women. Estrogen, a hormone that influences the production of dopamine and serotonin in the brain, plays a crucial role in regulating mood, focus, and executive functioning (decision-making, planning, organising, etc.).
When estrogen levels are high, many women experience improved cognitive functioning and mood stability. Conversely, when estrogen levels drop, ADHD symptoms often worsen. (I discuss this in more detail in the YouTube version of this article.)
2. Increased Cognitive Demands
For many women, midlife brings a convergence of responsibilities—caring for ageing parents, supporting teenage children, navigating career pressures, and managing household tasks. These cognitive and emotional demands can exacerbate ADHD symptoms.
3. Loss of Masking Abilities
Over time, the coping mechanisms women have developed to mask their ADHD symptoms can wear thin. Perimenopause often strips away the mental energy required to maintain these strategies, making the underlying ADHD more apparent.
The Cultural Blind Spot in Diagnosing Women
Historically, ADHD has been underdiagnosed in women for several reasons:
1. Gender Stereotypes
ADHD has long been seen as a “male” condition, with diagnostic criteria skewed toward hyperactive and disruptive behaviours more common in boys. Girls, who often exhibit inattentive or internalised symptoms, have been overlooked.
2. Societal Expectations
Women are often socialised to be nurturing, organised, and emotionally stable. When they struggle with focus, forgetfulness, or emotional dysregulation, these traits are often attributed to stress, anxiety, or a lack of discipline rather than ADHD.
3. Focus On Anxiety and Depression
Many women with ADHD are initially diagnosed with anxiety or depression, as these conditions often co-occur with ADHD. However, treating only these symptoms without addressing the underlying ADHD can leave women feeling stuck and misunderstood.
It is only in recent years that awareness of ADHD’s diverse presentations in women has grown. For many women, perimenopause serves as a catalyst for seeking help, as the intensification of symptoms becomes impossible to ignore.
I recommend watching my video 038 – 5 Reasons why ADHD is MISDIAGNOSED or UNDER-DIAGNOSED in WOMEN for more information on this topic.
Breaking The Stigma
The increasing recognition of ADHD in women, particularly during perimenopause, is a step forward in breaking the stigma surrounding this condition. By sharing our stories, we are challenging outdated stereotypes and helping to build a more inclusive understanding of ADHD.
If you suspect you might have ADHD, know that you’re not alone—and it’s never too late to seek support. Perimenopause, while a challenging time, can also be an opportunity for growth and self-discovery.
Embracing your diagnosis or simply taking steps toward managing your symptoms if you decide getting a formal diagnosis isn’t the right path for you can help you navigate this phase with greater clarity and confidence.
If you’re interested in this topic, another video that might be helpful is 056 – 25 Common ADHD Traits, plus why it often goes UNDIAGNOSED.
The Wrap-Up
The discovery of ADHD during perimenopause is a poignant reminder of the intersection between hormonal health and neurodiversity.
For many women, myself included, an ADHD diagnosis is not the end of the story but the beginning of a new chapter—one where we can finally understand ourselves and live authentically. That’s certainly been my experience!
By acknowledging the unique challenges women face and providing holistic support, we can create a world where no one feels left behind.
Personally, knowing what I know now, would I get a diagnosis? Maybe not! Has it drastically changed my life knowing that I have ADHD? Again, no. But what it has done is allow me to be kinder to myself.
If I’m having a tough time or find myself struggling with something, I now know why and what I need to do to recover. Instead of ploughing through with almost toxic positivity, I’m kinder to myself. I plan things differently and take better care of myself to lessen my triggers and keep myself fit and healthy—physically and mentally.
What Next?
Again, in the extended YouTube version, I discuss the role of hormones in ADHD and the benefits of a diagnosis in later life, and I provide strategies for navigating its complexities. You can watch it here.
If there are any specific subjects you’d like me to cover in upcoming content (it’s always so helpful!) or if you’d like help with any of the topics I discuss, message me at info@jobanks.net.
Finally, if you enjoyed this article and haven’t yet signed up to get my weekly newsletter straight to your inbox, hit the ‘NEWSLETTER’ tab at the top of the page.
As always, thanks for your continued support.
