Ask a Doc: Females, ADHD & Perimenopause/Menopause
July 10, 2025
By: Alyssa Plotts
Categories: Ask a Doc, Women's Health
Tags: Attention Deficit Disorder (ADD and ADHD), Menopause and Perimenopause, perimenopause
Symptoms of attention-deficit/hyperactivity disorder or ADHD can start in childhood and continue into adulthood. Women with diagnosed ADHD or undiagnosed symptoms may notice changes in symptoms as their hormones change. Dr. Kelly Wiersema shares important things for women living with ADHD to know.
Kelly Wiersema, MD
Obstetrics and Gynecology
Trinity Health Medical Group, OB Hospital Medicine - Grand Rapids Hospital
Accepting new patients
View DetailsHow does perimenopause or menopause affect someone who already has an ADHD diagnosis?
Kelly Wiersema, MD: ADHD symptoms may become more severe in perimenopause and menopause as estrogen and progesterone levels decline.
Women may experience worsening of ADHD symptoms during periods of hormone fluctuation and decline.
Are women more likely to be diagnosed with ADHD? Why?
Kelly Wiersema, MD: ADHD has been seen more in boys and men in the past. This is likely because many cases in girls and women go undiagnosed.
Women often present differently than men. Men often show clear symptoms like hyperactivity. Women usually show symptoms of inattention, which are less obvious.
Read: Adult ADHD Diagnosis Can Make Adulting Easier
What are the overlapping symptoms between ADHD and perimenopause/menopause?
Kelly Wiersema, MD: Women in perimenopause/menopause often have complaints and symptoms of brain fog, particularly affecting attention and memory, as well as executive dysfunction. Other common symptoms of ADHD and menopause include inattention, poor time management, emotional dysregulation, procrastination and impulsivity.
Read: What You Should Know about Menopause
Can perimenopause/menopause trigger ADHD-like symptoms even in women without a prior diagnosis?
Kelly Wiersema, MD: There is significant overlap in symptoms of ADHD and menopause, which can make differentiating between perimenopausal/menopausal symptoms and ADHD difficult. Doctors may diagnose ADHD in perimenopause or menopause because the hormonal changes of menopause may unmask the underlying ADHD condition.
How is ADHD commonly underdiagnosed or misdiagnosed in women, especially in midlife?
Kelly Wiersema, MD: Women tend to have symptoms such as inattention and difficulty with executive function. Many women have been able to compensate or hide their symptoms. Misdiagnosis is common. Doctors often diagnose women with anxiety, depression, fibromyalgia or chronic fatigue instead.
How can health care providers differentiate between hormonal changes and ADHD?
Kelly Wiersema, MD: A patient might have ADHD instead of menopausal symptoms if they have had symptoms for a long time. They may find that symptoms were mild before and worsen during the perimenopause and menopause period. Mild symptoms earlier in life may become unmanageable with the hormonal changes of perimenopause and menopause.
Are stimulant medications effective for women experiencing both ADHD and perimenopause?
Kelly Wiersema, MD: Some small studies show that using stimulants can improve thinking and brain function in menopausal women. Stimulant medications enhance the dopamine system and improve executive function.
What questions should you ask your doctor if you suspect ADHD or cognitive changes?
Kelly Wiersema, MD: Describe your symptoms. Ask if they think it could be related to ADHD.
Ask about any screenings or assessments you can do or ask if you should get a referral to someone who specializes in adult ADHD.
Bring a brief symptom log and share examples. Describe any school or work challenges. Note if you have any family history of ADHD.
What are non-medication strategies for managing cognitive symptoms during perimenopause?
Kelly Wiersema, MD: You can use cognitive-behavioral therapy for ADHD. Coaching can help with executive function.
Good sleep hygiene is important. Sleep is critical for attention, emotional control and working memory. Stress management and exercise also help. Having a structured routine is beneficial.
Good nutrition matters too. It can improve brain function, reduce inflammation and stabilize mood and energy. Try to avoid sugars and processed foods.
Reduce multitasking. Declutter your physical and digital space. Use cognitive strategies like lists, reminders, and planners. Cognitive training, such as brain-training apps, puzzles and engaging socially with others can help too.
