Menopause is gaining more media attention than ever, and with it a growing awareness of how hormonal changes in midlife can have unexpected effects on a woman's health. One interesting area is the link between menopause and ADHD.
New research suggests women with ADHD may experience perimenopause earlier and more severely than those without. A cohort study found that women with ADHD reported peak perimenopausal symptoms between the ages of 35 and 39, compared to 45 to 49 in women without ADHD.
This may be due to shared neurological pathways. Fluctuating oestrogen affects dopamine, serotonin and noradrenaline signalling, the same systems that are disrupted in ADHD. As oestrogen begins to decline during perimenopause, this disruption intensifies. For some women, this may also unmask ADHD that was previously being managed through coping strategies. This may explain why some women receive their first ADHD diagnosis in their late thirties or forties.
It is worth noting that this is an observational study, and we cannot draw firm conclusions about causation from that alone. The relationship between ADHD and perimenopause is likely more complex than a simple cause and effect, and more research is needed… But the association is significant enough to change how we ask questions in the consultation room.
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References:
Jakobsdóttir Smári U, Valdimarsdottir UA, Wynchank D, de Jong M, Aspelund T, Hauksdottir A, Thordardottir EB, Tomasson G, Jakobsdottir J, Lu D, Nevriana A, Larsson H, Kooij S, Zoega H. Perimenopausal symptoms in women with and without ADHD: A population-based cohort study. Eur Psychiatry. 2025 Sep 4;68(1):e133. doi: 10.1192/j.eurpsy.2025.10101. PMID: 40903825; PMCID: PMC12538516.