ADHD and Menopause: Why Your Brain Feels Different (and What You Can Do About It)
By Sam Botica, Naturopath
For many women, perimenopause and menopause bring a wave of changes that are of course physical but also significantly impact mental and emotional wellbeing. Hot flushes, mood swings and sleep issues are more commonly talked about, but what isn’t talked about enough - I think - is how significantly this transition can impact focus, motivation, memory, and emotional regulation.
For some women, it can even feel like they’ve suddenly developed ADHD.
And there’s a growing trend of women in their 40s being diagnosed with ADHD for the first time.
In this article I’m going to unpack why that happens, share a case study and talk about what you can do to support your brain (and keep sane!) during this phase of life.
Understanding Perimenopause and Menopause
Perimenopause is the transitional phase leading up to menopause, when the ovaries gradually begin to produce less oestrogen and progesterone. This stage can begin as early as your mid-to-late 30s and may last several years.
You officially graduate to Menopause when you’ve gone 12 consecutive months without a menstrual cycle.
During perimenopause, hormone levels don’t just decline, they fluctuate, and quite often unpredictably! This hormonal instability is what makes it so hard to anticipate energy levels that you might be accustomed to in your usual cycle, but it also drives many of the symptoms women experience, including:
Irregular periods
Sleep disturbances
Hot flushes and night sweats
Increased anxiety or irritability
Mood swings
Brain fog and forgetfulness
Reduced stress tolerance
Many women describe feeling “not quite like themselves” and it makes a lot of sense, considering everything that’s going on in their bodies!
When masking no longer works
Many women, particularly those with ADHD tendencies have spent years “masking” usually without even realising that’s what they were doing.
Masking simply describes those strategies you use to compensate for challenges like distractibility, forgetfulness, or difficulty with organisation. This might look like:
Multitasking that’s reactive but harder to focus on one thing
Excessive planning or relying on lists
Perfectionism
Pushing yourself to stay on top of tasks
Being overly agreeable or people-pleasing to avoid perceived failure
These strategies (or coping mechanisms we might call them) can work well, and even receive positive feedback, but when you add chronic stress and hormonal fluctuations into the mix, these coping mechanisms can start to fall short.
Systems that once worked become inaccessible no longer feel sufficient and this is often when women begin to notice more pronounced ADHD-like symptoms.
How are hormones and ADHD connected?
Oestrogen and Neurotransmitters
Oestrogen plays a key role in brain chemistry. It helps boost the release of dopamine and acetylcholine. These are two neurotransmitters essential for:
Focus and attention
Motivation and drive
Working memory
Emotional regulation
As oestrogen levels fluctuate or decline during perimenopause, these systems become less stable.
This is why many women report feeling like they’ve “suddenly developed ADHD” even if they’ve never had a formal diagnosis.
Executive Function Under Pressure
If you already have ADHD tendencies, you may notice that:
Starting tasks feels harder
Prioritising becomes overwhelming
You spend more time planning than doing
When dopamine and serotonin are disrupted, the brain’s ability to initiate action drops. The “activation energy” required to begin tasks increases, which can lead to procrastination, even when you want to get things done.
Sleep, Stress and the Dopamine Loop
Perimenopause often disrupts sleep through night waking and hot flushes. At the same time, stress hormones like cortisol can remain elevated.
This combination:
Reduces dopamine sensitivity
Increases fatigue
Drives the brain to seek quick dopamine hits
This can look like:
More scrolling
Increased snacking
Avoidance behaviours
Difficulty focusing on meaningful tasks
The Emotional Load
Both ADHD and perimenopause can heighten emotional sensitivity.
Many women experience:
Increased rejection sensitivity
Overwhelm
Perfectionism
Guilt or self-criticism
This emotional load can create a cycle where overwhelm leads to avoidance, which then reinforces feelings of frustration or inadequacy.
ADHD and Hormones Case Study
I recently worked with a patient who had been managing ADHD with dexamphetamine for some time. She came in experiencing quite disturbing hot flushes, increased anxiety, irritability, and had noticed an undeniable drop in focus at work.
She described feeling like her medication “wasn’t working anymore,” and was beginning to feel unusually flat and low moods.
As in most cases, we took a supportive, whole-body approach.
We started with a targeted probiotic, with specific strains known to support mood, energy, and the gut-brain axis. Alongside this, I prescribed a herbal blend, personalised to her needs, to support her adrenal glands and help regulate her stress response, while also supporting hormonal balance.
We also incorporated a supplement containing key amino acids that support neurotransmitter production, helping to improve focus and reduce anxiety.
After 8 weeks, she returned for a follow up consult feeling significantly better. She reported noticing changes around the 4-week mark which included improved mood, better focus, and her moods stabilising - no more emotional rollercoasters.
Supporting Your Brain Through This Transition
If you’re noticing changes in your focus, motivation, or emotional resilience during perimenopause, it’s not “just in your head” and it’s not something you need to push through.
With the right support, it’s absolutely possible to feel like yourself again.
This may include:
Supporting hormone balance
Addressing stress and adrenal function
Improving sleep quality
Replenishing key nutrients]
Supporting gut health and the gut-brain connection
Personalised herbal and nutritional support
You Don’t Have to Navigate This Alone
Whether you have a formal ADHD diagnosis, or you’re simply noticing these tendencies becoming more prominent - especially if you're in your late 30s, or 40s - getting support early on can make a significant difference.
If you think about it, being able to focus, follow through, and feel emotionally steady impacts every area of life from your work to your relationships, and your overall wellbeing. You might be surprised at how much of a difference this support can make, and the relief when you understand what’s driving your symptoms and how to effectively work with these changes.
If things have been feeling harder than usual, book an appointment with me here at Perth Natural Medical Clinic. We can do either in person consults or online via telehealth.