ADHD & Perimenopause - What’s Actually Happening in Your Brain and Body?

If you feel like your ADHD is getting worse in your 30s or 40s, you’re not imagining it. There’s a real, biological reason why perimenopause makes ADHD symptoms harder to manage - and it all comes down to hormones and neurotransmitters.

Let’s break it down step by step so it’s easy to understand.

What is Perimenopause?

Perimenopause is the transition phase before menopause (which is when you haven’t had a period for 12 months). It usually starts in your late 30s to mid-40s and can last anywhere from 2 to 10 years.

During this time, your hormones start fluctuating wildly before eventually dropping for good. This rollercoaster is what causes all the frustrating symptoms - and for women with ADHD, it can feel like everything is falling apart.

The Hormonal Changes in Perimenopause (And What They Do to ADHD)

1. Oestrogen Levels Start Dropping (But Not All at Once)

•Oestrogen doesn’t just decline smoothly - it rises and falls unpredictably, like a rollercoaster.

•Some days, you have normal levels, and you feel fine.

•Other days, oestrogen crashes, and suddenly you have brain fog, memory problems, and mood swings.

Why This Matters for ADHD:

•Oestrogen helps regulate dopamine, the brain chemical that controls motivation, focus, and emotional regulation.

•When oestrogen drops, dopamine drops too, making ADHD symptoms much worse.

•The constant hormonal ups and downs make symptoms unpredictable - some days, you’re fine, others, you’re struggling.

2. Progesterone Starts Dropping Too

•Progesterone is the calming, stabilising hormone.

•It works with GABA, a neurotransmitter that slows down the brain and reduces stress.

Why This Matters for ADHD:

•Lower progesterone means more irritability, anxiety, and trouble sleeping.

•Mood swings become extreme, going from rage to tears in minutes.

•More sleep problems - progesterone helps with deep sleep, so as it drops, insomnia gets worse.

3. Cortisol (The Stress Hormone) Goes Up

•As oestrogen and progesterone drop, cortisol (your body’s main stress hormone) increases.

•This can make you feel more anxious, overwhelmed, and on edge all the time.

Why This Matters for ADHD:

•ADHD brains already struggle with stress regulation - higher cortisol makes this even harder.

•More overstimulation and sensory sensitivity - sounds, lights, and social situations can feel unbearable.

•Meltdowns and burnout happen faster because your body is in a constant state of stress.

When Do These Hormonal Changes Happen?

Early Perimenopause (Late 30s - Early 40s):

•Oestrogen starts fluctuating wildly.

•Progesterone slowly declines, making anxiety worse.

•Sleep problems begin, leading to exhaustion.

Mid Perimenopause (40s):

•Oestrogen drops lower, causing more severe brain fog and memory issues.

• Hot flashes, mood swings, and energy crashes become more noticeable.

•ADHD symptoms become much harder to manage.

Late Perimenopause (Mid to Late 40s):

•Oestrogen and progesterone are at their lowest levels.

•Dopamine is at an all-time low, making ADHD symptoms feel unbearable.

•Brain fog, exhaustion, and emotional overwhelm peak.

Menopause (Usually Around 50+):

•Your period stops completely.

•Oestrogen and progesterone stay low permanently.

• The hormonal rollercoaster stops, so some symptoms stabilize, but ADHD may still feel different than before.

Why ADHD Feels Worse in Perimenopause (And Why No One Talks About It)

Most women with ADHD have masked their symptoms their whole lives - using structure, hyperfocus, and routine to cope. We weren’t diagnosed as children because research into ADHD in girls was pretty much missing until the late 1990’s/early 2000s.

But when hormones start fluctuating wildly, these coping mechanisms stop working because:

•Dopamine crashes make it harder to focus or get motivated.

•Emotional dysregulation gets worse because of lower oestrogen.

•Sleep deprivation makes executive function completely fall apart.

This is why so many women only realise they have ADHD in their 40s - they were holding everything together until perimenopause took away their ability to mask.

How to Support Your ADHD Brain in Perimenopause

Perimenopause isn’t just something to survive - you can actually make it easier by working with your brain and hormones.

Support dopamine levels naturally:

•Movement (even small bursts)

•Novelty (change your environment, try new things)

•Small wins (dopamine stacking techniques)

Regulate your nervous system:

•Yoga, breathwork, and deep relaxation to balance cortisol

•Sensory management (reduce noise, lights, and overstimulation)

Sleep support:

•Magnesium, herbal teas, and sleep routines that work for ADHD brains

Consider medical support:

•ADHD medication can help stabilise dopamine

•HRT (Hormone Replacement Therapy) can reduce the severity of perimenopausal symptoms

You’re Not Failing, Your Brain is Changing

If you feel like you’re falling apart in midlife, it’s NOT because you’re doing anything wrong.

ADHD and perimenopause is a real, biological shift - and you deserve support, not gaslighting.

Have you noticed your ADHD symptoms getting worse in your 30s or 40s? Let’s talk.

Explore the resources on my website, including free downloads and guides as well as more in depth courses to purchase. We don’t have to navigate this alone.