Why Perimenopause Can Make ADHD Symptoms Worse
Are you struggling with brain fog, focus, or impulsivity in your 40s? You’re not alone. Oestrogen decline in perimenopause doubles ADHD symptoms even in women who’ve never been diagnosed.
I’ve noticed this shift myself. While I don’t have a formal ADHD diagnosis, I have clear traits and tendencies, and perimenopause has amplified them.
What’s happening? The answer lies in oestrogen fluctuations and dopamine disruption.
How Oestrogen Impacts Focus, Motivation, and Impulsivity
Estrogen plays a critical role in brain function by regulating dopamine, the neurotransmitter responsible for attention, motivation, and reward processing. In ADHD, dopamine pathways are already disrupted. When estrogen drops, so does dopamine activity, making symptoms worse.
Key Times When Oestrogen Drops
Right after ovulation → Increased impulsivity and risk-taking
The week before menstruation → Attention struggles and brain fog
These fluctuations have always existed, but perimenopause makes them more extreme—leading to worsening symptoms.
Progesterone’s Role in Smoothing Attention Issues
Progesterone, which rises in the second half of the cycle, can soften the impact of estrogen drops. Studies show that women with higher average oestrogen levels across the cycle experience fewer attention difficulties. As perimenopause disrupts this balance, focus and memory take a hit.
Signs You’re Experiencing Perimenopausal ADHD Symptoms
Forgetfulness – Losing track of appointments, misplacing items, struggling with word recall
Mental fatigue – Feeling overwhelmed by routine tasks
Emotional reactivity – Increased frustration, mood swings, or impulsive decisions
Scattered focus – Difficulty completing tasks or following conversations
Restlessness – Feeling wired but tired, with trouble winding down
What Helps? Practical Strategies for Brain Support
Support oestrogen levels – Work with a practitioner to assess whether menopause hormone therapy (MHT) or dietary adjustments could help
Optimise dopamine naturally – Protein, omega-3s, dopaminergic herbs and B vitamins support neurotransmitter production
Fine-tune medication (if applicable) – Some women find ADHD meds feel less effective in perimenopause
Prioritise sleep – Oestrogen decline disrupts sleep, which worsens focus. Magnesium, glycine, and sleep timing can help
Move daily – Strength training and cardio both boost dopamine and improve focus (this works wonders for me!)
If perimenopause has made your brain feel like it’s running on fumes, it’s not in your head it’s in your hormones. Oestrogen fluctuations impact focus, motivation, and cognitive function. The good news? You can do something about it.
Let’s map out a strategy to support your brain health.
