ADHD in Women: Unmasking the Challenges
ADHD, often stereotyped as a condition primarily affecting boys, is increasingly recognised as a prevalent issue among adults, and especially those often-overlooked women. While the symptoms can vary, understanding the nuances of ADHD in women can be crucial for diagnosis and effective management.
ADHD in Women: The Hidden Epidemic
The symptoms of ADHD revolve around executive function, which helps you manage focus, concentration, emotional regulation, impulse control and self-motivation. ADHD in women is often underdiagnosed due to the subtle presentation of symptoms. The same ADHD subtypes of inattentive, hyperactive and combined still occur but can look different.
Women with ADHD can exhibit predominantly inattentive symptoms such as difficulty focusing, organising, and following through on tasks. Alternatively, women can be hyperactive, but it is more commonly a hyperactivity of the mind, not the body. This can manifest in women who are constantly on the go and juggling many things to stay stimulated. Impulsivity may present as interrupting or saying things without thinking, seeming to have no filter at times.
Women with ADHD may struggle with academic, professional, and personal challenges without realising the underlying cause, but many are also high achievers and leaders in their fields. Women with hyperactive type ADHD are at higher risk of burnout due to their inability to slow down and rest.
Adult ADHD Diagnosis
The current rate of adult ADHD is 3.1%, whilst approximately 5% of children have ADHD. As it is now understood that people do not ‘grow out of’ ADHD, as it’s a neurotype and not a disorder, it’s likely that adult rates will continue to climb. Many women were not diagnosed in childhood due to their more inattentive symptoms, and continue to go undiagnosed for years, attributing their challenges to personality flaws or stress. As awareness grows, more women are seeking evaluation and diagnosis, leading to a gradual increase in recognised cases.
Symptoms of ADHD in Women
ADHD symptoms in women can be multifaceted and often overlap with other conditions. Some common symptoms include:
Difficulty concentrating and maintaining focus
Problems with time management and organization
Procrastination
Forgetfulness
Challenges with multitasking
Emotional dysregulation
Perfectionism
Rejection sensitive dysphoria
Difficulty with planning and prioritising
It is important to note that these symptoms can vary in intensity and may not be present all the time or in all women. Women with ADHD often develop coping mechanisms to manage their challenges, which can mask the underlying condition.
The Impact of Hormonal Changes in ADHD
Hormonal fluctuations associated with perimenopause and menopause can significantly impact women with ADHD. Perimenopause begins with a lowering of progesterone levels, which is the dominant hormone in the second half of the menstrual cycle known as the luteal phase. Progesterone upregulates GABA receptors in the brain to promote a feeling of calm, and the reduction in progesterone can result in increase anxiety and lowered mood in this phase.
With the reduction in progesterone, estrogen becomes unopposed and can fluctuate for a while, before eventually declining also. Estrogen stimulates the production of dopamine and serotonin, enhances the sensitivity of their receptors in the brain and inhibits their breakdown to improve focus, motivation, mood and sleep. This happens especially in the first half of the menstrual cycle known as the follicular phase. When estrogen is produced in lower amounts in late perimenopause and menopause these changes can increase ADHD traits such as:
Increased forgetfulness and difficulty concentrating: Lowered estrogen can affect cognitive function, making it harder to focus and remember details.
Mood swings and irritability: Hormonal fluctuations can amplify emotional responses, leading to increased impulsivity and difficulty managing stress.
Sleep disturbances: Sleep problems are common during perimenopause and menopause, which can further exacerbate ADHD symptoms.
Difficulty with executive functions: Planning, organizing, and time management can become even more challenging due to changes in cognitive function and brain fog.
Recognising the connection between ADHD and hormonal changes is crucial for developing effective management strategies. There are a variety of supportive therapies that can be beneficial to women with ADHD, especially while adjusting to altered levels of hormones in perimenopause. To find out more about naturopathic support for ADHD you can view my free Webinar on Neuroaffirming Naturopathic Care here.
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