Menopause and mental health have long been gaining a lot of attention among women who are about to enter the golden period of their lives.
Besides causing women to decline in mental well-being, menopause is linked to a possible heightening of ADHD symptoms, making those who think they are under the control of their childhood condition now fall into a thick cognitive fog.
So how do menopausal women find their way out of a mental disorder during this critical stage? Is there any form of ADHD management that helps improve the symptoms of menopause and ADHD simultaneously?
ADHD Management: Hormone Replacement Therapy as a Possible Cure
What Is ADHD, and Who May Have It?
Attention Deficit Hyperactivity Disorder, or ADHD, is a neurodevelopmental disorder characterized by impulsivity, hyperactivity, and inattention. It affects 2-5% of adults and 5-10% of children, with boys being more susceptible. For some people, ADHD can linger into adulthood and impact daily activities and the quality of life.
Genetics, head injuries, and exposure to environmental toxins are the risk factors for ADHD. A mental health professional can typically make a diagnosis after a thorough evaluation of the symptoms and behavioral patterns of the patient. Unfortunately, ADHD usually goes undetected as it tends to be overshadowed by other conditions.
ADHD and Menopause: a Double Threat
Although ADHD is considered a common condition in children under 12 years old, it can be diagnosed at a relatively high rate in women going through menopause or the perimenopausal transition. In other words, the risk of ADHD becomes higher than at any different stage of a woman’s life when faced with the impacts of advanced age.
Because peri- and menopausal women are already vulnerable to cognitive decline due to the persistent episodes of hormonal fluctuations, those once diagnosed with ADHD as a child now encounter a double threat. First, a loss of concentration, difficulty in memorizing, and the inability to make decisions have long been attributed to menopause.
With ADHD, women are now exposed to another layer of cognitive fog that has a different root cause and induces more problems. The onset of menopause can be more disruptive and more severe. What can be worse is that because of the hormonal imbalance that leads to changes in the brain, medications for treating ADHD can be less effective.
Does ADHD Worsen During Menopause?
The relationship between ADHD and menopause is not yet entirely understood, but initial findings show they may be interconnected.
Some women report that their ADHD symptoms worsen during menopause, while others claim no change. Hormonal changes during menopause, such as fluctuations in estrogen levels, may play a role. However, other factors like sleep disturbances, stress, and mood swings can be a part of the upswing in ADHD symptoms during menopause.
According to the North American Menopause Society (NAMS), over 20% of peri- and postmenopausal women experience mood swings. This psychological instability typically begins in a woman’s mid-40s and can last for years.
Since mood swings – the emotional roller coaster of menopause – make it more difficult for women with ADHD to regulate their emotions and control impulsive behavior while increasing stress, ADHD symptoms can worsen during this stage.
How Does Menopause Affect ADHD?
A woman goes through various times when her hormone levels fluctuate, starting from adolescence to menopause. However, after menopause, the hormone levels, especially estrogen, have plummeted dramatically, and only less than half of the youthful levels remain. This irreversible estrogen decline is why ADHD worsens during this stage.
According to research, lower estrogen affects the release of some neurotransmitters, like serotonin and dopamine. Because these two substances are vital to the brain, estrogen decline causes various changes in the brain’s biochemistry. While serotonin deficiency causes depression, dopamine deficiency is one of the causes of ADHD symptoms.
In particular, dopamine regulates attention, motivation, and impulse control, among other functions. Low dopamine levels can lead to inattention, hyperactivity, impulsiveness, and other symptoms of ADHD. In some cases, ADHD medications that increase dopamine levels appear ineffective because of the detrimental effects of estrogen decline.
ADHD Management During Menopause
Cognitive Behavioral Therapy (CBT)
CBT is a form of psychotherapy that can be effective in treating ADHD. It focuses on helping individuals change negative thoughts, behaviors, and beliefs that contribute to symptoms of ADHD. The therapy also helps develop coping strategies, increase self-awareness, and modify behaviors that interfere with daily functioning.
CBT may also help individuals with ADHD improve time management, organization, and prioritization skills and develop better relationships with others. In addition, CBT can be used alone or with medication to treat ADHD more effectively.
Hormone Replacement Therapy (HRT)
HRT is a form of hormonal therapy that has been proven effective in optimizing hormone levels. It focuses on helping peri- and menopausal women increase their vital sex hormone levels to alleviate symptoms like hot flashes, night sweats, and reduced sex drive. HRT also helps prevent and treat menopause-related osteoporosis.
There has not been much research on the effect of HRT on ADHD, and this therapy is not typically used to treat the condition. However, because HRT increases estrogen, it can also affect some neurotransmitters, like serotonin and dopamine.
So HRT may have a positive effect on ADHD symptoms, but more research is necessary to understand the relationship between HRT and ADHD management.
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