How to manage ADHD and menopause

Since low or fluctuating hormone levels drive the worsening of ADHD symptoms during menopause, managing ADHD during this time can be made easier by supporting your hormone levels.

And here’s how you can do that:

Medication

Research shows that hormones like oestrogen and progesterone can influence key brain chemicals like dopamine, norepinephrine, and serotonin, which are targeted by ADHD medications, especially stimulants.^[1]

Because these chemicals are directly involved in attention, motivation, mood, and executive function, periods of low oestrogen and progesterone (like the menopause) coincide with:

• worsened inattention,
• executive function challenges,
• and emotional dysregulation,

and many women report that their usual stimulant medications seem less effective during menopause.^[1]

ADHD medications, especially stimulants, work by increasing dopamine, norepinephrine, and serotonin in the brain. So, a lower baseline level of these brain chemicals (partly due to hormonal changes around menopause) may mean that someone needs medication adjustments like:

• higher doses; or:
• switching to a different type of medication.

This is why working closely with mental health specialists is so important. They can tailor treatment as a person’s needs change during this transition, ensuring that it stays safe and effective.

Can HRT improve ADHD symptoms?

Hormone Replacement Therapy (HRT) isn’t a treatment for ADHD in and of itself, but it can help stabilise your brain chemistry, especially during menopause when oestrogen and progesterone levels fall.

Studies suggest that when hormone levels are stabilised through HRT, many women notice improvements in:

• cognitive function, like increased focus and less brain fog,
• mood regulation,
• energy levels,
• and attention,

essentially bringing their ADHD symptoms closer to what they were before perimenopause. This more balanced hormonal state can make ADHD medications feel more effective.

In other words, HRT isn’t a cure for ADHD, but by balancing your hormones, it can help your ADHD medication work more effectively and keep your symptoms at bay.

Can you take HRT and ADHD medication at the same time?

Yes. There is no known contraindication between standard ADHD medications and HRT. The two types of medication operate in different ways:

• ADHD medications influence dopamine and norepinephrine pathways to help support focus and executive function.
• HRT works by supplementing declining hormones to stabilise your mood, sleep, and cognitive function.

Because HRT can improve your hormone levels, it can allow ADHD medications to work more effectively and reliably. So HRT can complement your ADHD treatment rather than interfere with it.

However, individual responses and medical history differ, and it’s always important to discuss your medication plan with a mental healthcare specialist who understands both menopause and ADHD.

For example, because both HRT and stimulant medications can affect blood pressure and heart rate, combining them may impact cardiovascular health. Your clinician will check whether this could be a concern for you, especially if you have a history of heart disease.

Lifestyle changes

Along with medication and hormone support, certain lifestyle changes can also benefit both ADHD and menopausal symptoms:

Practice self-compassion

Navigating a major biological transition while also managing a neurodevelopmental condition, ADHD, is going to take a huge physical, mental, and emotional toll on you. So it’s really important to recognise that:

• If your ADHD symptoms worsen during menopause, this isn’t a personal failure. It’s just a biological reaction to hormonal shifts and changes in brain chemistry.
• Your experience with this transition may not be linear, as some days will feel harder than others.
• Sometimes, you might need to take regular breaks, seek professional support, or adjust your work expectations. But try to see these changes as signs of strength, adaptability, and resilience, not signs of weakness.

So remember to be kind to yourself and allow yourself to process this transition at your own pace.

Back to:

Overview

References

1. Osianlis, E., et al. (2025). ADHD and Sex Hormones in Females: A Systematic Review. Journal of Attention Disorders, 29(9), pp.706-723.