ADHD & Hormones
In April 2025, a hugely important review was published called “ADHD and Sex Hormones in Females: A Systematic Review”.
The review opens with the observation that “[i]n females (including women and people assigned female at birth), ADHD is under-recognized, and knowledge about the relationship between ADHD symptoms and sex hormones is lacking”.
YET the limited studies available suggested that sex hormone changes are associated with changes in ADHD symptoms.
In relation to midlife females, the review states:
“Perimenopause is characterized by decreasing and fluctuating estrogen and progesterone levels which stabilize to very low levels in postmenopause. Our literature search found no empirical studies that investigated ADHD during menopause. However, clinicians’ experiences and non-peer reviewed preliminary findings suggest many females report an exacerbation of ADHD symptoms during menopause” [emphasis added].
The lack of studies is appalling, but unsurprising. As we wait for relevant research, what can be done?
First, test the theory. Are there days during your menstrual cycle when your ADHD symptoms flare? Are there days during your menstrual cycle when you could swear your ADHD medication is less effective? If so, gather the evidence (plot your symptoms against your cycle) and then discuss your findings with your prescriber.
Beyond any adjustments to medication, there are some fundamentals to supporting optimal brain function in ADHD:
there must be adequate blood flow to your frontal lobe (this comes from fluid intake + blood pressure),
you must eat enough to fire your frontal lobe,
you can ring fence your supply of dopamine, by having effective stress management strategies in place. Adrenaline is made from dopamine. If you are pushing your foot on the stress pedal 24/7, your body will prioritise the production of adrenaline, as the survival hormone, at the expense of your dopamine.
If you want to go deeper, I recommend the Lifecode Gx Nervous System panel. If you have been diagnosed with or suspect you have ADHD, this genetics panel is an absolutely invaluable tool. It can help us understand how well you make dopamine, how sensitive you are to dopamine and how quickly you deactivate dopamine. We can then support the potholes in your dopamine pathway and optimise your brain function.
Beyond dopamine, my experience in working with clients with ADHD is that the Glutamate/GABA pathway is often at the root of ADHD-type symptoms. To put it simply, Glutamate is our “on switch” and GABA is our “off switch”. If we struggle to convert Glutamate to GABA, it can be almost impossible to focus, to switch off, to relax and to get a good night’s sleep.
This extract from a sample Lifecode Gx report shows the Glutamate/GABA pathway. The genes are in capital letters, the presence of genetic SNPs is indicated by the coloured dot, and the arrow shows whether the function of the gene is increased or decreased by the SNP.
In this sample, the person struggles to convert Glutamate down to GABA. The GABA receptor (GABRA2) then struggles to hear the switch off message of any GABA which manages to trickle down. This is the profile of someone who cannot find their off switch, is mentally exhausted but can’t sleep, feels restless, feels overwhelmed and cannot concentrate. This person may constantly feel a knot in their stomach and/or feel dread or panic for no reason. This person might be dependent upon alcohol to relax as alcohol activates GABRA2.
With this knowledge, we can then put in targeted support in a stepwise manner to optimise mood, brain function and sleep. Life changing.
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Ref: “ADHD and Sex Hormones in Females: A Systematic Review” (2025) Osianlis, E. et. al. Journal of Attention Disorders, 0(0) (https://doi.org/10.1177/10870547251332319).
