🧠 Menopause can wreak havoc on your executive function and mood. And if you’re also navigating ADHD? The chaos can feel relentless.

What is ADHD?

ADHD — Attention-Deficit/Hyperactivity Disorder — is a neurodevelopmental condition that affects executive function: things like focus, memory, emotional regulation, motivation, and impulse control.

Traditionally, ADHD was studied — and diagnosed — in young boys, which means the hyperactive and disruptive traits became the “standard profile.”

But in girls and women, ADHD often looks very different. It’s more likely to show up as:

• Daydreaming or zoning out

• Being overwhelmed by tasks
  Forgetfulness

• Mood swings or sensitivity 

• A constant inner restlessness rather than outward hyperactivity 

  And because of this, many women are missed. They’re told they’re “just emotional” or “not trying hard enough.”

Fast-forward to adulthood — and especially midlife when we look after kids and aging parents — AKA we use the prefrontal cortex where executive functions are housed - and those symptoms can spike. Why? That’s where hormones come in. Let’s get into that..

Estrogen isn’t just a reproductive hormone. It has a powerful influence on how the brain works — especially in the areas of attention, memory, and mood.

Here’s what we know:

Estrogen increases dopamine, which supports focus, motivation, and executive functioning — all areas where ADHD plays out. It also supports acetylcholine, which is essential for learning and memory. And it helps regulate serotonin, which affects mood and emotional balance. So when estrogen levels drop — like during PMS, perimenopause, or post menopause — women often experience:

• Brain fog
• Difficulty concentrating 
• Memory lapses
• Emotional reactivity
  
  For women with ADHD, who already experience challenges in these areas, the impact can feel amplified.
  
  ADHD and Pre Menopause Cycle
• For individuals with ADHD who menstruate, fluctuating estrogen and progesterone across the menstrual cycle absolutely impact symptoms, emotions, and day-to-day functioning.
• We don’t have large studies on this yet, but we use what we know from hormonal research — combined with clinical experience and what women tell us — to understand the connection.
  
  Here’s how it works:
• Days 1–14 (Follicular phase): Estrogen rises steadily. For many, this means more focus, better mood, and improved executive function.
• Ovulation: Estrogen peaks.
• Luteal phase (last two weeks): Estrogen drops and progesterone rises. This is when many experience more ADHD symptoms, poor sleep, increased anxiety, and emotional dysregulation.
  
  If your ADHD shows up as low energy, inattention, or anxiety, you might feel better in the follicular phase. But the luteal phase can be especially hard. Women with ADHD are also more likely to experience PMDD, a severe form of PMS.
  
  There are currently no large-scale formal studies that explore the relationship between ADHD and menopause. That’s a major gap. But we do have solid research about estrogen’s effects on:
• Executive functioning
• Mood regulation
• Cognitive flexibility
  
  There’s evidence that exercise can boost the same neurotransmitters that drop during menopause — especially dopamine and serotonin. So while we don’t have a full map yet, the puzzle pieces are starting to fit together. And most importantly, we have the stories — thousands of them — from women living through this.
  
  Medical options include:
• Hormone Replacement Therapy (HRT) – especially when started within 10 years of menopause, can help stabilize symptoms
• Stimulants – may require dosage adjustments or work better when paired with low-dose estrogen
• SSRIs or SAMe – support mood regulation
•  Acetylcholinesterase inhibitors – sometimes used off-label to support memory and attention
  
  These need to be evaluated case-by-case with your healthcare provider.
  
  Non Medical Treatment Options
  ✅ Cognitive Behavioral Therapy (CBT) – helps restructure thinking patterns and build executive skills
  ✅ ADHD Coaching – which is what I do: helping women rebuild routines and strategies that match where they are now             also education on this new phase of their life. 
  ✅ Mindfulness and psychoeducation – understanding what’s happening reduces fear
  ✅ Sleep, nutrition, and movement – they sound basic, but they’re incredibly impactful
  And of course — exercise. It’s one of the most evidence-based interventions we have. Regular movement boosts dopamine, serotonin, and norepinephrine — exactly what the brain needs more of during menopause.
  
  💡 Executive Function
  These are the brain-based skills that help you:
  ✔️ Stay organized
  ✔️ Manage time
  ✔️ Follow through on tasks
  ✔️ Control impulses
  ✔️ Adapt when things change
  
  When estrogen declines, so does dopamine—a key neurotransmitter for executive function. That’s why so many women in perimenopause suddenly feel:
  ➡️ Foggy
  ➡️ Distracted
  ➡️ Unmotivated
  ➡️ Disorganized
  
  🌪️ Mood Regulation
  Estrogen also supports serotonin, your mood stabilizer. As hormones shift, you may experience:

• Mood swings

• Irritability

• Anxiety

• Emotional reactivity

  
  Now layer ADHD into that picture—where executive function and emotional regulation are already vulnerable—and the result can feel overwhelming. There are currently no large-scale formal studies that explore the relationship between ADHD and menopause. That’s a major gap. But we do have solid research about estrogen’s effects on:
• Executive functioning
• Mood regulation
• Cognitive flexibility
  
  There’s even evidence that exercise can boost the same neurotransmitters that drop during menopause — especially dopamine and serotonin. So while we don’t have a full map yet, the puzzle pieces are starting to fit together. And most importantly, we have the stories — thousands of them — from women living through this.
  
  🚨 But here’s the truth:
  This isn’t just in your head. It’s happening in your brain.
  And there are science-backed tools that can help.
  ✨ At PAUZ, we combine:
   🔹 Hormone-informed care
  🔹 ADHD-aware coaching
  🔹 Behavior change science
  🔹 A supportive community that gets it
  
  You're not lazy. You're not broken. You’re in the middle of a major transition—and there’s support available.