ADHD, ADHD Parenting

The role of Estrogen in females with ADHD

I love getting the ADHD report in the mail.

This month it was like reading my life story. For a bit of background if you are new to ADHD Done Differently. I live in a house bursting with ADHD. My 3 children have ADHD diagnosed and my husband and I are absolutely ADHD, but no formal diagnosis… as yet. I am on a waiting list!

The article I read was by Littman, Dean, Wagenberg and Wassertein (2021) called ADHD in Females Across the Lifespan and the Role of Estrogen and I feel that this is so important for all families to know and understand if you are raising warrior princesses with ADHD like I am.

The main discussion points were:

  • Research supports the idea that the menstrual cycle is associated with changes in ADHD symptoms. This is due mainly to the fluctuations of ovarian hormones across the menstrual cycle.
  • Females with impulsivity in particular, are highly sensitive to the effects of cycling ovarian hormones.
    • When estrogen levels are high (and progesterone was low) typically in the first half of the menstrual cycle, females with ADHD had improved cognition and mood. This also can come with diminished ADHD symptoms.
    • When estrogen levels are low (and progesterone was high) in the mid to late phase of the menstrual cycle, ADHD symptoms worsen. This puts females at significantly higher risk of depressive symptoms and increased risk for suicide.   
  • Females with ADHD have a higher risk of having Premenstrual Dysphoric Disorder (PMDD) than females without PMDD. PMDD is a severe mood disorder related to the menstrual cycle. It is a horrific disorder, that affects your daily life in all areas of work, school, relationships and social life. 5% of females of childbearing age will have PMDD and are at significantly increased risk of suicide.
  • Females with ADHD are also more likely to experience Post Partum Depression (PPD) after the birth of their first child and more severe peri- and menopausal symptoms than females without ADHD.

I had PPD after the birth of two of my children and was diagnosed with PMDD in 2017. I cannot even start to explain the impact that it had on my family, my life, my marriage, and my mental health. I ended up having a radical hysterectomy in 2018 (due to PMDD and severe endometriosis) and am now on hormone replacement therapy (HRT).

For me, this seriously saved my life and I am on high alert for the same with my daughters.

My incredible friends threw me a “goodbye uterus” party before my radical hysterectomy! It was a blast!

What are the take home messages here:

  • Ensure that you are looking out for signs of these cycles with the amazing females in your life and seek professional help if you notice them.
  • Clinicians who are treating our children and adolescents need to inquire should be asking about cycle phases, hormone profiles and birth control to support them.
  • As parents and carers, please don’t put it off if you notice this. The risk of self-harm and suicide for this population is significant!

For Further information regarding PMDD you can read this article here.

Main photo by Jonathan Borba on Unsplash

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