Adderall Doesn’t Work When I Have My Period
If you’re telling yourself “Adderall doesn’t work when I have my period,” you are not wrong. There IS a relationship between hormones and stimulants.
While estrogen and progesterone are typically associated with the reproductive system, they can impair brain function when in flux. Changing hormones also can impact how a stimulant is metabolized. Both hormones drop before your period, which can worsen your ADHD and interfere with your medication.
Estrogen and ADHD
While I haven’t personally noticed my Adderall not working before my period, it’s probably because I’m too distracted by other intense PMS symptoms. This was never more pronounced than when my Nexplanon birth control implant expired. I now know that estrogen is tied to serotonin and dopamine. Lowering levels of estrogen mean a whole fun buffet of symptoms including “moodiness, sadness, irritability, fatigue, fuzzy thinking, and memory lapses. These may be more pronounced in women with ADHD.”
Stimulants and Menstrual Cycle
A quick Google search of terms like “adderall and menstrual cycle” will unearth plenty of women who are looking for answers.
Dr. Patricia Quinn, who studies the impact of ADHD on women at length, knows of this phenomenon all too well. The author of 100 Questions & Answers About Attention Deficit Hyperactivity Disorder (ADHD) In Women And Girls clocks the impact around the week before your period.
“I tell all women, you need to look at this for two consecutive months and pick out five symptoms. Rate them every day for those two months, one being a good attention span, four being a terrible attention span, one being in a good mood, four being depressed,” Dr. Quinn explains in a TotallyADD webinar.
“If you see everything getting worse before your period, you may want to increase the dose of your medicine for that week – your stimulant medicine – but you also may want to think about evening that out with hormones now if you’re pre-menopausal.”
(If you are considering adjusting your Adderall or supplementing with hormones, please consult your doctor.)
A 2016 study published in the medical journal Pharmacoepidemiology and Drug Safety echoed Dr. Quinn’s observations. The college-aged women in that study, who were not on birth control, tended to take more central nervous system (CNS) medications at the onset of their periods, particularly Adderall.
“The pattern of greater CNS medication during the early phase of the cycle, particularly the time around menses, may be due to changes in hormone levels relating to premenstrual syndrome (PMS), in combination with high levels of stress or anxiety,” researchers reported.
“Adderall, most commonly used to treat attention deficit hyperactivity disorder (ADHD), was the most frequently used CNS medication, followed by prescription formulations to treat migraines (e.g. eletriptan HBr, sumatriptan succinate).”
Interestingly, the study excluded women with psychiatric conditions. This would suggest that any Adderall ingested by the subjects wouldn’t have been prescribed. While the study raises the possibilities that the Adderall could have been taken recreationally or as a performance-enhancer to get through finals (which is definitely possible), maybe they were living with undiagnosed ADHD? If that were the case, the spike could be tied to these women needing additional support during their menstrual cycle to accomplish tasks.
Is It Bad To Take Adderall On Your Period?
It’s not bad if it’s been prescribed to you for ADHD, but you may need more of it before and in the beginning of your period. If you are considering going that route, definitely check in with your doctor first. If you don’t want to take more Adderall because of your menstrual cycle, there are other options.
Therapist and renown author Sari Solden recommends that you plan ahead for a difficult time when you know that your period’s arriving soon. This isn’t the time to be hard on yourself or be an overachiever. instead, practice self-compassion and self-care.
“If you don’t want to look at adjusting your medication on those days you have to then accommodate your life on those days,” Solden said. “So knowing just in advance that you’re gonna have a harder time can sometimes help just knowing that you don’t want to over schedule yourself on that day. You want to make sure you have plenty of rest, plenty of sleep and as little stress as possible.”
In addition, health journalist Gabrielle Lichterman, founder of the educational site Hormornology, recommends the following practical tips: taking a multivitamin with iron during your cycle, invigorating exercise such as a brisk walk, listening to fast music, and/or playing a stimulating video game.
“Iron loss as you bleed during menstruation is one key factor behind period-related fatigue,” Lichterman said. “Taking iron in a supplement (aim for 18 mg. daily) or loading up on iron-rich foods (such as beans, lentils, spinach and lean beef) can help replenish your body’s store of this energizing mineral.”
Can Adderall Affect Your Menstrual Cycle?
While there isn’t a widely known relationship between Adderall and your period, there has been a little bit of study on this issue, as well as tons of anecdotal accounts (if online forums are any indication).
For example, while estrogen and progesterone are low at the beginning of the menstrual cycle, how about when the levels go back up? According to a 2000 study in Pharmacology Biochemistry and Behavior, the women studied experienced negative effects as these hormone levels increased while they were on Adderall (referred in the study as AMPH).
“Subjects reported greater Unpleasant Stimulation after AMPH, and less Unpleasant Sedation, during the late follicular phase than during the early follicular phase,” researchers said. “These results provide limited evidence that higher levels of estrogen during the late follicular phase alter the subjective effects of AMPH in normal, healthy women.”
While there’s not an extensive amount of information about stimulants and the menstrual cycle, we’re learning more over time. It’s very likely there’s something to the tons of anecdotal accounts you’ll find if you start to research the relationship on your own.
“When doctors diagnose girls and women with ADHD, they rarely consider hormonal fluctuations when developing a treatment plan,” according to ADDitude magazine. “But professionals are learning more about the connections between hormones and ADHD.”
Hormonal Fluctuations Affect Women’s ADHD Symptoms – A two-part series by Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD).
“The investigation [of] the role of estrogen, progesterone, and other sex steroids has the potential to generate new and improved diagnostic and treatment strategies that could change the course of cognitive-behavioral disorders like ADHD,” -Dr. Haimov-Kochman and Dr. Berger
ADHD and PMS – Blog post by ADHD Coach Jacqueline Sinfield.
“Estrogen is thought to help the effectiveness of stimulant meds, while progesterone can make stimulants less effective, which also help to explain why your ADHD symptoms seem worse towards the end of your cycle.”
Women, Hormones, and ADHD – A deep dive by ADDitude magazine.
“Estrogen promotes the release of the feel-good neurotransmitters, serotonin and dopamine, in the brain. Not surprisingly, studies suggest that the first two weeks of the cycle go more smoothly for women with ADHD than the second two weeks, when progesterone levels rise. During the third and fourth weeks, called the luteal phase, progesterone diminishes the beneficial effects of estrogen on the brain, possibly reducing the effectiveness of stimulant medications.”
A Radical Guide for Women with ADHD: Embrace Neurodiversity, Live Boldly, and Break Through Barriers – This widely anticipated book by Sari Solden has been described as an ADHD-friendly workbook that will leave a lasting impact. Women with Attention Deficit Disorder is another classic by Solden that’s recommended reading!
“A Radical Guide for Women with ADHD is the first guided workbook for women with ADHD designed to break the cycle of negative self-talk and shame-based narratives that stem from the common and limiting belief that brain differences are character flaws. In this unique guide, you’ll find a groundbreaking approach that blends traditional ADHD treatment with contemporary treatment methods, such as acceptance and commitment therapy (ACT), to help you untangle yourself from the beliefs that have kept you from reaching your potential in life.”