How ADHD and Menopause Are Related

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adhd and menopause

I chat with Lisa Alecci, life coach and founder of ADHD Freedom, about ADHD and menopause. Lisa, who has ADHD herself, didn’t realize she had it until menopause hit. She explains why this happens and her thoughts on the broader conversations (or lack thereof) in our community.

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Sarah 8:45

awesome. Okay, I'm gonna go ahead and just have occupational hazard issues you. Okay, everyone? This is the adult with ADHD podcast, self empowerment for women with ADHD. Today, I am excited to welcome Lisa lychee in ADHD coach, how's it going, Lisa?

Lisa 9:10

Doing well. Thanks, Sara. Thanks for having me.

Sarah 9:13

Well, I'm so happy to have you here. And to set up our interview a little bit. We had discussed in a group that we're in about how ADHD and the relationship to hormones is so huge in a woman's life. And I have a feeling you have experienced with this because as soon as I said that you were like, Oh my gosh, like you knew exactly what I was talking about. And yeah, and I specifically remember you saying, because we were talking about my podcasts, and I specifically remember you saying when you're doing this work, please include the menopause piece. It was so important to you when we were talking. So I had to have you on the show to talk about it and what better person than you Since you've probably talked to a lot of people who've probably experienced some issues, and maybe yourself, So, welcome to the show. I'm so happy to have you. So for those of us not in the know, because I come across a lot of people who are even surprised there's this hormonal link to ADHD. Can you explain a little bit what the link is between a menopause and ADHD symptoms?

Lisa 10:26

Sure, yeah, it's huge. So with menopause, your estrogen decreases. And it actually decreases by about 65%, which is huge. That's a lot. It's a lot. And estrogen is a key factor in the production and use of serotonin, dopamine, norepinephrine, all those neurotransmitters that those of us who have ADHD don't have enough of anyway. So as your estrogen drops, so do your other neurotransmitters serotonin and dopamine especially, which means that our executive function capabilities drop along with them. So it's, that's that's the basic link?

Sarah 11:31

Yeah, that sounds like a complete nightmare.

Lisa 11:34

Oh, it is? Oh, it is.

Sarah 11:39

So um, can you tell me a little bit? Um, do you? Do you get this from clients? Do they come to you with this? Are they aware of it? or How did you become familiar with this?

Lisa 11:51

I became familiar with it because I, I experienced it unknowingly. It It was. It was a rude awakening. And I have had symptoms of ADHD all my life. But back then, there wasn't such a thing as adult ADHD in the first place. In fact, what professionals looked for was mostly little boys who were acting out in school. And that's about it. And other people thought, you know, it was just an excuse for the little boys to act up. They didn't even look at little girls back then. So all my girls, I have three daughters adults. One was diagnosed with an executive functioning deficit at age 12. One was diagnosed with ADHD at age 11. She has an identical twin, who also has ADHD. Wow. So when they were diagnosed, they were telling us about all the symptoms, and I kept thinking, I have that. Well, I do that. Oh, yeah. I thought everybody did that.

Sarah 13:16

Right. Yeah, totally. Wow. So did you get tested? Or how did that conversation happen? Are

Lisa 13:23

you just No,

Unknown Speaker 13:25

no, you know,

Lisa 13:26

I didn't, I didn't. In fact, I remember feeling envious, that they actually had a medication, and for these things, and then I just thought, Oh, well, you know, keep going with however you're doing it.

Sarah 13:44

Wow. And how old were you when you found out if they were 1112. You were?

Lisa 13:52

So at that time, I my girls have an eight year gap in between. So what happened? That so I don't even remember how old I was then. But what happened is I went through menopause very early. Okay. Um, and so perimenopause, menopause struck at about age 42. Oh, so that's when my estrogen really started tanking. And I started I couldn't remember anything. I lost everything, including both financially valuable jewelry and also just treasured.

Unknown Speaker 14:38

Jewelry saved and mental. Yeah.

Lisa 14:40

sentimental. Oh, yeah. And I couldn't I was confused a lot. I couldn't assimilate what was being said to me or what was being asked of me. I my career was in corporate healthcare. back then. Then I so I was in corporate healthcare for about 35 years. Mm hmm. And it had always been sort of an up and down performance. I went from all levels from, you know, the the face to face on the ground, kind of sales to the executive suite. So I was at all levels, and always people. I did well, but then I didn't do well. And no one could figure it out. Nor could I. And I just kept working hard. And pretty soon, you know, especially once perimenopause hit. I couldn't. I couldn't hide it anymore. Yeah. So when I was, it just kept menopause actually happened for me at age 47. Okay, so it's early, early. Wow.

Sarah 16:01

So when this is all going on, what did you think it was before you figured it out? What did you think was happening?

Lisa 16:09

I went in for an Alzheimer's test.

Sarah 16:11

Right. I hear this a lot. I literally

Lisa 16:13

did. Because I was panicky.

Sarah 16:17

Yeah, like early onset. Wow.

Lisa 16:19

Exactly. Yeah. So they told me I didn't have Alzheimer's. So I went back to work and did my thing. And finally, at about age 57, I was asked to step down from an executive level position, because they said they didn't know which me they would get the high performing Lisa, or the one who had just missed her latest deadline. Yes, so I was unreliable. And I was crushed and embarrassed and shamed by me. And so I, I was very lucky, I had an executive coach who used to be a doctor, an MD. And she said, Lisa, have you ever considered that you might have ADHD? And I don't know how this happened. Sara, I must have been in La La Land for all those years. But I said, No, I haven't. And she said, I think you do need to have you need to be tested. So I took a leave of absence. Yeah. And found a guy named Dr. William Dodson, who is one of the foremost specialists actually in the world on ADHD. He was here he lives here in Denver, where I live. Wow, I was so lucky. So so lucky. So he diagnosed me. I'll never forget, I was in his office after I had done. I mean, hours of different sorts of testing. So I was in his office, and I was in tears. And he said, What are the tears about? And I said, I'm afraid you're going to tell me I don't have ADHD?

Sarah 18:11

Oh, boy. Yeah, I know that feeling.

Lisa 18:14

And I said, No, you have profound ADHD.

Unknown Speaker 18:19


Lisa 18:20

And that was both a relief. And then pretty soon the sadness came. Because of all the years I'd lost,

Unknown Speaker 18:31

right? Yep.

Lisa 18:33

So it was it was really remarkable. The journey began there. I had to try five different meds before we found the one that was right for me. And then I found an ADHD coach, who I stuck with for a year, she was great. She suggested I become an ADHD coach, which I ultimately did was able to leave the corporate world and here I am.

Sarah 19:05

Wow, I was just about to ask how you came into ADHD coaching. That is, that is some story. There's a lot of elements of that. I definitely related to while you were talking, yeah, that.

Lisa 19:20

Wow. And it's not uncommon. Um, I mean, you say you related to it.

Sarah 19:28

Yeah, I was in my mid 30s at a corporate job. And the same kind of thing. They never I mean, my, if you've read my annual reviews, it's like Jekyll and Hyde. And it's like, I mean, one time, the the person reviewing me used the word outstanding, like five or six times, few months later, I'm in a boardroom getting the talk about if you make another mistake, we're gonna cut you all within months of each other and nothing had changed. Mike, okay. This is so scary, you know. So yeah, I'm definitely just listening to you. It's like Yelp. Yep. And, and it was such a relief because I, I actually did also even though I was in my 30s, I wondered if I had something like early onset Alzheimer's or maybe some sort of neurological condition. I was like, do I have brain damage? Like, what is going on here? I just I was in this boardroom with like, a pile of papers. And I, it was like, I was about to give, like, a case or something like I was going to prove my case, like, No, no, no, no, no, I, you know, this is what happened. And I had all these emails, and they're just looking at me like, we, you this has got to stop. And, and, and to me, I just felt like I was losing my mind.

Lisa 20:53

Yes, that's it. Yeah. That's it.

Sarah 20:57

Yeah. So that that's incredible. And so, um, did when you went to Dr. Dotson, was were hormones a part of the conversation? Was that?

Lisa 21:10

Did that come later? You know, interestingly, yeah. I'm not sure we have ever discussed hormones. sand. Yes. And very, very few doctors bring hormones into the equation. When talking about ADHD, or especially when talking about medications. It doesn't even really come up. And a big part of that reason is because in med school, they don't even talk about ADHD. I have had so many doctors say to me, that things to the effect of you could put in a thimble, or in two or three sentences. The amount that I heard about ADHD in med school.

Sarah 22:03

Well, I believe it. I, I believe it. Yeah. Yeah. I don't get a lot of engagement when I bring it up to any other doctors besides my psychiatrist. So yeah, I get that feeling. And even my psychiatrists, I'm so grateful. She diagnosed me and figured it out. She's the one who put it all together. But hormones never came up. Even through my pregnancy and beyond. It never came up. Gosh, I know, it never came up. Yeah, it is a strange thing not to bring up to me. I mean, it. It was brought up in the context of the stereotypical stuff like being emotional and being stressed and being a new mom. But it was never brought up in the context of, there's also this link to ADHD and cognitive function. And, you know, I remember talking about mom brain when I went home to see my folks, you know, and they just roll their eyes about mom brain, like, What are you talking about? Like, that's so silly. Oh, and he's like, No, no, no, this is science. This is a thing. And my grandma thought it was a wives tale. So can you imagine in her day, how awful it must have felt, you know, because it's like, you do feel like you're going out of your mind. And it's like, oh, there's something wrong with you.

Lisa 23:26

It's like, Oh, absolutely. And my grandmother, so clearly had ADHD. She, she was like, my soulmate. I, she's the woman who I was closer to than I think anyone else in my life. And she, she everything was always a mess in her house. It I have such warm and wonderful memories of that mess. She forgot everything. She lost everything. And it I just and she was so ahead of her time. She was so brilliant. And read the New York Times every day even though she had a fourth grade education. Wow. And so and so here's this woman who's losing everything for getting everything or clutters everywhere. What what appropriate medication could have done for her. It just makes me sad. Absolutely.

Sarah 24:35

Yeah. And from what I hear it's like highly highly inheritable from the mother to the children from my understanding i i there Yeah, I took an intro to coaching interred ADHD coaching class earlier this year when the pandemic for set and I forget the number but it was like

Lisa 24:57

it was super high.

Sarah 24:58

Yeah, I was sick. Hi. Yeah, really high. And that to me really stuck out. And then the other thing I did I did a Ctrl F, back to your thimble comment. I did a Ctrl F on the word estrogen in my, my really thick textbook and it had all the stuff about ADHD and the word estrogen came up once. And that to me mirrors what the doctors are saying like it, you know how little first of all how little ADHD came up, and even within our own ranks, estrogen not even coming up, but once and entire, and it had the deepest scientific in, don't get me wrong. It was an excellent text. Like, I feel like I know a lot about ADHD now. But I was so surprised. It was like a few studies. They talked about it, it could have fit on one page. Like, wow, there's so much more than one page. Like, we need more of this. Oh, my gosh,

Lisa 25:56

I just in front of me right now, full disclosure, I have a pages worth of bullet points. Just bond. Just bullets on things, too, that I could talk about with regard to this. And I'm not an expert.

Sarah 26:11

Exactly. Well, me especially I'm a lay person. And oh Yeah, me too. Yeah. And I was talking to a guest a few a couple weeks ago. And she's like, yeah, I'm learning about this stuff on tik tok. I am learning about it on Twitter. Me I

Lisa 26:31

like, and I've heard people are on Revit Oh, yeah. There's an ADHD Reddit channel. There are so many ADHD Facebook groups. You can't count them anymore.

Sarah 26:44

Yes. What you're great in their own right for community building. Absolutely. But the fact that that's where we're left to getting information about this, it's just blows my mind. Yeah. Yeah. Yeah, I agree. So when you put it together? Are there things you've done differently now that you know, the relationship between low estrogen and ADHD? Have you done anything differently? Or is it just the awareness that helped?

Lisa 27:18

What happened for me was I was diagnosed pretty much after my estrogen had dropped, you know that her had taken that steep plummet. And I believe they had leveled off already. So finding the right dose, we we tweak the dose over time, but my dose of my medication has stayed steady. That makes sense.

Sarah 27:51


Lisa 27:52

yeah. Yeah. But the biggest thing that I can say is that when you're going through perimenopause and menopause, you really need to self advocate, because the absorption of your medication is different in your body. Yeah. And you've got to, as we've discussed, doctors don't even bring it into the conversation, right? So you have to as a patient, bring it into that conversation. If you're not seeing an ADHD specialist, who is your prescriber, you need to find the one. And in order to find one, you can go to or And they can help you find resources in your area. But you do need a specialist so many people go to their family doctor, that's great to get an initial prescription. Yeah, that's not okay. To really titrate your meds that's I really just specialist. Yeah. And so your dose does need to be modified or changed to a different medication, or to take you to different times during the day. Those are the three variables what the med is, how much and what time of day, you take it. Also, something that two most important things, especially during perimenopause and menopause, but anytime that are not medications are sleep, and exercise. So those are two things you can do for yourself.

Sarah 29:50

I believe it and i i i started getting interested in this a few months ago because I was having I thought I was I thought I had hit her menopause. And I may have, who knows. But I'm, I became so aware of the exercise and the sleep after that, it got my attention because I realized how few resources I had, except for taking care of my body. Like, that's all I had. I had no I had a doctor who didn't, who wasn't listening to me. I had, you know, I had Google. And that's it. And yeah, I developed so many healthy habits out of that experience, because I'm like, this is the only buddy I got. I like,

Lisa 30:33

Oh, my God, you're cutting it. So well.

Sarah 30:35

That's it. Yeah. Like, I better take care of his because, you know, I started realizing how much it does affect your cognition, and you always will have things like you always hear these things that are good to do. And you're just like, Okay, I know, you know, whatever. But then when, like, something happens to you, and you're like, Okay, you got my attention now. Okay. Okay. I'll do yeah. It's like, I track my sleep. I track my exercise. It's so funny, because I got this thing. I don't know if you see it, but it's a fitness tracker.

Unknown Speaker 31:08

Oh, my gosh, yes, I, I,

Sarah 31:11

I'm garbage at charging trackers. And so I got this one, it has a like a watch battery. So only every six months, you have to charge it. Ha such a lifesaver. Yeah. But the reason I bring it up is in the app, it actually has, you know, it's got your water and your movement and all that. But it has this panel, where it tells you kind of like your likelihood that you're going to be stressed based on how often you've been sleeping and exercising and your your menstrual cycle, and it just gives you this like percentage. Wow. And so I'm setting up this app yesterday. As soon as I typed in first name, I got the thing on the first day of my cycle, as soon as I typed in today was my first day, immediately it shoots the 90% like you're gonna have, you know, problems right now with stress. But then I started typing in my movement, my water, that they have something for meditation, and and then the numbers fluctuate. And so you can, it's empowering to know that there are some things you can do to bring that number down. You're not completely, you know, a prisoner, but it just like, just the visual representation of just how doing those things can bring down your stress level

Lisa 32:32

is absolutely. And I think you bring up one other really important factor and that is meditation. Yeah. Um, I recommend that to my clients. It probably three or four or five times a week. Because what we need is for our brains to calm down more than anything, we need to be centered. And it's that's the case for everyone. But for us, it's absolutely critical. And so, and the flip side of that coin, is that most of us who have ADHD, hate the idea of meditation, it's like, No, no, no, that's not for me. Oh, no. So I there, there are two apps that I love. One is calm. And when is headspace, headspace? I do too. I do too. That's mine. Yeah. And the thing that I love about those and about being able to remember that recommend those is that you can do it, they go all the way down to three minutes. So you can just meditate for three minutes. And it is actually affects

Unknown Speaker 33:57


Lisa 33:58

level. You're the rate at which your brain fires, it brings you down. So it's amazing.

Sarah 34:09

I believe it. I believe it because I remember when I first returned to work after my, my daughter after having her I would do this in the car like three minutes on headspace. Like it's like okay, I have like five minutes before I have to walk in there. Okay, I'm gonna pop pop in my earbuds and I would meditate in my car in the parking lot before I go in the work. Game Changer just complete game changer. And I that was another one where it was like, Yeah, I know. I'm supposed to you know, this is supposed to be helpful. Whatever. Like it never made sense to me. Until I was so desperate. I'm gonna try this because I am just frazzled as hell. I'm gonna try it. And then it works. And you're like, Oh, that's why everyone keeps saying no meditate. Got it. Okay.

Lisa 34:52

Yes. And then you kind of think, why didn't I do this before?

Why did I wait?

Sarah 34:59

Yeah. Or if you're like me, my father, he was really into yoga and meditation growing up. And so I heard it so many times that being the defiant teenager, I'm like, stop pushing it on me. I'll do it if I want, you know, and so then it's just like I went the other way. But I think I think you're right that a lot of us like for me, I always said, Why can't calm down long enough to do yoga? Like, it's like this catch 22 thing. But when you say, well, only three minutes will shoot, I can do you know, one pose, I can do that. And if you could just do that little bit, a lot of times, you know, you can build from that, at least in my experience, but Oh, yeah. Oh, yeah. Yeah. And then the only problem for me is like when people say, to unwind and to pause. My fear is, if I pause, am I ever going to get that momentum back? Like, I'm afraid of losing that momentum? It's like, Oh, my gosh, I mean, today is a perfect example. You don't know this. I'm going to tell you right now in the interview, but like, I after my daughter was picked up today. She's, she's with her grandma. I completely forgot about our interview, I was so focused on my daughter. And then she got picked up and I was like, whoa. So immediately, the pajamas went on. And I was like, All right, I'm getting my Netflix picked out. And I happen to look at my phone, I just happened to look at my phone. And I was like, I have an interview, it's and talk about shifting gears. Like mentally, I was ready to just game over like, this is it? I'm gonna just, you know, and I'm always afraid of that. Whenever people say take a day off, I'm always afraid to do that. Because it's like, will I ever come back? If I, you know, let myself do that? Yeah. Yeah.

Lisa 36:52

Yeah. And

it's interesting with my clients, what I always suggest is, if they're, especially with regard to hyper focus, which is either bad or good, but when we're hyper focusing in a very productive way, um, don't interrupt yourself, take advantage of it, right, keep like, keep them up. But check in with yourself every half hour, 45 minutes, just to make sure that what you're hyper focusing on is what you want to be doing at that time. So set a timer for 45 minutes, and and just do that 32nd check in, if it is stick with it. And if it's not, then step back and pause and make a mindful choice. Is this what I want to be doing? Or is it transition time? Do I need to take that time for either as you said, the meditation or for walking outside, or something, to transition me into what maybe I really need to be doing at this moment.

Sarah 38:10

I love that. And I'm definitely going to use that the next time I start googling the royal family. Every time I watch the crown, I have to pause it. And I have to get on my phone and be like, Did this really happen? And then I google guys, and it's like game over? It's like, just like down this rabbit hole. I love that idea. I think you could get so much out of your day if you approached it like that. Well, did you have anything else on your bullets that we missed? Or do you think we covered? menopause?

Lisa 38:46

Yeah, a couple quick things. Yes, yes, it is. Because that one of the big things is always keeping your ADHD symptoms under control. It's that is important not to let them control you instead of instead, you manage them to the greatest extent you can, with full knowledge that they're going to win every now and then. But when you sense that they're starting to get out of control, don't wait, contact your specialist, because something may be going on. And it very well could be hormonal, that needs to be attended to in that moment. So or in that time period. So don't just say this is going to pass this is going to pass and pretty soon a month two months have passed and you've been unproductive and you're mad at yourself, pay attention and do get in touch. And hormone therapy is something that people often say, Oh no, no,

Unknown Speaker 39:58

no bye.

Lisa 39:59

There is very safe hormone therapy out there. So around the topic of perimenopause and menopause, consider it, it actually really can make a difference. I did do that. And that it was a huge help to me.

Sarah 40:18

I'm glad you mentioned that. I forgot to ask back when you were talking about the stimulant medication that, that that's one of the other things you could do is look at. And I was looking at Patricia Quinn, Dr. Patricia Quinn's work. And the third thing she also said is, depending on what kind of SSRIs you're on, if you are, they might be able to do stuff with that as well. So there's like three different things, it's stimulants on hormone therapy, and SSRIs. They might be able to help you there. So there's, there's always something hopefully that they can do for you. I know sometimes I'll go through something and think, what's the point of contacting then what are they going to do about it, but you might be surprised there's new information coming out every day, maybe they'll have something up their sleeve for you if something weirds going on. So really great advice. Yeah. So where can people find you if they want to learn more about what you're up to? And you have a website for your practice?

Lisa 41:17

I do. I do. It's ADHD freedom. That's all one ADHD freedom calm, and people can reach me they can email me at Lisa at ADHD.

Sarah 41:32

excellent. Lisa. Well, thank you so much for being on the show. This is gonna be such a wonderful episode for our listeners, and I really appreciate it.

Lisa 41:39

Oh, thank you so much for having me, Sarah. No problem. Bye bye.

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