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The estrogen and ADHD connection was definitely not something I thought would be on my radar right now during The Shitstorm™ (aka 2020). Then this summer, an ill-timed med adjustment coincided with the days immediately before my monthly cycle.
I had just written about the phenomenon of how many women question whether their meds even work during their cycle. This was all fresh on my mind – I knew estrogen dropped right after ovulation. And that low estrogen was bad for ADHD.
It’s confusing enough to go through a med change and analyze every shift in mood or focus to analyze whether it’s working. Add to that the stress and anxiety of the pandemic and nobody’s even pretending that being “okay” is a given.
Now add to that the sinking feeling that for the meds you are taking, you may as well be taking a Flinstone vitamin because it’s not making a damn bit of difference.
This is the quandary I fear I’ll be in someday – if it’s not happening now, then when perimenopause hits. A recent and unprecedented shift in my cycle has brought this even more to the forefront of my mind.
And it may not be just estrogen. Progesterone might weaken the effects of stimulants for ADHD. And if they don’t, according to 2010 study published in Hormones and Behavior “it is possible that an estrogen/progesterone interaction plays a role in the effects of oral progesterone on stimulants.”
This all got me to thinking how that since puberty – nearly three decades of my life – ADHD and my period could have been wreaking complete havoc on a monthly basis … and I would have had no idea.
If you’re about my age, join me for a ride down memory lane.
ADHD and Puberty
Close your eyes and picture a time when Seattle grunge was just reaching the mainstream. Maybe you were trying to catch your favorite Pearl Jam and Nirvana songs on the radio for your mixtape.
Unless you had the good fortune of both being diagnosed before puberty AND having a doctor who understood Auntie Flo’s impact on ADHD (unlikely since they only started talking about this in the mid-1990s), your ADHD and hormones were duking it out monthly.
Puberty is hell. It’s hell for everyone, but imagine how much hell it must have been on you if either you were undiagnosed with ADHD or you didn’t know the relationship between hormones and ADHD.
Yeah, let that sink in and try not to get You-Oughta-Know-level pissed off.
I don’t know about you, but as a child of divorce during a time when my body was already going through massive shifts – life was hard. And it didn’t help that for various reasons I occasionally was a target for bullying.
But the fact that on top of all of this … I also had undiagnosed ADHD?
If I Could Just Work A Little Harder …
In my adolescent mind, I thought if I worked hard enough, got into the right university and studied diligently in the correct field I would earn my way to a better life. Instead, I stumbled into this better life after decades of painful experiences that I originally thought were just typical, age-appropriate things.
It wasn’t even until I emerged out of my 20s that I even suspected I may be on a different trajectory than a lot of my peers. And not in cute or quirky ways that make for good rom-coms (although this was my truth longer than I care to admit). I now know that my issues with perfectionism, substance abuse, low self-esteem, and more go deeper than being an angsty young adult.
Buying a pack of cigarettes on your 18th birthday, then getting immediately addicted wasn’t a rite of passage for all women. Nor was getting put on scholastic probation your freshman year in college.
I didn’t have to be so shitty with money. Or self-medicate with alcohol, food and whatever else was around that grabbed my attention. Friendships, jobs and romantic relationships didn’t have to be a merry-go-round of chaos.
But I digress.
I was finally diagnosed in my mid-30s and figured it out. Life’s been pretty okay since, The Shitstorm™ notwithstanding.
Pregnancy and ADHD
So, you deal with the aforementioned buffet of bullshit for a decade or three, then pregnancy comes along. Maybe you’ve been chilling with your diagnosis for a while now. Maybe you’re on meds and they’re working. Maybe you’ve finally decided you have your shit together enough to make another human and you found somebody else who’s willing to do this with you.
The surprise here isn’t the estrogen drop – we’ll get back to that in a bit. You actually typically have more estrogen during pregnancy. The kicker is you may be among the majority of women who are encouraged not to take your stimulant medication while pregnant. (And, if you intend on breastfeeding, possibly tack on more time for that).
Noticed I said most women. It depends on the woman, it depends on the meds. It’s another article for another day. But if you do decide to forgo ADHD meds while pregnant, you have to develop an entire toolset of med-free ADHD interventions.
And I’m going to stop here and rephrase; you get to do this. Because if you count trying to conceive, being pregnant and breastfeeding – that’s a long time to be without stimulants. You are going to want a toolbox.
For example, consider that you might develop a condition someday that will cause you to forego meds forever. This is a good time to develop and practice those non-med interventions.
Would doing this while you also weren’t also growing a human body in your uterus be more helpful? Yeah. But you, my friend, get to go on both of these journeys at the same time. (Spoiler alert: it’s totally fine. Probably almost as shitty as childbirth, but then you forget about it. It’s all really very much fine.)
Perimenopause, Menopause and ADHD
So we’ve survived puberty, drank our way through our 20s and created a human being at some point in our 30s. Life is okay. You’ll never be able to buy a house on your own, but you have acquired a nice collection of fitness trackers and water bottles you lose interest in almost immediately after purchasing them.
Then on some random month – maybe fall just arrived and you’re surviving both a global pandemic and recession – Auntie Flo starts acting really strange. First she’s kinda aloof and her visits are brief and erratic. Then out of the blue she moved in and won’t go away for more than a week.
You’re freaked out, so you call your doctor. Even though you know it could be your birth control, stress or your recently changed diet, you reach out anyway. Of course, the doctor calls you in for bloodwork because he kinda has to in today’s litigious environment.
Time will tell what the hell’s going on with me – or it won’t. But one thing’s for sure: now that I know the relationship between estrogen and ADHD, I can never unthink it.
And while someday this will be a blessing, right now I just feel cursed.
Want to learn more about ADHD and estrogen? Be sure to check out my latest ebook This Is Your Brain On Estrogen.