According to the Centers for Disease Control and Prevention (CDC), as of 2019, six million children in the U.S. alone had been diagnosed with Attention-Deficit/Hyperactivity Disorder, or ADHD. And girls are less than half as likely to be diagnosed with ADHD than boys. And now research suggests there’s a link between symptoms of ADHD and hormones. Here’s everything we know.
What, exactly, is ADHD?
Believe it or not, the term ADHD, or Attention-Deficitiy/Hyperactivity Disorder, actually didn’t exist until 1987. Prior to that, the condition was known as Hyperkinetic Reaction of Childhood – we know – and then just plain Attention Deficit Disorder.
Simply put, ADHD can mean that you’re impulsive, that you struggle to concentrate, and can’t sit still, among other things. Although, an ADHD diagnosis doesn’t necessarily mean you’ll exhibit all those traits.
In fact, around 30% of those with ADHD struggle with focus and concentration, but don’t have the impulsiveness or hyperactivity issues that the majority of those diagnosed do.
Why should I care about ADHD?
Since ADHD was initially recognized as a disorder for children, it can be more difficult for adults to receive an official diagnosis – even today. And although inattentiveness has been listed as an official symptom for decades, hyperactivity is still the default characteristic of ADHD that many clinicians look for.
And that can be an issue for women and girls. Why? Well, as you’ll see, ADHD presents differently in girls and boys. With less visibility or understanding of their symptoms, women and girls can have less access to resources, and that can impact on time to diagnosis.
In recent years, though, awareness of the full array of ADHD symptoms has increased, so things are slowly improving.
ADHD symptoms: They’re different for girls and boys
So, what exactly is the difference between ADHD in girls and boys?
Well, nowadays, symptoms of ADHD are divided into two main categories: Hyperactivity and Inattentiveness. Someone with ADHD can have symptoms from one category or both.
Common symptoms of Hyperactivity include:
- An inability to sit still
- Difficulty taking turns
- Talking a lot and interrupting conversations
- Little to no sense of danger
Common symptoms of Inattentiveness include:
- Getting easily distracted
- Being forgetful
- Constantly starting a new activity or task before finishing the previous one
- Having difficulty following instructions
Now, as you’ve probably worked out, Hyperactivity symptoms are more common in boys, and Inattentiveness symptoms are more common in girls.
All of this matters because if healthcare professionals and society, in general, don’t recognize the differences between ADHD symptoms in boys and girls, and it may well be challenging for them to accept that there is a link between ADHD and hormones. And that’s what we’re going to talk about next.
ADHD and hormones in puberty
Now, so much of puberty is focused on how hormones change our bodies, but one part of the body gets left out of the puberty talk: our brain!
So, what does that mean for kids with ADHD?
For boys, evidence suggests that increased levels of Testosterone affect the way Dopamine works in the brain, which can lead to increased ADHD symptoms. Levels rise throughout puberty, which could be part of the reason teenage boys seem to be particularly impulsive. So, no, moms. You’re not crazy.
Testosterone levels even out eventually, but they do still fluctuate in men. However, unlike women, their hormone levels fluctuate daily instead of monthly. Testosterone levels peak at around 8 AM and fall throughout the day, hitting their lowest point at about 8 PM, At which point, they begin to rise and start the whole cycle again.
For girls and women, it’s all based around – you guessed it – the menstrual cycle. And massive changes in hormone levels, like those during puberty, Menopause, or even childbirth, can significantly impact the severity of ADHD symptoms.
ADHD and your cycle
Before we jump in, remember: Research about ADHD and hormones is relatively new. So, we still have a lot to learn! Also, keep in mind that everyone’s body works differently, and it’s okay if your symptoms don’t match up exactly.
Okay, now to the juicy part.
A study published in 2017 followed 32 women with ADHD and asked them to keep a daily report of their ADHD symptoms. At the end of the study, researchers concluded that:
- ADHD symptoms increased when Estrogen levels decreased
- ADHD symptoms also increased early in the Follicular and Luteal phases
Clearly, there is a link between ADHD and hormone levels throughout the menstrual cycle.
Now, if you’re familiar with hormone levels and the menstrual cycle, you know that Estrogen is typically low early in the Follicular and Luteal phases. So, their findings seem to track well with what we already know.
So what’s the connection between Estrogen and ADHD?
ADHD and Hormones: Estrogen
Estrogen affects moods, emotions, and cognitive functions. This is largely attributed to the fact that high levels of Estrogen have been shown to improve function in the frontal lobe – which is responsible for rational thought, impulse control, and decision-making – and the hippocampus – which is responsible for memory and learning.
If this is starting to sound familiar, it’s because ADHD affects those exact functions.
So, imagine having ADHD and the hormone that minimizes your symptoms takes a dip a couple of times every month. You’re probably not going to be at your best. But it’s not your fault.
Unfortunately, this information isn’t widely known by practitioners, parents, teachers, or even people with ADHD. So, instead of being recognized for what it is, girls fall behind in school, or these heightened symptoms get labeled as PMS. And how seriously do people take PMS? Not very.
ADHD and Menopause
In Menopause, Estrogen levels vary wildly. And in Postmenopause, Estrogen levels are significantly lower. And guess what? Decreased cognitive function is already a common side effect of Menopause. But low Estrogen levels can worsen ADHD symptoms. So, Menopausal women with ADHD will need a new treatment plan.
ADHD and hormones: Coping strategies
First things first, if you recognize any of the things we’ve talked about so far, in either yourself or other family members, tell someone. Talk to your doctor, a local clinic or a specialist — sharing your concerns is never a waste of time.
And remember that you’re always — and we mean always — entitled to a second opinion.
If you or a family member have received an ADHD diagnosis, following the treatment plan outlined by doctors is vital. And that may include medication, different forms of behavioral therapy, or a combination of both. But, there are a few things you — or they — can do to help manage symptoms during hormonal changes.
Monitor your symptoms
The first thing you’ll want to do is track your period and ADHD symptoms. You can record both of those things in the Hormona app. Remember to be specific and consistent. Set a reminder for yourself if you have to.
After tracking for a couple of months, check the analytics section of the app to see your cycle statistics and symptoms analysis. This section is a goldmine if you are looking for patterns in your cycle and ADHD symptoms.
Hormona can tell you when in your cycle you’ve tracked certain symptoms, and can help you determine if there may be a correlation between hormones and symptoms. This is also handy data to show your doctor.
Girls going through puberty and women in Menopause can also benefit from tracking their symptoms. Though it may be difficult to find a pattern in your symptoms, you will have a consistent, easy-to-read record to share with your healthcare provider. And that can make a world of difference when creating a treatment plan and monitoring its efficacy.
If you have the flexibility to plan around your symptoms, do it. This could look like waiting to start a new project at work until your ADHD symptoms are likely to be milder – according to your symptom tracker. It could mean scheduling breaks more frequently when you expect your symptoms to ramp up. Young girls may find it beneficial to study for a test early in order to stay focused and retain the information better.
This strategy may not work all the time in every aspect of your life. Some tasks can’t be put off. And your work schedule and workload may be completely out of your control. Teenage girls may have a pop quiz during their period. The idea is to do what you can when you can. You can’t ask any more of yourself than that.
Eat, sleep, exercise
There are countless anecdotes from parents – yes, even yours – about the effects of sugar on their kids. But so far, researchers haven’t been able to corroborate that sugar makes kids – or anyone – hyper! We know that sounds so crazy.
Regardless, eating whole foods is good for your body and your mind. There is some evidence to suggest that people with ADHD may have lower levels of Omega 3. You can increase your intake with a supplement, but you should always talk to your doctor first. The best option is to get what you can from real food. Foods with Omega 3 include:
If you’re not into seafood, you can also get Omega 3 from:
- Cod liver oil
- Flaxseed and flaxseed oil
- Chia seeds
A good night’s sleep can be a game-changer for many with ADHD. So, set a bedtime and stick to it – even on weekends. A consistent, calming nighttime routine can help quiet your mind and help you get to sleep on time.
Lastly, exercise is good for your body and brain. There’s evidence that kids with ADHD focus better after physical activity. So, find something you like doing, bring a friend, and work up a sweat!
ADHD and hormones: Be patient
Having your personal experience validated in medical literature can be incredibly validating. And knowing that you’re not the only one can give you the courage to advocate for yourself.
But if it feels overwhelming, frustrating, and lonely some days, that’s okay too.
You don’t need to manage your symptoms perfectly all the time. That’s a lot of pressure! So, be patient. Be kind to yourself. Know that you aren’t alone and that, with the right treatment plan and strategies, you can do this.