ADHD Women in Perimenopause: Special Risks of Depression

What is Perimenopause?

Perimenopause begins as early as 35 and ends after your last period, usually around 52. It is  the  transitional period before menopause characterized by hormonal fluctuations.

Adhd women often see wild fluctuations in emotion, attention, and physical symptoms during this time.


What are the Emotional impacts of Perimenopause for ADHD Women?

  • Increased depression
  • Overwhelm
  • Frustration
  • Sadness
  • Irritability
  • Anxiety
  • Mood swings
  • Memory problems.

Perimenopause can cause significant emotional distress due to hormonal changes. One women Adhd women are at particular risk is because of emotional regulation issues.

These mood swings can be very hard to manage.


What is happening with your hormones during Perimenopause?

  1. Estrogen receptors are located throughout regions of the brain that regulate mood, sleep, and cognition.
  2. Estrogen increases the amount of both serotonin and noradrenaline, favorably influencing mood.
  3. Progesterone and its metabolite, allopregnanolone, are involved in neuroprotective mechanisms, cognitive function, and mood.
  4. Decreased levels of allopregnanolone have been associated with depression in women.
  5.  Some women may have an unfavorable response to the fluctuating levels of hormones that predispose them to depressive symptoms.

Learn more about hormones and adhd

Learn about pregnancy and adhd



Key points to know about Perimenopausal depression

  1. Perimenopausal depression may manifest different from more traditon female depression with  higher levels of anger, hostility, sleep disturbance, and fatigue.
  2. Risk factors for maladaptation include a prior history of major depressive disorder (MDD), which is the strongest predictor for a reoccurrence during perimenopause and a history of hormone-related mood symptoms such as premenstrual syndrome (PMS)
  3. or premenstrual dysphoric disorder (PMDD), which are moderately linked.
  4. Both of those groups of women may have a genetic predisposition and vulnerability to hormonal fluctuations.
  5. The best way to screen for depressive symptoms is to ask all perimenopausal women and to be mindful that those with a personal or family history of depression and/
  6. or a history of PMS or PMDD are especially vulnerable. We know that adhd  and autistic women have higher rates of pms and pmdd, so they would be at higher risk here.

What are some tips to manage perimenopause symptoms? |

Estrogen and progesterone fluctuations can cause a variety of symptoms, including hot flashes, memory problems, bloating, and loss of sex drive.

For Adhd women in particular , estrogen is related to dopamine, which is connected with your motivation, focus and attention.

These changes worsen executive funcitoning challenges, soemthing you already likely struggle with.

These factors, in part may explain why so many women are diagnosed later with Adhd. There is also evidence of a later onset of adhd, and older women make up this subset in large part.

What societal factors contribute to anxiety and depression during Perimenopause?

The societal pressure on women, increased responsibilities, and lack of understanding or support often execacerbate what adhd women got through during these years.

You may not understand what is happening, and many healthcare providers won’t either. This can cause frustration and a sense of isolation, exacerbating issues you alredy face as a neurodivergent women. .

There is a lack of  knowledge around women’s issues, and there is secrecy in society around discussing aging and menopause.  Women feel ashamed and embarssed.

What are some physical symptoms of Perimenopause?

Symptoms include hair loss, bloating, hot flashes, heavy bleeding, mood swings, etc. I’ve heard it referred to as reverse puberty, which I found helpful and accurate.


  • Tracking menstrual and mood cycles
  • Reaching out for support of other women who  understand you
  • Prioritizing sleep and self care
  • Asking for help and delegating responsiblities
  • Accommodating yourself when you aren’t feeling well by making things easier and more comfortable
  • Self Advocacy and Seeking knowledgeable health care providers
  • Various strategies can help manage perimenopausal symptoms and maintain overall well-being.
  • Practicing Self Compassion
  • HRT/ Increase your stimulant/ssris ssnris

Marino, J. M. (2022). Depressive symptoms in perimenopause. Women’s Healthcare, October 2022. Link to Full Text


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