Have you ever left home leaving your full, perfectly made coffee cup on the side or frantically looked where your phone is only to realise, you’re already holding it, to then check the dates and realise you’re PMS-ing?
This might just be me, but your PMS symptoms and hormones can influence our brain, often more than we think, and forgetfulness is very normal during PMS. However, those menstruators who also suffer with ADHD (attention-deficit/hyperactivity disorder) can experience far worse & more disruptive symptoms like brain fog, forgetfulness & hypersensitivity.
WHAT IS ADHD?
Firstly, let’s get some info. ADHD - attention-deficit/hyperactivity disorder – is a neurodevelopment, behavioural, and mental health condition characterized by difficulty with attention, routine, hyperactivity, hypersensitivity, fidgeting, focus, organization, and planning.
It was often thought to only affect young children, mainly young boys between the age of 6-12 years old, however research shows that the disorder is under-researched and under-diagnosed in young girls, adult women and people assigned female gender at birth. There are more and more adult diagnoses happening. Consequently, it makes sense that the disorders relationship with oestrogen would also have gone unrecognised, so for people with a menstrual cycle who suffer from PMS, the ADHD symptoms can worsen.
WHY DOES PMS EFFECT ADHD?
A 2021 article published in the International Journal of Molecular Sciences suggests ADHD symptoms frequently worsen a week before menstruation and improve during the first two weeks of your cycle (as well as during pregnancy). The reason? Oestrogen fluctuation & dopamine.
The hormone oestrogen affects receptors in the brain that release the naturally occurring neurotransmitter chemicals serotonin, dopamine, and norepinephrine, these assist with important cognitive functions such as focus, concentration, mood and memory.
When oestrogen levels drop during the weeks before a menstrual period, so does the level of these brain chemicals. Because symptoms of ADHD are affected by many of these same brain chemicals, it stands to reason that women with ADHD are more sensitive to the change in oestrogen. Equally we know that dopamine levels are lower in the brains of ADHDers compared to non-ADHDers. So, when you add in the lower starting levels of dopamine, and the fluctuations from the dropping oestrogen levels affecting neurotransmitters, it’s no surprise it’s a challenge of balance and can feel like an awful lot to juggle and steady in your head!
HOW DOES PMS EFFECT ADHD?
PMS is never easy, and we all experience it in different intensities, however when you have ADHD it can hit you louder & harder. During the first half of the cycle, you probably feel some sort of ‘normal’, clear headed and productive, then as your period gets closer you may feel that shift and start to feel like a very different version of yourself.
In addition to the regular PMS symptoms of affected sleep, headaches, low energy, mood swings and cramps, ADHD symptoms can worsen and add to the challenge with difficulty concentrating, focusing, remembering things, acting impulsively & forgetfulness. You can also experience extreme mood swings, depression, irritability, easily overwhelmed & anxiousness – to name a few!
None of this is fun or easy, and can seriously affect your daily life, relationships, work life, friendships and your overall quality of life.
WHY HORMONE LEVELS ARE IMPORTANT
Menstruators bodies are in a constant hormonal balance throughout our repeating 28-day cycles. And it’s when those hormones drop out of balance towards the end of our cycle that we experience the PMS symptoms.
ADD & ADHD stems from an imbalance of neurotransmitters in the brain, so when your menstrual hormones drop and are imbalanced, ADD & ADHD imbalances can become more severe.
Hormonal fluctuations affect you and your ADHD symptoms throughout your life too. During puberty, both oestrogen and progesterone levels increase, which can result in intense emotions. In pregnancy, oestrogen levels increase and remain elevated, so ADHD symptoms often (but not always) decrease.
During perimenopause, oestrogen levels rise and fall making ADHD hard to manage. By menopause, women often report feeling better, this is because although oestrogen levels are lower, they have stabilized and so ADHD symptoms are often easier to manage.
WHY IS ADHD OVERLOOKED & UNDER-RESEARCHED IN GIRLS & WOMEN?
Part of the problem is a lack of research. According to psychologists and researchers who specialize in ADHD, “One of the important shortcomings of most of the research-based information on ADHD is that the vast majority of studies have been conducted solely on boys, or have included very few girls in the sample. As a result, the scientific literature on ADHD is almost exclusively based on male subjects
Studies have also found that girls often have ADHD without hyperactivity. They don’t fidget or squirm or get up to sharpen their pencil every two minutes. Instead, they just sit at their desk and zone out. These girls have the same ADHD problems of inattention, distractibility, and poor impulse control, but few parents, teachers, or clinicians ever suspect these girls have ADHD because they aren’t hyperactive.
A clinical professor of paediatrics at the University of California at Irvine, found the same: ADHD often expresses itself in girls through excessive talking, poor self-esteem, worrying, perfectionism, risk-taking, and nosiness — not the typical hyperactivity and lack of focus that is often seen in boys.
Which would also explain why PMS reactions on ADHD in girls & women is also so under researched and misunderstood as most research and studies were conducted on males. Female symptoms and behavioural differences were and still are unrecognised or brushed off as anxiety.
HOW TO MANAGE WORSENED SYMPTOMS OF ADHD
Being aware of what’s going on and where you are in your cycle, relative to how you’re feeling is the best place to start. Keeping an eye on your changes in behaviour, mood & concentration levels leading up to and during menstruation. This close monitoring can help if you need to go to a healthcare professional for help and to develop any necessary treatment.
Managing exacerbated symptoms can start with getting enough sleep, eating well & healthily, not skipping meals, not eating fast food or sugars, and staying well hydrated. Eating foods high in phytoestrogens is also recommended, such as soy, flaxseeds, walnuts, lentils, tempeh, apples, and carrots. Your body registers the phytoestrogens like oestrogen and responds to them accordingly. Research in phytoestrogens is inconclusive, however it has the potential to reduce severe symptoms.
Switching from disposable period protection, to reusable, natural, breathable, organic Rosaseven Period Underwear can help to take the stress out of your period, and the anxiety of possibly starting early with no protection, changing your tampon or pad at work or school, or leaking at night, you’re fully covered and helping the planet too!
Some research has remarked that reducing your exposure to endocrine disruptors from harsh chemicals could help to reduce additional disruptions to your hormones. Eliminating using tampons & disposable pads and using natural breathable Rosaseven period underwear instead can help to eliminate the possibility of additional hormone disruptions from the harmful chemicals used in many disposable tampons & pads. Whilst also giving you a simple, easy, super comfortable solution to managing your period.
Increasing your daily levels of dopamine and adopting regular stress-reducing techniques & routines can also help to keep your exacerbated symptoms at bay. Things such as exercise, meditation, yoga, walking in nature, sleeping well, eating clean whole foods & Omega-3 supplements can also help for some people.
Cutting out or reducing caffeine intake, alcohol, sugar, dairy & very salty foods can help, as these have been found to make PMS worse. Adding in some vitamin supplements can help, B6, B12, vitamin D and C and E are all important to help PMS. Make sure you check with your healthcare professional before taking additional supplements.
Tracking your own menstrual cycle in your own calendar or on a period tracking app will help you to see any patterns and may help you to feel more in control. It can also be valuable information to your doctor.
If you have any concerns about your own hormones, ADHD or PMS please speak to your doctor or a healthcare professional.