What’s the biggest issue for half the adult population with ADHD? Our hormones, and how they show up every day–in our monthly cycles and everywhere else too. How many even know there is a direct link between the changing nature of our ADHD symptoms and a menstrual cycle? Come hear Moira drop some of the knowledge that led to her “cutting edge” rep.
Topics discussed in this episode:
Getting off on the right foot 04:16
- help reduce the stigma around this topic because there is vital health information for anyone who has a monthly cycle.
- even more important if you have ADHD.
- Use of inclusive language for respect and inclusion of diversity.
- We now understand there is more gender diversity among people with ADHD
Why bother knowing about our hormones? 04:58
- studies that have taken place in people with a cycle have shown significant hormonal influences on our brains, moods and bodies, and even more so when you have ADHD.
- Two studies comparing menstrual cycle experiences of those with and without ADHD found the ADHD group had double the number, experiencing severe premenstrual mood, and physical symptoms, four times as many suffering from postpartum depression and a 10x increase in Premenstrual Dysphoric Disorder (PMDD).
- hormones play a central role in our day-to-day experiences and ADHD symptoms when you have ovaries. This includes menstrual cycles, all life stages or events including puberty, pregnancy, post-partum, perimenopause, and menopause, as well as external hormonal use like oral contraception, and hormonal replacement therapy,
- Our changing hormonal state is also sensitive to environmental, biological and social influences too.
- Dr Sara Binder has stated that as people with ADHD age, without appropriate treatment and support, comorbid conditions increase, and ADHD symptoms worsen.
- Russel Barkley’s research has shown that when we have challenges that decrease our quality of life and health, that it can shorten our lives.
- These situations are fully preventable and most clinicians and people with ADHD are not even aware of it, but we can change that right now.
The hormonal big picture 08:16
- Higher levels of estrogen start in puberty as part of the menstrual cycle.
- increase in estrogen alters the sensitivity in our neurotransmitter systems in our brains with ongoing change over time hormonal variations continue and increase our vulnerability to mood disorders, and changing ADHD symptoms .
- As hormones fluctuate over a month, this determines how effective stimulant medication can be.
- Many of us with ADHD experience a tipping point at one or more of our hormonal life stages.
Our monthly cycle 11:11
- every month hormones rise and fall at different rates, and in different amounts that create varying combinations that directly impact our thinking, mood, emotions and physical body.
- Review basics of monthly cycles
- many cultures women slow down during then and rest more.
- a time to rest, reflect, and use the time for work related to our insight and understandings.
- Are we trying to fit into a world made for those living without a cycle?
- Overview of how hormones fluctuate and impact on meds and ADHD symptoms
- our experiences with hormones are both way more intense and frequent than those without ADHD
- wanting our bodies and brains to be different than they are doesn’t help
- a lot that can be done to help alleviate the situation
- Monthly menstrual cycles create a lot of variability in the severity and symptoms of ADHD AND they also impact the effectiveness of stimulant medication
- Our changing hormonal state every month and at different life stages are also sensitive to environmental, biological and social influences too
- without appropriate treatment and support, comorbid conditions increase, and ADHD symptoms worsen.
- The second half of our cycle is known as the luteal phase is when so many of us can struggle. It’s helpful to figure out your own personal cycle, and how long each phase lasts as it is individual.
- There is actually a lot that can be done to help alleviate the situation but wanting our bodies and brains to be different than they are doesn’t help us.
We need more research in this area that leads to better understanding of the hormonal impact on ADHD.
Moira Maybin 00:05
How many of you menstruate? Before you decide this episode is not for you do you know or love anyone who has a period? If so, can you help reduce the stigma around this topic? Because there’s vital health information for anyone who has a monthly cycle, it becomes even more important to know if you also have ADHD. If this is not in your comfort zone, then I would encourage you to listen to this episode twice. My own life is going to change. And I believe for the better way more than I thought it would as I dove deeper into this topic. This is an episode that I would really encourage you to share far and wide as everyone needs to know about hormones in ADHD because even if you don’t have a cycle, there are some really fundamental and influential pieces of our biology that more people need to know. Today we’re talking about how monthly menstrual cycles have shown up in every part of our life. Kind of like ADHD, what these four phases are, and how they create a regular change in our ADHD symptoms and treatment needs. Please take this information and either help yourself or share it with others. For show notes and more information on this topic visit ADHDfriendlylifestyle.com.
Moira Maybin 1:22
Welcome to the ADHD friendly lifestyle. It’s a place to practice putting on our own oxygen mask so we can breathe and make it possible to show up in our own lives without guilt or shame. I’m your host, Moira Maybin a woman mom, educator, and I have late diagnosed ADHD. Join me as we dive into the stories, adventures and mishaps, all while trying to make sense of the published research that could make your tomorrow a more ADHD friendly day. There are things that I wish I had known about my ADHD sooner, and I want to share them with you. We are in this together, if you have questions or ideas for me, you can share them at ADHDfriendlylifestyle.com. While you were there, subscribe to the podcast and sign up for emails to get every episode delivered to your inbox and be the first to hear what is going on.
Moira Maybin 02:19 Okay, let’s get started.
You will hear me saying variations on people who have a monthly cycle frequently today. Here at ADHD friendly lifestyle our message includes respect and inclusion for diversity. I don’t want to create something that makes others feel marginalized, unseen or unheard. This is especially true when it comes to hormones and ADHD. As you will hear they are integral to the health and well-being of everyone who has a menstrual cycle. We now understand there’s more gender diversity among people with ADHD. And I want to be respectful and inclusive. One thing I know for sure, I will make mistakes. I appreciate anyone who wants to help me as I continue to learn and grow.
Moira Maybin 04:58
So when asked what they want to know from science about their ADHD 200 people with menstrual cycles responded that they wanted to know more about the impact of hormones on their lives and ADHD. Studying ADHD in those of us with a monthly cycle is in its infancy. Having a cycle has typically meant exclusion from study or being noted as a complicating undesired factor due to the hormones making us so variable. Seriously. Yet the studies that have taken place in people with a cycle have shown significant hormonal influences on our brains, moods and bodies, and even more so when you have ADHD.
Two studies comparing the menstrual cycle experiences of those with and without ADHD, found that the group with ADHD had double the number experiencing severe premenstrual mood and physical symptoms. Four times as many suffering from postpartum depression, and 10 times increase in premenstrual dysphoric disorder pmdd. Not enough people know that hormones play a central role in our day to day experiences, and ADHD symptoms when you have ovaries. This includes menstrual cycles, all life stages or events including puberty, pregnancy, postpartum, perimenopause, and menopause, as well as external use, like oral contraception and hormone replacement therapy are changing hormonal state every month, and at different life stages are also sensitive to environmental, biological and social influences too. One of the leading experts on ADHD and hormones in Canada. Dr. Sara Binder has stated that as people with ADHD age, without appropriate treatment and support, comorbid conditions increase and ADHD symptoms worsen. Dr. Russell Barkley’s research has shown that when we have challenges that decrease our quality of life and health, it can shorten our lives. These situations are fully preventable, and most clinicians and people with ADHD are not even aware of it. But we can change it right now.
Moira Maybin 07:10
Part of our struggle is that we have been led to believe that we can disregard all of this and live just like those without a cycle, or by trying to fit ourselves into what works for others. negative attitudes, shame and disinterest color much of the conversation about menstrual cycles. This has contributed to so much pain, discomfort, and lack of understanding or treatment about what having a monthly cycle actually involves. This also completely disregards or negates how 50% of the population exists. To give ourselves a fighting chance it requires all of us, anyone with or without a menstrual cycle, to recognize, understand and accept how hormones have an undeniable role in our daily lives. Following that, it requires awareness of what this means, how it complicates ADHD, and what we need to happen. So we no longer have the impossible task of living as if we don’t have a cycle.
Moira Maybin 08:16
Currently, most adults with ADHD and a menstrual cycle are not diagnosed prior to puberty. I wonder if you look back to the ages between nine and 14 if there were some major changes for you physically, in your mood, thinking, energy levels, or anything that needed managing, including emotions. This time can be a tipping point for some things that they could do before become harder, and the ability to hide or compensate is more of a challenge. It can accelerate unhealthy behaviors or lead to giving up on some things in an effort to manage other things.
Higher levels of estrogen start in puberty as part of the menstrual cycle. It is thought that this increase in estrogen alters the sensitivity in our neurotransmitter systems in our brains. Over time, as estrogen and progesterone levels go up and down during our monthly cycle. These neurotransmitter systems continue to experience change with pregnancy and delivery. There are marked changes in estrogen and progesterone which lead to increased vulnerability to postpartum depression. As we enter our 40s and perimenopause, hormonal variations in estrogen, progesterone, and testosterone continue and increase our vulnerability to mood disorders. Further fluctuations in estrogen levels increase or decrease our serotonin and dopamine to the result of all of this our effects on our attention, memory, mood, emotional regulation, circadian rhythms, anything requiring executive functions, management of any kind for gesture and plays a larger role in previous They thought it’s really the relationship between it and estrogen that determines if it can help us sleep and calming or increase our forgetfulness. The icing on the cake? As all of these hormones fluctuate over a month, this determines how effective stimulant medication can be.
Some of us may manage or muddle our way through, but there’s often a straw that breaks the camel’s back and trying to cope with life, ADHD, and hormonal fluctuations. For me, it was the trifecta of having undiagnosed ADHD, and being postpartum at the same time as I was starting perimenopause. It took eight more years before I learned that though, something I’m still coming to terms with. This episode has helped me. It is now clear to me that my challenges with coping were completely understandable. I ended up in that situation, because no one around me understood how many of these things individually were affecting me. And there are too few people who understand the compounding burden when these are experienced together.
Moira Maybin 11:11
So over the course of a typical month, these hormones rise and fall at different rates, and in different amounts that create varying combinations that directly impact our thinking, mood, emotions, and physical body. If like me, you have combined type ADHD, we are more sensitive to these fluctuations. I’m taking that to mean that the way forward definitely means understanding and paying more attention to what is going on in my body, so we can coexist peacefully.
To keep us on the same page, here’s a brief primer. Menstrual cycles are made up of four phases that average 29 days, about a week each. This varies from person to person. So knowing your own length will help If like me your cycle is irregular. There’s a way to take some of that guesswork out that I’ll share in the next episode. It helps to think of the four phases as split into two halves before ovulation and after ovulation. The first half starts on day one of a period and last until we ovulate or release an egg and is known as the follicular phase.
During week one, what I call caring week, menstruation can last from four to seven days, and typically is the time we experienced our lowest energy levels can feel tired and have more of a desire to be on our own. It makes sense that for so many cultures, it is the norm for women to slow down during this time and rest more. Menstruation was a time to rest reflect and use the time for work related to insight and understanding. I wonder if our 24 seven fast paced society is creating another impossible ideal for us to be able to go at the same pace all the time. And is it asking us the impossible to fit into a world made for those living without a cycle.
At the beginning of the first week, progesterone, testosterone and estrogen are at their low point and steadily increase as estrogen rises the fastest. As it improves so does many other things serotonin, mood executive function and thinking and stimulant effectiveness will increase daily. Each person does have a different point when they feel an increased sense of well being. For some this starts as soon as their period begins. Others it can take longer into the first week. Knowing all of this, it makes sense that we may wish to cocoon and slowly become visible. Again, it’s helpful to figure out your own personal cycle and how long each phase lasts as it is individual. Common suggestions to match our activities to our state include many things that people with ADHD can struggle with, including taking time to organize, sort, clean out the spaces we live in. Yeah, but when we feel energetically low, it may not be the best time for personal challenges. We can take that concept and tweak it for a better fit. If we want to we could spend this time in more solitary pursuits, things that comfort, ground and give us pleasure. Without much outward energy. That sounds good to me. For me that would involve reading, researching, working on my own, exploring ideas, or puttering in my garden, I probably would like to do some lower level organizing and sorting, maybe not the garage by going through some of my saved bookmarks on web browsers for my work, family, my own interests that would feel good, all things that could help lead to growth and productivity, but without needing to put on a face for the outside world and go at a pace that I feel capable of.
As we grow and strengthen towards the second week and ovulation our energy rises or mood can improve. We can have expanded ideas and creativity. This could be the time to initiate new projects, brainstorm, connect with others or if you have the tendency to have too many projects on the go. Maybe just take the next step on some things. Personally, I’m staying away from new projects right now my plate cannot hold any more. There’s also research to show that how and what we do for physical activity, including recovery time is influenced by our hormones. As our estrogen rises during the follicular phase, it’s a good time for those more intense physical activities you may desire. While testosterone and estrogen are still rising, stimulant medications do their best work, and it’s easier to feel happier and focused.
Moira Maybin 15:35
Ovulation is an interesting time. It is often described as occurring on day 14 at the end of the follicular phase, and it actually occurs anywhere between day 10 to day 17. There are signs in our bodies, and basal body temperature that can help us know more precisely when we all relate. During this time, not only is our skin and sex drive at their peak, we also find it easier to be receptive to others. communicate, collaborate and feel confident. Once we ovulate, our energy does begin to dip with decreasing estrogen and increasing progesterone. Testosterone decreases initially and then starts rising again. The impact of rising progesterone is twofold it diminishes the effect of estrogen and in turn that lowers the effectiveness of stimulant medications.
The second half of our cycle is known as the luteal phase. If a pregnancy has not occurred, this is when so many of us can struggle. As the premenstrual phase starts in the last week, all hormones decrease with a big impact on mood and energy, especially with ADHD. Our dopamine levels are less than half when compared to people without ADHD. That typical experience of someone with ADHD at this time of the month is not fun. We live a life with increased mood instability and increased ADHD severity. That can include severe inattention, inability to focus, impulsivity, irritability, anger, outbursts, depressed mood, increased sleep disturbance, anxiety and panic attacks, suicidal thoughts, and living knowing that these symptoms recur every month.
Here’s another piece in case you haven’t realized in society prefers the version of us that exists in the first half of our cycles, and the second half less so we can be judged as less productive. And there’s a negative outlook on our change in energy, emotions, and mood. Until very recently, I actually bought into these ideas, that the goal is to figure out how to get the second half of my cycle to feel more like the first two weeks. I realized based on what I’ve learned that that’s not going to happen. And so, I guess it’s time to try out more of that acceptance, awareness and self-compassion, there is actually a lot that can be done to help alleviate the situation. I’ll say that again, there is a lot that can be done to help alleviate the situation. But wanting our bodies and brains to be different than they are doesn’t help us. As I got deeper into what too many of us experience and learn that our experiences are both way more intense and frequent than those without ADHD this made me think about how hard it is each and every month to reconcile these very different lived experiences from day to day and week to week. Yet part of the solution lies in understanding what we can expect from treatment, and how we can use the cyclical nature of ours to help manage things. I’ve already got the next two episodes ready to go and I promise, I’m not going to leave you hanging here.
The changing nature of our ADHD and symptoms are a direct result of hormonal fluctuations during our monthly cycle. We are able to become aware of and plan for this variability because they’re cyclical and repeat every month. We can learn individual timing, signs and symptoms of what our brain and body are showing us as our experience of ADHD and our cycle and use that knowledge and treatment options to increase our quality of life. That’s what’s coming up on the ADHD friendly lifestyle.
Moira Maybin 19:43
Okay, you’ve done the hard work by staying to the end. Your reward? Here are the main takeaways from today’s episode. Number one, monthly menstrual cycles create a lot of variability in the severity and symptoms of ADHD, and they also impact the effectiveness stimulant medication. Number two, our changing hormonal state every month and at different life stages are also sensitive to environmental, biological, and social influences. Number three, without appropriate treatment and support comorbid conditions increase in ADHD symptoms worsen as we age. Number four, the second half of our cycle is known as the luteal phase. And it’s when so many of us can struggle. So, it’s helpful to figure out your own personal cycle, and how long each phase last as its individual. Number five, there is a lot that can be done to help alleviate this situation. But wanting our bodies and brains to be different than they are doesn’t help us. We need more research in this area that leads to better understanding of the hormonal impact on ADHD than women girls, anyone who has a menstrual cycle.
I hope you enjoy today’s show. This is the place for the late diagnosed, women, moms, professionals, those who want to understand ADHD be heard and know they are not alone. We can have an ADHD friendly lifestyle that includes more time with our strengths and passions. Less with our challenges and has ways to adjust what and how we do things to suit us better and expand the ways and places that ADHD is understood and accepted. I’d love to know your thoughts about today’s episode, and appreciate questions you’d like to hear on the show too. All questions will be anonymous, respected and appreciated. And I can’t wait to continue this conversation with you. To get in touch you can check out my website ADHDfriendlylifestyle.com or email Moira@ADHDfriendlylifestyle.com or comment below on this podcast. Please remember, I am not a doctor. The information presented in this podcast does not replace the individual recommendations from your health care providers. help spread the word about understanding and accepting ADHD. By subscribing to the ADHD friendly lifestyle on Apple podcasts or the podcast player of your choice by rating and reviewing you help it get to more people. If you can share the podcast with the people in your life. It helps all of us. Thank you for your support. And now for our feature. Tell me you have ADHD without actually telling me you have ADHD. I turn on the radio. Get in the shower, then have a mini heart attack because I hear something in the kitchen. If you want to tell me you have ADHD without actually telling me you have ADHD, visit my Facebook page. Maybe you’ll hear yours on a future episode. Thanks for listening. See you later.