By: Johanna Badenhorst
I used to think I was just inconsistent.
Some weeks I felt focused and in flow ticking off tasks, having creative ideas, managing life like I finally cracked the code. Then, out of nowhere, everything would fall apart. I’d feel foggy, overwhelmed, irritable, and emotionally all over the place. I’d forget the simplest things and feel ragey over nothing.
I blamed myself for years. For not being disciplined enough. For not sticking to the strategies that “should” have worked.
It wasn’t until I was diagnosed with ADHD and started tracking my cycle that it all started to make sense.
The truth? My brain wasn’t defective; it was wired slightly differently and simply responding to fluctuating hormones. And no one had told me that ADHD can show up differently across your cycle, or that motherhood, postpartum, and perimenopause can radically shift your symptoms.
The Estrogen Effect: Why You Might Feel Clearer Mid-Cycle
Estrogen isn’t just about reproductive health — it plays a key role in brain function. It boosts dopamine and serotonin levels, which are crucial in ADHD for:
- Attention
- Motivation
- Emotional regulation
According to the recent systematic review by Osianlis et al. (2024), estrogen appears to have a neuroprotective effect on ADHD symptoms. That’s why:
- Many women report feeling more focused, confident, and emotionally stable during the follicular phase (first half of the cycle, when estrogen is rising).
- Stimulant medication may feel more effective during this time.
“Hormonal fluctuations appear to significantly modulate the severity of ADHD symptoms, with estrogen exerting neuroprotective effects on cognition.”
– Osianlis et al., 2024 (Journal of Attention Disorders)
The Luteal Low: When Symptoms Spike
The second half of the cycle (the luteal phase) is when progesterone increases and estrogen drops. For many ADHDers, this phase brings:
- Brain fog
- Emotional reactivity
- Sleep disturbances
- Increased impulsivity or rejection sensitivity
This is especially relevant for women who also experience PMDD, which is significantly more common in those with ADHD (Dorani et al., 2021).
ADHD, Pregnancy, and Postpartum: A Dopamine Deficit Storm
During pregnancy, estrogen and progesterone skyrocket — and surprisingly, some women report fewer ADHD symptoms during this time. But after birth?
The postpartum crash can hit like a truck.
That’s because estrogen drops dramatically after delivery, pulling dopamine down with it — which can worsen:
- Mood
- Memory
- Focus
- Emotional regulation
Women with ADHD are at higher risk for postpartum depression, yet it’s often missed or minimised, especially when executive dysfunction is mistaken for “normal” new mum struggles.
Perimenopause: The ADHD Comeback No One Warns You About
Perimenopause is another phase where symptoms can suddenly intensify — often catching women off guard. This is when many first get diagnosed, after a lifetime of coping.
Why?
- Estrogen levels fluctuate unpredictably, impacting cognition and mood.
- Sleep quality worsens.
- Coping strategies no longer “cut it” — especially for high-achieving women trying to juggle work, parenting, and aging parents.
Studies (Camara et al., 2021; Haimov-Kochman & Berger, 2014) confirm that this stage is linked with worsening working memory, attention, and mood in women with ADHD.
Final Thoughts: Hormonal Shifts Are Not Just a Footnote
This isn’t just about being “hormonal.” It’s about recognising the real neurobiological shifts that influence how ADHD shows up across our lifespan — and how little many of us were told about this.
For me, one of the most helpful changes has been learning to track my cycle and adjust how I work, plan, and show up each week.
I’ve stopped expecting consistency from a brain that moves in patterns — and started designing systems that flow with those patterns, not against them.
I share this not just as a psychologist, but as someone who’s lived the frustration of not knowing why everything felt harder some weeks.
If this resonates, know you’re not alone.
There’s growing research, better tools, and spaces where we’re starting to have these conversations more openly.
That’s the heart of the work I do now — helping women with ADHD understand themselves more deeply, and connect with others doing the same.
Further Resources
Listen to the podcast: “ADHD, Hormones, and the Cycle We Weren’t Taught About”
Explore the Crisis Survival Kit for Overwhelmed ADHDers for when you need quick resources during the luteal phase in particular!- For community support, connection and education, you’re welcome to join the ADHD Her Way Hub — a space designed with these rhythms in mind.
References
Camara, E., Ekhtiari, H., & Lawrence, N. S. (2021). The impact of sex hormones on cognitive functioning in women with ADHD: A systematic review. Archives of Women’s Mental Health, 24(3), 405–419. https://doi.org/10.1007/s00737-021-01181-w
Dorani, F., Samadikhah, A., & Ghanizadeh, A. (2021). Premenstrual dysphoric disorder and its overlap with ADHD and mood disorders: A study among women with ADHD. Journal of Psychiatric Research, 143, 356–362. https://doi.org/10.1016/j.jpsychires.2021.08.019
Haimov-Kochman, R., & Berger, I. (2014). Cognitive functions in regularly cycling women may be affected by hormonal fluctuations. Frontiers in Human Neuroscience, 8, 191. https://doi.org/10.3389/fnhum.2014.00191
Osianlis, E., Thomas, E. H. X., Dwyer, D. B., Adikari, A., & Gurvich, C. (2024). ADHD and sex hormones in females: A systematic review. Journal of Attention Disorders, OnlineFirst. https://doi.org/10.1177/10870547251332319
Young, S., Adamo, N., Ásgeirsdóttir, B. B., Branney, P., Beckett, M., Colley, W., & Gudjonsson, G. (2020). Females with ADHD: An expert consensus statement taking a lifespan approach providing guidance for the identification and treatment of attention-deficit/hyperactivity disorder in girls and women. BMC Psychiatry, 20, 404. https://doi.org/10.1186/s12888-020-02888-9
