New study explores how ADHD symptoms relate to menopause in midlife women

Women with attention-deficit/hyperactivity disorder (ADHD) often navigate a range of challenges that extend far beyond childhood. One area of increasing interest is how this condition interacts with the menopausal transition, a period marked by significant hormonal and cognitive shifts.

A new study published in the Journal of Attention Disorders offers an in-depth look into this issue. The findings suggest that while women with ADHD do not report more severe menopausal symptoms than women without ADHD, the relationship between ADHD symptoms and menopausal complaints appears to differ across groups, especially when medication use is considered.

This research highlights the need to better understand how overlapping symptoms between ADHD and menopause are experienced and interpreted. The findings contribute to a broader effort to improve clinical awareness and care for women whose reproductive and cognitive health may intersect in complex ways during midlife.

The study was designed in response to growing calls for a deeper understanding of how reproductive hormone changes affect women with ADHD. Although ADHD affects both males and females, women are often diagnosed later in life, partly due to subtler symptom patterns and the masking effect of co-occurring conditions like depression and anxiety. Researchers have suggested that hormonal fluctuations throughout a woman’s life—including during menstruation, pregnancy, and menopause—may significantly influence the course and expression of ADHD symptoms.

While previous research has examined the effects of short-term hormonal shifts such as those during the menstrual cycle, little is known about how longer-term changes like menopause affect women with ADHD. The menopause transition typically spans several years and brings with it physical, psychological, and cognitive symptoms, some of which overlap with those seen in ADHD. These include mood swings, memory issues, reduced concentration, and disrupted sleep. Yet until now, few studies have addressed how these experiences may differ for women already managing a diagnosis of ADHD.

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“It occurred to me that there are two underdeveloped areas of research here. Much of the ADHD research focus has been on children and on males with females typically underrepresented in research. Additionally, menopause is somewhat of a taboo subject in society, healthcare and research, so is under-researched. When the two collide, there is so much missing understanding,” said study author Ellie Dommett, a professor at King’s College London and head of the ADHD Research Lab.

To explore this, the researchers conducted a large-scale online survey between October 2023 and June 2024. They recruited 656 women between the ages of 45 and 60, all based in the UK. Of these, 245 reported having a formal ADHD diagnosis, including both women who were on medication and those who were not. The remaining 411 participants reported no ADHD diagnosis. Women were excluded if they were undergoing hormone therapy, taking hormonal contraceptives, or had experienced surgical menopause. This ensured the sample reflected the natural course of menopause.

The survey included validated tools to measure ADHD symptoms, such as the Adult ADHD Self-Report Scale, as well as several scales to assess menopausal symptoms and quality of life. These included the Women’s Health Questionnaire and the Menopause-Specific Quality of Life Questionnaire, both of which examine areas such as mood, memory, concentration, vasomotor symptoms like hot flashes, and sleep quality. Participants were also asked about their medical history, medication use, and healthcare utilization.

The researchers had several expectations going into the study. They hypothesized that women with ADHD would experience worse menopausal symptoms than those without the condition, and that this effect might vary depending on whether the woman was in premenopause, perimenopause, or postmenopause. They also examined whether being on ADHD medication changed this relationship. Finally, they tested whether ADHD symptom severity was linked to the severity of menopausal complaints.

When the data were analyzed, the researchers found no significant differences in reported menopausal symptoms between women with and without ADHD. This held true across different menopausal stages and regardless of medication use. In other words, having ADHD did not appear to worsen the overall experience of menopause in terms of symptom severity.

The picture became more nuanced when the researchers looked at correlations between ADHD symptom scores and menopausal complaints. Across the full sample, higher ADHD symptom scores were linked to greater difficulties in several areas of menopausal experience, including anxiety, depressed mood, physical symptoms, and quality of life. These associations were particularly strong among women without an ADHD diagnosis.

In contrast, among women who had an ADHD diagnosis, especially those taking medication, the link between ADHD symptoms and menopause complaints was weaker. For example, among medicated women with ADHD, only a few correlations remained significant, such as those involving memory, concentration, and psychosocial distress. Women with ADHD who were not taking medication showed a somewhat stronger pattern, but still not as pronounced as in the non-ADHD group.

These differences may reflect how women interpret their symptoms. The researchers suggest that women who know they have ADHD might attribute certain challenges—like forgetfulness or lack of focus—to their underlying condition rather than to menopause. This attribution could influence how they report symptoms on self-assessment scales, leading to weaker statistical associations in this group.

“I think we expected women with ADHD to have worse menopausal experiences than those without because there is such a big overlap between ADHD and menopausal symptoms, but this was not what the data showed,” Dommett told PsyPost. “When we thought about this we realized we now need to look more carefully at how women interpret their experiences and that needs more than survey data. For example, if you have knowingly lived with ADHD all your life, you might think concentration difficulties associated with the menopause are actually your ADHD symptoms worsening. We need to better understand how fluctuations in female hormones across the lifespan interact with other conditions, including ADHD.”

“We had always planned to conduct in-depth interviews, but this work really reinforced the need to do that. We also need to look more at the effects of medication for ADHD as this was hard to do in a study the size of ours. More participants would be needed to pick this apart.”

Although these findings provide useful insight, the authors caution that more work is needed to confirm and expand upon them. The study relied on self-reported data, including ADHD diagnosis, which introduces some uncertainty. Additionally, while the sample was large, certain subgroups—such as women not taking ADHD medication—may have been too small to detect smaller effects. The study also did not capture the full diversity of menopausal experiences, as most participants were White and based in the United Kingdom.

“This is the first study where anyone has looked at how menopausal experiences relate to ADHD traits and so I think the key thing for readers to take away is that this area warrants more investigation,” Dommett said.

Despite these limitations, this research represents an important step toward addressing a gap in women’s health. Both ADHD and menopause are often misunderstood or minimized in clinical settings. By exploring how the two conditions may interact, the study contributes to a more nuanced understanding of women’s health across the lifespan.

“Menopause is so much more than hot flushes and night sweats and ADHD is much more than getting distracted and being disorganised in planning,” Dommett explained. “Both the menopausal transition and ADHD have become so simplified in reels and other forms of media that we forget these are complex experiences that can impact individuals is a huge variety of ways.”

The authors are planning follow-up research involving interviews with women and healthcare providers. These qualitative studies could help capture aspects of lived experience that are difficult to measure through surveys alone.

“Our long term goals are to find out more about how women with ADHD experience natural hormonal fluctuations across the lifespan and the support they need for these,” Dommett said. “This includes during menopause but also in menstruation and pregnancy. For the menopause work, we are about to start interviewing women and then clinicians.”

The study, “Examining the Link Between ADHD Symptoms and Menopausal Experiences,” was authored by Lauren Chapman, Kanak Gupta, Myra S. Hunter, and Eleanor J. Dommett.