If you’re a woman navigating the uncertain middle of life, you might find yourself asking: is it ADHD, perimenopause, or maybe…both? It’s a question I know all too well. 

There are a surprising amount of symptoms that overlap across ADHD and Peri/menopause, which is why if you have gone through your whole life without an ADHD diagnosis, it can then be tricky to distinguish what your exact symptoms are related to.

Women and girls are particularly adept at masking their ADHD symptoms, yet when perimenopause hits it can heighten all of those masked symptoms and suddenly the coping mechanisms we’ve spent years developing, crumble beneath us. It can feel like a double blow, because not only are we now dealing with perimenopause, but we’re also having to face up to the reality that we may have gone our entire lives with undiagnosed ADHD.

As if living with ADHD isn’t enough of a balancing act, the hormonal changes that come with perimenopause can feel like throwing petrol on a fire. And with so much overlap in symptoms, it’s no wonder so many of us are left wondering.

Let’s dive into some of the overlapping symptoms that can make things a little murky:

Brain Fog & Forgetfulness 

ADHD is already known for its ability to create brain fog and forgetfulness, but throw fluctuating hormones into the mix, and those “where did I put my keys?” moments seem to multiply. For some you may lose the ability to string sentences together and lose vocabulary or find it hard to follow a conversation. Others may find it difficult to maintain the regular household chores and leave ovens and washing on for hours on end. Perimenopause can add an extra layer of mental fog, making it hard to remember simple things or stay organised. 

Mood Swings

The inability to regulate our emotions is a huge part of ADHD. But if you then add hormonal imbalances and huge changes into the mix, those emotions become even more difficult to get a handle on. For me I would feel like the Incredible Hulk and my anger spikes would come out of no where and disappear as quick as they came. 

Perimenopause often brings more mood swings, irritability, and feelings of overwhelm… Very similar to the emotional patterns many of us with ADHD experience.

Sleep Disturbances

Insomnia or restless nights are no strangers to those with ADHD, but perimenopause adds a new twist. Hot flashes and night sweats can disrupt sleep even further, leaving us feeling more drained and mentally foggy during the day. 

Anxiety

ADHD can make managing anxiety a regular part of life, as we navigate the day-to-day challenges of focus, organisation, and sensory sensitivity. Perimenopause can amplify these feelings, leaving us more sensitive to stress and quicker to feel anxious over things that might not have phased us before.

Trouble Focusing

With ADHD, staying focused can feel like swimming upstream without a paddle. But with the hormonal shifts of perimenopause, that focus seems harder still to achieve. You might find yourself feeling like you’re back to square one, trying to rein in your wandering thoughts or struggling to concentrate on what’s in front of you or prioritise the most basic of tasks. 

Some more of the symptoms that cross-over are:

• Weight changes

• Periods of burnout

• Irritability

• Low sex drive

• Depression

• Tense muscles

• Restless Legs

• Headaches

• Fatigue

• Overwhelm

• Impulsivity

• Low motivation

• Physical restlessness

So, how do we tell the difference?

Honestly, it can be hard. Understanding whether these symptoms are rooted in ADHD or perimenopause means listening closely to your body, noticing any changes, and maybe even adjusting some of your routines. It’s a good idea to keep a diary and notice if your symptoms worsen at specific times of the month alongside your monthly cycle if you still have one. It’s good to notice when things really ramp up. Try the Balance App which is a free app helping you to monitor your signs and symptoms. 

Sometimes, it’s less about pinpointing the exact cause and more about finding what works to help us manage both worlds.

While seeking a diagnosis for ADHD and/or Peri-menopause can be a difficult journey for many reasons, it can also be incredibly important and healing for you. Often ADHD symptoms will have been prevalent to some degree since childhood as it’s not something that people can develop with age or circumstances. While perimenopause can be diagnosed through blood work and checking testosterone and oestrogen levels, the tests are not always indicative of whether you are or are not in perimenopause unfortunately.

Both diagnoses can be treated medically in some cases, which may or may not be for you, but knowledge is power so the more you know about yourself and the treatment options for you, the better placed you are to start working with your brain instead of against it.

A full list of perimenopause symptoms is included in our handy cycle tracker.

Remember, you’re not alone in this journey. Many women are now discovering the unique ways ADHD and perimenopause intersect, creating new challenges but also opening doors to greater understanding. If this resonates with you, come and join our community. Together, we’ll find ways to balance our mental and physical wellness with a little more compassion, and a lot less judgement.