How Estrogen Decline Crushes ADHD Women’s Brains

Think of your body as very sophisticated, automated smart house. Every device and system that runs your house—windows, lights, thermostat, ovens, even faucets and toilets—is connected to a timer and automated. You never have to flip a switch or flush a toilet.

Imagine what would happen if the central clock that controls all the different timers went on the fritz. Suddenly, everything starts turning on and off at the wrong times. Your lights go on in the middle of the night, the thermostat spikes unexpectedly, the toilets flush at weird times.

This is essentially what happens in women’s bodies during perimenopause.

Every organ and system in the body — from your heart to your liver to your lungs, operates on a rhythm. The hormonal fluctuations that occur in perimenopause knock the body’s systems out of their respective rhythms.

This is true for all women, but these changes hit harder for ADHD women. One of the main reasons why ADHD women suffer more the connection between estrogen and the neurotransmitters dopamine and norepinephrine.

Read: 5 Reasons Why Perimenopause Hits Harder for ADHD Women

Here’s a deeper look at what’s going on.

Dopamine and Norepinephrine in ADHD Brains

One of the key challenges of ADHD is a deficit of dopamine and norepinephrine — the neurotransmitters that power motivation, reward systems, focus, attention, and pain inhibition.

In addition to its roles in regulating motivation and the reward center, dopamine is also the “software” that runs the Pre-Frontal Cortex.

The PFC is like the “command center” of the automated house. It is responsible for executive functions like planning, coordination, prioritizing, impulse control, and emotional regulation.

Without enough dopamine, the software can’t run and the command center goes offline.

Why Estrogen Decline Crushes ADHD Women’s Brains

A hallmark of perimenopause is the dramatic fluctuation and decline of estrogen. Estrogen doesn’t just steadily decline; it ebbs and flows in unpredictable spurts.

Most people think of estrogen primarily as “reproductive” hormone, but it actually has a much bigger role in the system.

Most relevant to ADHD women are two functions of estrogen:

(1) It’s facilitation of dopamine and norepinephrine; and
(2) It’s independent role in the Pre-Frontal Cortex.

(1) The Estrogen-Dopamine Connection

It’s unclear whether ADHD brains don’t make enough dopamine or whether the dopamine clears out too early.

Either way, estrogen is a crucial chemical that helps create and stabilize dopamine and norepinephrine. It plays a role in both creating the neurotransmitters and ensuring that they aren’t cleared out too quickly.

As estrogen fluctuates and drops, it wreaks havoc on the neurotransmitters and the functions they serve. When estrogen isn’t available to create and release dopamine and norepinephrine, motivation, focus, and attention decrease and pain increases.

In addition, the software running the “command center” becomes unstable, wreaking havoc on the already fragile executive function of ADHD women.

Although estrogen decline creates this impact in all women, ADHD women start with a deficit of dopamine and norepinephrine. That means

• focus, motivation, and attention fall off a cliff;
• pain skyrockets; and
• the command center crashes.

(2) Estrogen’s Independent Role in the Command Center

Estrogen also has an independent role maintaining the infrastructure of the brain’s command center.

When estrogen declines, the command center’s wiring gets brittle and experiences power outages. This is what creates symptoms like brain fog, forgetting why you entered a room, and working memory lapses.

For all women, this is disorienting. For ADHD women, it’s catastrophic.

While neurotypical women start with a well-functioning automation system in their body house, ADHD women had a glitchy system even before perimenopause sets in.

It’s common for ADHD women to spend years creating strategies and workarounds to compensate for our “buggy software.” We rely on rigid routines, intense exercise, and external pressure to get things done. These strategies are energy-intensive and consume a lot of bandwidth.

The estrogen decline that arrives in perimenopause causes our systems to collapse under the new strain. We no longer have the bandwidth to maintain the systems that kept our lives from falling apart.

Neurotypical women might experience estrogen decline as a mini-earthquake that creates some minor cracks in the walls. For ADHD women, the decline of estrogen is like an implosion: it can cause the entire structure of the house to collapse.

Finding Solace in Rhythms and Rituals

When we understand perimenopause as an dysregulation of the body’s systems, we open the door to new solutions.

For all perimenopausal women, and especially women with ADHD, maintaining rhythms in our lives becomes a crucial strategy for navigating these challenging years.