Perimenopause and ADHD: What Every High-Achieving Woman Needs to Know
Perimenopause and ADHD: What Every High-Achieving Woman Needs to Know
As a licensed mental health counselor and life coach working with entrepreneurs and executives navigating ADHD and burnout, I’ve seen a powerful, often overlooked intersection emerge in my practice: the convergence of perimenopause and ADHD. If you’re a high-performing woman in your 40s or 50s suddenly struggling with focus, energy, and emotional regulation—despite years of managing ADHD—you’re not alone. There’s a physiological shift happening beneath the surface, and understanding it is the first step to reclaiming your clarity and vitality.
What is Perimenopause?
Perimenopause is the transitional phase leading up to menopause, marked by fluctuations and gradual declines in estrogen and progesterone levels. This phase can start as early as your late 30s, but most commonly begins in your early to mid-40s and can last anywhere from 4 to 10 years.
Common Symptoms of Perimenopause
Perimenopause brings a wide array of symptoms, which can vary significantly from woman to woman. Common experiences include:
Brain fog
Memory lapses
Difficulty concentrating
Fatigue and low energy
Mood swings and irritability
Anxiety or depressive symptoms
Sleep disturbances
Irregular periods
Hot flashes and night sweats
Why Perimenopause Can Exacerbate ADHD Symptoms
If you’ve been diagnosed with ADHD, you’re already familiar with challenges like distractibility, impulsivity, and mental fatigue. Estrogen plays a critical role in modulating neurotransmitters like dopamine and serotonin—both essential for executive functioning, mood regulation, and sustained attention. As estrogen levels drop during perimenopause, ADHD symptoms can intensify dramatically.
Tasks that once felt manageable can suddenly seem overwhelming. Your tried-and-true systems may stop working. Emotional reactivity may rise, and your once-sharp memory may feel unreliable.
How This Shows Up in Entrepreneurs and Executives
For high-achieving women with ADHD, this hormonal shift can be especially destabilizing. You may find yourself:
Struggling to make strategic decisions you used to make with ease
Missing deadlines or forgetting key meetings despite using calendars and reminders
Feeling chronically fatigued, yet unable to rest
Experiencing self-doubt and a loss of confidence in your leadership
Overworking to compensate for perceived “laziness” or disorganization
This can lead to a cycle of burnout, guilt, and frustration—especially when your internal drive remains high, but your cognitive resources feel diminished.
You're Not Broken—You're in Transition
This isn’t a personal failure or a lack of willpower. It’s a neuro-hormonal reality that deserves attention, compassion, and targeted support. By understanding the intersection of perimenopause and ADHD, you can begin to work with your body and brain instead of fighting against them.
Join Us: Spring Vitality Book Club
To support women navigating this critical phase, I’m thrilled to co-host the Spring Vitality Book Club with Dr. Amanda Tracy, a naturopathic doctor who specializes in women’s hormone health.
We’ll be diving into "The Menopause Brain" by Dr. Lisa Mosconi, a groundbreaking book that explores how menopause impacts brain health—and what you can do to support your mental clarity, energy, and focus.
This book club is more than just a reading group. It’s a supportive space to:
Learn the science behind your changing brain
Discover strategies to regain your cognitive edge
Connect with other driven women navigating similar challenges
Explore holistic solutions with both psychological and hormonal perspectives
Together, we’ll explore actionable tools to reclaim your focus and vitality—so you can continue to lead, create, and thrive through every phase of life.
Spots are limited—join us and rediscover the power of your mind.