How my period is supercharging my ADHD

The relationship between attention deficit hyperactivity disorder and the menstrual cycle is one of the most under-researched and under-discussed topics in women's health, and for the millions of women who live with both, the silence has consequences.

I was diagnosed with ADHD at 34, after a lifetime of being told I was lazy, disorganised and not living up to my potential. The diagnosis was a revelation: there was a neurological reason for the chaos in my head, and medication helped to quiet it. What nobody told me was that my menstrual cycle would dramatically affect how well that medication worked — and that for a significant portion of every month, it would barely work at all.

The science, what little of it exists, suggests that oestrogen plays a significant role in dopamine regulation, the neurotransmitter system that ADHD medication targets. When oestrogen levels drop in the week before menstruation, dopamine function declines, and the medication becomes less effective. The result is that many women with ADHD experience a week or more of significantly worsened symptoms every month — just when their bodies are already dealing with the physical and emotional effects of premenstrual syndrome.

The solution is not complicated: it involves adjusting medication dosage across the menstrual cycle, a practice that some specialist clinicians already employ. But the research to support that practice barely exists, because ADHD research, like most medical research, has historically treated the male body as the default and the female body as a variation.

The result is that millions of women are being undertreated for a condition that affects every aspect of their lives, because the medical system has not bothered to understand how their bodies work. The silence is not neutral. It is a form of neglect, and it has consequences that are measured in lost jobs, broken relationships and lives that are harder than they need to be.