ADHD and Menopause
Many women with AD/HD report an increase in AD/HD symptoms when they enter perimenopause and menopause. Medications that were once effective for AD/HD may not work as well. Estrogen influences neurotransmitter systems and the levels of neurotransmitters (dopamine, norepinephrine, and serotonin) involved with AD/HD as well as depression and anxiety.
Someone with AD/HD already has dysfunction of neurotransmitter systems in the brain, which are only magnified when estrogen levels begin to fall in the perimenopausal period causing further dysfunction. Many women complain of memory problems, mood changes (sad, irritable, worried), hot flashes, sleep problems, memory problems, and problems with mental clarity during the years prior to the onset of menopause, which add to symptoms related to AD/HD.
Some women report increased symptoms of AD/HD during any low estrogen state: with increased hormonal fluctuations when girls enter puberty, in the premenstrual period, the postpartum period, and with the onset of menopause, and may report a decrease in AD/HD symptoms during pregnancy and while nursing, when estrogen levels are high. To make matters worse, some women with AD/HD entering perimenopause have a teenage daughter with AD/HD entering puberty!
Comprehensive treatments are often indicated for women with AD/HD whose symptoms are increasing during the perimenopausal period and during menopause.
Sometimes an increase in stimulant medications is effective, but sometimes it is not as some studies have found the response of stimulants to be related to estrogen levels (a better response with higher estrogen levels). Sometimes, estrogen replacement is beneficial, especially in women who not only have a worsening of AD/HD symptoms, but a significant worsening of mood.
However, risks versus benefits must be considered with estrogen replacement. Since falling estrogen levels influences the neurotransmitter serotonin, SSRI antidepressants that increase serotonin are often helpful for depression and anxiety (which can increase inattention and distractibility).
In summary, treatment of increased symptoms of AD/HD during the menopausal period often consists of some combination of a stimulant medication, an SSRI antidepressant, and sometimes short-term estrogen replacement. There are many other things to do about symptoms related to menopause which can be found on WebMD and on www.healthewomen.com.
It's extremely important for women with AD/HD to find a physician who is not only knowledgeable about AD/HD, but is knowledgeable about AD/HD in women.
Dr. Richard Sogn
Related Topics: WebMD Video: Menopause Myths, WebMD Video: Is it ADHD or Vision Problems?
Technorati Tags: ADD, ADHD, AD/HD, menopause, perimenopause
Someone with AD/HD already has dysfunction of neurotransmitter systems in the brain, which are only magnified when estrogen levels begin to fall in the perimenopausal period causing further dysfunction. Many women complain of memory problems, mood changes (sad, irritable, worried), hot flashes, sleep problems, memory problems, and problems with mental clarity during the years prior to the onset of menopause, which add to symptoms related to AD/HD.
Some women report increased symptoms of AD/HD during any low estrogen state: with increased hormonal fluctuations when girls enter puberty, in the premenstrual period, the postpartum period, and with the onset of menopause, and may report a decrease in AD/HD symptoms during pregnancy and while nursing, when estrogen levels are high. To make matters worse, some women with AD/HD entering perimenopause have a teenage daughter with AD/HD entering puberty!
Comprehensive treatments are often indicated for women with AD/HD whose symptoms are increasing during the perimenopausal period and during menopause.
Sometimes an increase in stimulant medications is effective, but sometimes it is not as some studies have found the response of stimulants to be related to estrogen levels (a better response with higher estrogen levels). Sometimes, estrogen replacement is beneficial, especially in women who not only have a worsening of AD/HD symptoms, but a significant worsening of mood.
However, risks versus benefits must be considered with estrogen replacement. Since falling estrogen levels influences the neurotransmitter serotonin, SSRI antidepressants that increase serotonin are often helpful for depression and anxiety (which can increase inattention and distractibility).
In summary, treatment of increased symptoms of AD/HD during the menopausal period often consists of some combination of a stimulant medication, an SSRI antidepressant, and sometimes short-term estrogen replacement. There are many other things to do about symptoms related to menopause which can be found on WebMD and on www.healthewomen.com.
It's extremely important for women with AD/HD to find a physician who is not only knowledgeable about AD/HD, but is knowledgeable about AD/HD in women.
Dr. Richard Sogn
Related Topics: WebMD Video: Menopause Myths, WebMD Video: Is it ADHD or Vision Problems?
Technorati Tags: ADD, ADHD, AD/HD, menopause, perimenopause
7 Comments:
I WISH THIS INFORMATION WAS AVILABLE 5 YEARS AGO. I WENT TO SEVERAL PHYSICIANS WHEN I BEGAN ENTERING AN EARLY MENOPAUSE. I KNEW MY BODY, I EXERCISED DAILY, ATE WELL, WAS EDUCATED IN EXERCISE SCIENCE, RAN MARATHONS, DIDNT DRINK USE DRUGS OR SMOKE. I WAS DISCOUNTED, WHEN I SUGGESTED THAT I NEEDED HORMONRES. MY LAST MENSES WAS AT AGE 43. I KNOW NOW THAT MY VERY BALANCED STRUCTURED LIFE WAS MY OWN WAY OF MANAGING UNDIAGNOSED ADHD. UNFORTUNETLY I SLOWLEY STARTED BECOMING MENTALLY ILL. I SELF-MEDICATED WITH DARV ON. I BECAME VERY ADDICTED, I HAVE TWO BEAUTIFUL DAUGHTERS, A WONDERFUL HUSBAND, ALIFE I WORKED SO VERY HARD TO ACHIEVED. I HURT MY FAMILY SPENT 2 YEARS TRYING TO STOP. I WAS BLAMED, BY THE EVERY MEDICAL PERSON I ENCOUNTER. I WAS ONE OF THE MOST HUMILATING EXPERIENCES OF MY LIFE. I LOST MY DIGNITY. THEN ALMOST LOST MY LIFE. I BELIEVED IF I DIED IT WOULD BE BETTER FOR MY LOVED ONES. IT WAS CONTRARY TO EVERYTHING I HAD EVER BELIEVED.FOR MY DAUGHTERS I NEVER STOP ASKING FOR HELP. I FOUND A DOCTOR WHO LISTENED WITHOUT MAKING ME FEEL HUMILATED. NO MOTHER WOULD WILLING CHOOSE A PILL OVER HER CHILDREN IF SHE REALLY HAD THE POWER TO CHOOSE. I WAS GIVEN HORMONE REPLACEMENT, MEDS FOR ADHD, FOLLOWED WEEKLY. I FEEL SO GRATEFUL FOR THIS DOCTOR. MY DAUGHTERS ARE SMILING AND SINGING AGAIN. MY HUSBAND IS PUTTING ON BACK THE WEIGHT HE LOST FROM STRESS. I'M ALMOST AS FUNCTIONING AS I WAS PRIOR TO MENOPAUSE. I'M EXERCISEING DAILY, HANGING OUT WITH MY NOW ALMOST GROWN DAUGHTERS. I'LL NEVER GET BACK THE YEARS I LOST WITH THEM. THAT IS MY BIGGEST REGRET I LOST RESPECT FOR MOST PERSONS IN THE MEDICAL PROFESSION.
I have been trying to find more information regarding this very topic. I am a 32 year old, married, mother of two children. I was diagnosed as being perimenopausal approx. 9yrs. ago. Prior to this I was treated for depression and anxiety from Dec.'99 until the first of 2001,when my psych. as well as myself, felt I no longer needed the meds. Approx. 3 years ago I was diagnosed with ADHD and put on Straterra, which had seemingly no effect on this condition. Eventually I felt that old familiar feeling of hopelessness,wash over me yet again. There just doesn't seem to be an answer to the "what is wrong with me" question that has disrupted my whole life. I once again gave up. Recently I decided to try yet again, to find the answer. I began to research ADHD and was stunned to find I was all bu looking at the mirror image of myself. The problem at this point is that I tried Straterra, as mentioned before,as well as Cymbalta. During the past few months my psychiatrist has tried me on Ritalin, Concerta, and now Adderall. I am becoming increreasingly frustrated, however, as there has been no noticeable effect good, bad or otherwise by anything I have been tried on. Having read your post, gives me some hope that my resistance to the meds could be caused by the fact that I am perimenopausal. If anyone has any information concerning this, it would be greatly appreciated.
Dear cheryl and gcanfield, you should visit dyslexia.com to find out how your symptoms of ADD can be dealt without medication.
There are many articles on the internet available on this topic. The difficult part is where are the physicians?? As a woman in my mid 40s with previously well controlled symptoms on Ritalin and an SSRI, now that perimenopause has started, where can I find a physician who understands this?
I was just asked to participate in a study on ADHD and peri/menopausal women. Shocked, I looked this up to find this site. Interestingly enough, I have depression & anxiety disorder, ADHD, neurological issues, visual spatial issues, 19% processing speed, diabetic, overweight, and my skin just turned papar dry. I feel like a waking talking lunatic. Yes, I share that part about being mentally ill but also being abused for being mentally ill by those who once saw me as competent. I did not do this deliberately. I did not ask for this array of disorders, and I certainly hate every danm drug I am taking. I want me BACK. Now I am being told I have personality disorders--geez, will it ever end.
I don't think so, but I can tell you I cannot walk two feet without putting stuff down at work and it is lost to me, and WORSE, I am surprised when I find it. That is crazy, and it frightens me to death.
I just started progesterone, but they didn't want me to have estrogene as my sister died from breast cancer, and others have had cancers. But now I might just push for estrogen. (I could always cut off my breasts, cause I don't need them when I don't have a intimacy drive). See--- everything ties in together.
If anyone is interested in this study, its startings Aug/07 at Royal Inland Hospital by Teresa Rutledge. 250-374-5111.
Maybe if we participate, we can learn together.
The comments in these postings are, for me, the most succinct and clearly stated of anything I've searched through on the web. Thank you all for giving me a sense of not being alone. The struggle of trying to sort this out alone is so difficult, and I have not yet found a medical or practitioner or an alternative caregiver who will go further than attempting to treat the symptoms, and only some of the symptoms, at that. I am almost 55 years old, and as far back as my memory serves me, I have felt a sense of being "out of step". Last year I was diagnosed ADD with one of the many variations of dyslexia and I'm handling it without medication, in an attempt to minimalize what is within my own power. Now that I'm in perimenopause, I'm having many times of "quiet madness" - loss of mental clarity, not being able to do simple math calculations (checkbook!), nervousness and anxiety - things that never occurred for me before my change in estrogen levels. I'm trying to save my family and entourage from what I am going through in my head, but they suffer because of me.
I've recently read about the link between estrogen and neurotransmitters, which seems a very logical explanation to what I've been going through these past few years. So, to reiterate, it is with gratitude to those of you who have written with frankness and clarity.
I'm giving serious consideration to some sort of hormone therapy, possibly birth control (!) to see if it will ease the effects a bit. Also, regarding the ADD, I'm making some progress in trying to structure my lifestyle, which helps greatly in taking off some of the daily pressure of ADD/dyslexia. I will continue to avoid medications until I have eliminated naturally what is possible, through means of being aware of my actions/reactions, forcing myself to slow down mentally and finding strategies that can reduce the effects of my "weaknesses", i.e. being unorganized; disjointed and racing thoughts; inattention to what's going on in the moment. A little reality check from time to time helps me keep things in perspective.
I figure this is my little cross to bear - it could be a lot worse (and I am far from being an "optimist"). Trying to keep a handle on perspective is something I'm learning to incorporate in my thinking. We can't walk away from our minds and our acts, but we can observe ourselves and look for solutions within ourselves. Maybe there are changes we must make in ourselves, maybe some of it is just too "chemical" to deal with alone. For myself, I won't go back to doctor-prescribed medicine or alternative treatments until I can go as far as I can on my own strength. But I will try to use good judgement, now that I realize just how precious life and health really are.
Good luck to us all!
Thank you for sharing ladies!
After reading your comments, the layers of dark clouds that have been lingering over my head for the past 3 years have finally cleared!!
Amazingly, I owe this clarity and sense of relief to all of "you" who took the time to share your personal struggles with ADD/ADHD and Menopause.
It's ironic that we, the ones with
absent-minded,irritable,depressed,
AND ADD/ADHD" brains, managed to keep "communicating" our symptoms.
Unfortunately,the practice of communicating and sharing (consented) patient information within the medical profession, is an antiquidated, "costly" & "time" consuming practice.
Consequently, the "costly" & "time" consuming practice is passed on to us, the patients. We spend our "time" visiting numerous revolving door style, Dr's offices, who spend 5-10 min. assessing generic questioneers,writing a prescription,and ending the visit saying:"See how this med works for you, if not come back and we'll try something else." Meanwhile, you find yourself visiting "another" revolving door office at the "cost" of our health.
In a "nut"shell (Hee hee hee), keep communicating our symptoms to whomever lends an ear or blog site.
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