I Thought Menopause Was to Blame, But It Was Undiagnosed ADHD

Hot flashes and sleepless nights aren’t the only challenges midlife women face. For a growing number, menopause is shining a light on something that’s been there all along: undiagnosed ADHD. Many women report an increase in ADHD symptoms around their 40s and 50s, with surveys showing up to 94% experiencing worsening symptoms during perimenopause and menopause.

Take Clare, 49, from London. For years she prided herself on running a busy household like clockwork. But when perimenopause set in, everything began to slip. She forgot appointments, lost her train of thought mid-meeting, and lived in a constant state of frazzle. “I thought it was just menopause brain fog,” she tells CrunchyTales. “When I was finally assessed for ADHD, it felt like someone had handed me the missing piece of the puzzle.”

Mary, 52, from Las Vegas, had a similar experience. When her youngest left for university, she says she felt as though she was falling apart. “I couldn’t keep up with emails, I cried at the smallest things, and I felt like a terrible wife and mother,” she recalls. “It turned out it wasn’t just hormones. I had been living with undiagnosed ADHD my whole life.”

Menopause And ADHD: When Estrogen Shifts, So Does the Brain

These stories are becoming increasingly common.  Research shows women are two to three times more likely than men to receive an ADHD diagnosis later in life, often right as they enter perimenopause or menopause.

This isn’t coincidence. As estrogen dips and hormones fluctuate, the brain’s delicate balance shifts. Suddenly, the coping strategies that once kept everything afloat begin to unravel, leaving women grappling with brain fog, memory lapses, and emotional overwhelm.

Unfortunately, too often, these struggles are written off as “just menopause,” when in reality they may point to a deeper, overlooked story.

“Hormonal changes during perimenopause and menopause can intensify ADHD symptoms in women. This may be due to changing estrogen levels,” explains to CrunchyTales Amy Dykstra, MEd, Registered Psychologist at Bluebird Psychology in Calgary. “Estrogen helps regulate neurotransmitters, including dopamine, and we know that dopamine plays a crucial role in attention and focus. Women may find that they experience greater difficulty concentrating, increased mood swings, and more frequent memory lapses.”

Dykstra adds that many women with ADHD report feeling more irritable or anxious during this time, find it harder to maintain routines, and struggle with sleep, all of which further exacerbate ADHD symptoms.

Randall Turner, DO, Medical Director at Able2Change Recovery, offers a similar perspective: “Estrogen supports dopamine and norepinephrine signaling in the prefrontal cortex, the brain circuitry that powers focus, working memory, and impulse control. When estrogen fluctuates (perimenopause) or declines (menopause), it can magnify core ADHD domains like focus, working memory, and emotional regulation.”

This helps explain why some women who never met the criteria for an ADHD diagnosis earlier in life suddenly experience noticeable cognitive changes during menopause. “Many women experience worsening or more variable ADHD symptoms in perimenopause with steadier cognitive bandwidth post-menopause,” Turner says, though he notes that research is still emerging. “Common challenges include hormonal changes intensifying ADHD symptoms, brain fog worsening cognitive issues, mood swings due to overlapping ADHD and menopause effects, sleep problems, and self-esteem and identity struggles as symptoms become harder to manage,” notes Dr. Turner.

The Lost Generation of Women With Undiagnosed ADHD

Part of the problem lies in how ADHD has historically been defined and diagnosed. Early diagnostic criteria, first recognized in the 1980s,were largely based on how ADHD presented in boys: hyperactivity, classroom disruption, and poor academic performance. Girls, meanwhile, often exhibit more subtle, internalized symptoms like daydreaming, emotional sensitivity, or difficulty with organization.

“Since women are typically diagnosed with Inattentive or Combined type ADHD they don’t tend to present the outward physical symptoms of ADHD,” explains Kristin Koliha, LICSW, a licensed therapist and coach specializing in late-diagnosed women. “Plus, women are more tuned in to social norms and will often internalize the hyperactive expression of ADHD.”

This masking often begins in childhood and continues for decades. Women develop elaborate coping strategies: over-preparing, over-scheduling, over-working,  that help them “pass” as neurotypical. But as responsibilities grow and hormonal shifts occur, those strategies become harder to sustain.

“What I hear from many of my clients is that they have carried diagnoses like anxiety or depression for years. When we finally assess for ADHD, which often shows up during perimenopause or menopause, they feel truly understood. They have been trying to hold everything together for so long and it works until one day it does not,” says Koliha. The emotional toll is profound. “When clients receive an ADHD diagnosis in midlife, our work often focuses on three main areas: education and tools to strengthen executive functioning, strategies to support emotional regulation, and grief work- says Koliha-. Many women naturally reflect on how life might have been different if they had understood their ADHD earlier.”

Midlife Pressures, Amplified ADHD Symptoms

The cognitive and emotional challenges of ADHD don’t happen in a vacuum. They collide with one of the busiest chapters of a woman’s life.

“Women in midlife are unbelievably busy managing their lives, work, caring for children and often aging parents. They do not have the time to care for themselves, and this becomes the first major challenge women face in managing ADHD symptoms,” says Corinne Arlès, LPC-S, LCAT, a licensed therapist specializing in women’s mental health.

In this context, even minor ADHD symptoms can snowball. Brain fog can undermine productivity. Emotional dysregulation can strain relationships. Sleep problems can erode resilience. And as symptoms become harder to manage, self-esteem often takes a hit.

What You Can Do: Diagnosis, Treatment, and Daily Strategies

The first step, experts agree, is getting clarity. “If you don’t already have a diagnosis, it’s important to meet with your family doctor or a psychologist to get clarity on your symptoms,” advises Dykstra. “Medication is currently one of the most effective tools we have in treating ADHD. Working with a therapist who offers Cognitive Behavioral Therapy (CBT) or an ADHD coach can also be helpful.”

Standard ADHD treatments such as stimulant medications are generally effective, while some women also benefit from hormone replacement therapy, indicating a complex interaction between hormonal status and ADHD symptom management.

Therapeutic support plays a major role, too. Arlès incorporates CBT techniques like cognitive restructuring and attention tracking, alongside mindfulness, nutrition, exercise, and even art therapy. “Once the brain transitions through menopause and is supported either through nutrition, hormones, or all of the above, women’s symptoms appear to decrease,” she says.

Lifestyle changes are also powerful tools. Experts recommend:

• Regular exercise to support dopamine production and mood regulation.
• A balanced diet rich in protein, fiber, and omega-3s to fuel brain health.
• Mindfulness practices like yoga and meditation to improve focus and emotional balance.
• Sleep prioritization, as quality rest is essential for managing ADHD.

Practical habit-building strategies can help, too. “Motivation is fluctuating and not reliable,” says Stephanie Lewis, LICSW, Executive Director at Epiphany Wellness. “Without systems and cues, people rely too heavily on ‘feeling motivated,’ which isn’t sustainable.” She suggests tactics like “if-then” planning (“If it’s 7am, then I put on my shoes”) and attaching new habits to existing routines.

A New Chapter — With Compassion and Clarity

“The most important message is this: ADHD does not start in menopause — but menopause can make it visible”.As Koliha emphasizes: “ADHD is a neurodevelopmental disorder, which means it has always been present. What often happens in perimenopause or menopause is that the brain and body are under new stressors, and the strategies women have used to cope no longer work as well.”

For many women, this is both a crisis and an opportunity: a chance to finally understand themselves and their brains with compassion and clarity. The diagnosis, far from being a label, can be liberating. It opens the door to effective treatment, practical support, and a renewed sense of agency.

“Navigating ADHD in perimenopause and menopause can be more challenging but is not impossible,” says Dykstra. “With the right support — medical, psychological, and lifestyle — women can not only manage their symptoms but thrive in this stage of life.”

If you’re in midlife and noticing new struggles with focus, memory, mood, or motivation, it’s worth exploring whether ADHD could be part of the picture. You are not alone — and it’s never too late to understand your mind and reclaim your well-being.

ADHD doesn’t start in menopause, but menopause can make it impossible to ignore. For many women, that turning point is painful, but also profoundly liberating.

“The most important message is that women are not broken,” says Dykstra. “With the right support — medical, psychological, and lifestyle — they can thrive in this stage of life.”

For Clare, that’s exactly what happened. “My diagnosis didn’t fix everything overnight, but it gave me compassion for myself. Now I understand my brain. I don’t feel like I’m failing anymore — I feel like I’m finally starting to live.”

This article is for informational purposes only and is not a substitute for professional medical advice. If you suspect you may have ADHD or are struggling with menopause-related changes, consult your healthcare provider.