ADHD and Menopause: Why Symptoms Can Change in Midlife

Short answer: Many women with ADHD say their symptoms get harder to manage around menopause, and clinicians report that some women’s ADHD is “unmasked” at this stage.¹² Changing hormone levels may play a part, but research is still at an early stage.³ Menopause can also cause concentration and memory problems of its own,⁴ so new symptoms in midlife shouldn’t be assumed to be ADHD — a diagnosis still needs evidence that symptoms began in childhood.⁵

What are perimenopause and menopause?

Menopause is when your periods stop for good: you’ve reached it once you’ve gone 12 months without a period.⁴ The average age of menopause is 51, and most Australian women reach it between 45 and 55.⁴

Perimenopause is the lead-up. It begins when your periods become irregular and lasts until 12 months after your final period — usually about 4 to 8 years, somewhere between the ages of 45 and 55.⁶ During this time your ovaries make less oestrogen and progesterone, the hormones that control your menstrual cycle, and these changes bring on perimenopausal symptoms.⁶

Common symptoms include hot flushes and night sweats, sleep problems, difficulty concentrating, forgetfulness, anxiety, and low mood or mood swings.⁴

Can perimenopause make ADHD worse?

Many women with ADHD say it does. In an Australian online survey of 600 women and people assigned female at birth who reported an ADHD diagnosis, most participants felt their ADHD symptoms had worsened during menopause (97.5%) and after having a baby (70.4%).¹²

Clinicians report a similar pattern, and say many women are “unmasked” at menopause, with their ADHD becoming obvious for the first time.²

Hormonal changes seem to matter at other times too. In the same survey, 88.6% of premenopausal participants who weren’t using hormonal therapy noticed their ADHD symptoms change across the menstrual cycle, with most saying they got worse in the second half of the cycle.¹

These findings need careful reading. The survey was a one-off snapshot of how people felt their symptoms had changed, and when the researchers compared ADHD symptom scores between participants at different hormonal life stages, severity was similar across all of them.¹ That doesn’t make women’s experiences any less real. The authors say their findings support what clinicians have seen in practice, and point to a need for more research.¹

Why might hormones affect ADHD?

Sex hormones such as oestrogen interact with several of the brain’s chemical messengers, including dopamine and serotonin, according to animal and human studies.⁷ Dopamine is one of the brain chemicals that stimulant medicines for ADHD act on.⁸ And one study of young women found their ADHD symptoms varied with hormone levels across the menstrual cycle.⁹

How this plays out in perimenopause hasn’t been well studied. A 2025 systematic review found just 11 studies on ADHD symptoms and sex hormones in females — often with small samples — covering puberty, the menstrual cycle and pregnancy.³ It concluded that hormonal changes may be associated with changes in ADHD symptoms, and called for research into other hormonal milestones, including menopause.³

Menopause brain fog or ADHD?

Menopause can bring its own changes in thinking and mood, often described as brain fog. Difficulty concentrating, forgetfulness, sleep problems, anxiety and low mood are all common menopause symptoms⁴ — and they overlap with what many adults with ADHD experience, such as trouble sustaining attention, sleep difficulties and rapid changes in mood.¹⁰

That overlap cuts both ways. New concentration or memory problems in midlife can be part of menopause, and other health problems can cause similar symptoms; an ADHD assessment includes checks for other causes, such as thyroid disease or anaemia.¹¹ On the other hand, Australia’s Senate inquiry into ADHD heard that ADHD in older people is very poorly understood, and that its symptoms can be put down to ageing.¹²

The key question is timing. Under the DSM-5 criteria, several ADHD symptoms must have been present before age 12.¹³ If similar difficulties go back to your school years — even if you found ways to cope — ADHD may be worth looking into. If they’re genuinely new in midlife, something other than ADHD, such as menopause, is more likely to be the cause, and your GP can help work out what’s going on. See also does ADHD get worse with age?

Undiagnosed ADHD and menopause: diagnosis in midlife

Some women first recognise their ADHD in midlife.² ADHD in girls is often missed: many mask their difficulties with compensatory strategies, and they’re more likely to be diagnosed with another condition first, such as anxiety or depression.¹⁴ The Australian ADHD Guideline notes that ADHD may be easier to identify in women during adulthood, when they may become aware of their symptoms and seek an assessment themselves.¹⁵ For more, read undiagnosed ADHD in women and ADHD in women.

A first diagnosis in midlife follows the same rules as any adult ADHD assessment. To diagnose ADHD in adulthood, it needs to be established that your symptoms began in childhood, and you may be asked for school reports.⁵ A full assessment also covers your developmental, mental health and medical history, and includes reports from people who know you well.¹¹ If you don’t have school reports, a parent, sibling or old friend may be able to describe what you were like as a child.

What we don’t know yet

Research on ADHD and menopause is limited. Witnesses at Australia’s 2023 Senate inquiry into ADHD called for research into the potential role of hormone changes, including pregnancy, breastfeeding and menopause.¹² The 2025 systematic review reached a similar conclusion about the need for menopause research.³

Until there’s better evidence, it makes sense to consider both menopause and ADHD rather than assume one explains everything.

What you can do

• See your GP. Talk to your doctor if menopause symptoms are getting in the way of daily life.⁴ Mention changes in focus, memory, mood or sleep, and whether they’re new or long-standing.
• Keep a symptom diary. For a few months, note your concentration, memory, mood and sleep alongside your periods (if you still have them) and symptoms such as hot flushes. Because ADHD symptoms can shift across the menstrual cycle,⁹¹ a diary can reveal patterns that are hard to recall in an appointment.
• Look back at childhood. If ADHD is a possibility, find old school reports or ask a family member what you were like as a child, since an ADHD diagnosis depends on symptoms that started early.⁵
• Consider both. Menopause symptoms have their own treatments — including menopausal hormone therapy, non-hormonal medicines and lifestyle changes — which your GP can talk through with you.⁴ If ADHD is part of the picture too, it needs its own assessment.
• Already diagnosed? Tell your doctor if your ADHD symptoms change. Don’t start, stop or change any medicine without talking to them first.

If low mood or anxiety is getting on top of you, talk to your GP. For 24-hour support, call Beyond Blue on 1300 22 4636 or Lifeline on 13 11 14. If you or someone else is in crisis and needs help now, call 000.¹⁶

Frequently asked questions

Can perimenopause make ADHD worse?

Many women with ADHD say it does, and clinicians describe the same pattern. Research is still at an early stage, though, and it isn’t yet clear how much hormonal change itself affects ADHD symptoms.

Can menopause cause ADHD?

No. ADHD begins in childhood. Menopause may make existing ADHD harder to manage or more noticeable, and it can also cause concentration and memory problems of its own.

Is it menopause brain fog or ADHD?

It can be hard to tell, because difficulty concentrating and forgetfulness are common in menopause. A key question is whether similar difficulties were there in childhood, which is needed for an ADHD diagnosis.

Can you be diagnosed with ADHD during menopause?

Yes. Some women first recognise their ADHD in midlife. The assessment still looks for evidence that symptoms began in childhood, such as school reports.

What should I do if my ADHD symptoms change in perimenopause?

See your GP. Keeping a diary of your focus, mood, sleep and periods for a few months can help your GP work out whether menopause, ADHD or both need attention.

Next steps

Read ADHD in women and how to get an ADHD assessment in Australia, or start with the free ADHD self-assessment.

This article is general information only and is not medical advice. Only a qualified health professional can diagnose ADHD. ADHD GP is a private telehealth clinic staffed by AHPRA-registered Australian GPs.

Book your ADHD assessment

References

1. Osianlis E, Thomas EHX, Li Q, et al. ADHD in females: Survey findings on symptoms across hormonal life stages. Journal of Psychiatric Research. 2026. PubMed PMID 41330200 — Cross-sectional survey of 600 females with ADHD: most perceived worse symptoms at menopause (97.5%) and postpartum (70.4%); 88.6% reported cycle-related changes; measured severity was similar across life stages.
2. RACGP newsGP. How do hormones alter women’s ADHD symptoms?. 2026. www1.racgp.org.au — ADHD symptoms in women often worsen before a period and can be unmasked at menopause.
3. Osianlis E, Thomas EHX, Jenkins LM, et al. ADHD and Sex Hormones in Females: A Systematic Review. Journal of Attention Disorders. 2025. PubMed PMID 40251875 — Systematic review of 11 studies, often small: sex hormones and hormonal phases may be associated with ADHD symptom changes in females; more research is needed, including on menopause.
4. healthdirect (Australian Government). Menopause — symptoms and treatments. 2025. www.healthdirect.gov.au — Menopause is reached after 12 months without a period (average age 51); symptoms include sleep problems, difficulty concentrating, forgetfulness, anxiety and low mood; see a doctor if symptoms affect daily life.
5. healthdirect (Australian Government). Attention deficit hyperactivity disorder (ADHD). 2025. www.healthdirect.gov.au — ADHD is a neurodevelopmental condition that begins in early childhood; around 1 in 20 people in Australia has ADHD; it is partly genetic; an adult diagnosis requires evidence that symptoms began in childhood; learning difficulties can occur alongside it.
6. healthdirect (Australian Government). Perimenopause. 2025. www.healthdirect.gov.au — Perimenopause runs from when periods become irregular until 12 months after the final period, usually between 45 and 55 and for about 4 to 8 years; the ovaries make less oestrogen and progesterone.
7. Barth C, Villringer A, Sacher J. Sex hormones affect neurotransmitters and shape the adult female brain during hormonal transition periods. Frontiers in Neuroscience. 2015. PubMed PMID 25750611 — Review of animal and human studies reporting interactions between sex hormones and brain neurotransmitters, including dopamine and serotonin, with a focus on hormonal transition periods.
8. healthdirect (Australian Government). ADHD medicines — children and adults. 2025. www.healthdirect.gov.au — Stimulants adjust dopamine and noradrenaline; short-acting forms work soon after a dose and long-acting forms last longer; common side effects include reduced appetite, weight loss, anxiety, irritability and insomnia, and stimulants can raise blood pressure; prescribing is tightly controlled and there is a risk of dependence if not taken as prescribed.
9. Roberts B, Eisenlohr-Moul T, Martel MM. Reproductive steroids and ADHD symptoms across the menstrual cycle. Psychoneuroendocrinology. 2018. PubMed PMID 29197795 — ADHD symptoms in young women varied with ovarian hormone levels across the menstrual cycle.
10. Better Health Channel (Victorian Government). ADHD — adults. 2026. www.betterhealth.vic.gov.au — About 7 in 10 children continue to experience ADHD symptoms as adults; treatment can include education, psychological support, coaching, practical strategies and medication.
11. Australian ADHD Professionals Association. Australian ADHD Guideline — summary of recommendations. 2022. adhdguideline.aadpa.com.au — Medication is the most effective treatment for core symptoms, with non-medication treatments adding support (3.1.1); diagnosing clinicians should be registered and trained in ADHD assessment (2.1.1); the diagnosis must be confirmed before starting medication (5.1.2); CBT should be offered to adults (4.2.11); stimulants are first-line for impairing adult ADHD, with heart rate, blood pressure, weight, sleep, mood and anxiety monitored during titration; co-occurring conditions get best-practice treatment.
12. Parliament of Australia — Senate Community Affairs References Committee. Assessment and support services for people with ADHD — Chapter 8. 2023. www.aph.gov.au — Submitters said ADHD in older people is often put down to ageing; witnesses called for research into the role of hormone changes, including pregnancy, breastfeeding and menopause.
13. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). 2013. www.psychiatry.org — Diagnostic criteria for ADHD, including the five-symptom threshold for adults aged 17 and over.
14. Young S, Adamo N, Ásgeirsdóttir BB, et al. Females with ADHD: An expert consensus statement taking a lifespan approach providing guidance for the identification and treatment of attention-deficit/hyperactivity disorder in girls and women. BMC Psychiatry. 2020; 20:404. PubMed PMID 32787804 — Expert consensus: the gap between males and females diagnosed with ADHD is due at least in part to lack of recognition and referral bias in females; many girls with ADHD are likely to remain unidentified and untreated, often mask with compensatory behaviours, and are more likely to first be diagnosed with an internalising or personality disorder, delaying the ADHD diagnosis.
15. Australian ADHD Professionals Association. About ADHD (Australian ADHD Guideline). 2022. adhdguideline.aadpa.com.au — ADHD affects 6–10% of Australian children and 2–6% of adults; heritability 70–80%; symptoms begin before 12 though diagnosis may come later; 60–86% persist into adulthood; inattentive presentation most prevalent; up to 80% of adults have another mental health condition; describes executive-function, brain-maturation and dopamine differences.
16. healthdirect (Australian Government). Mental health helplines. 2025. www.healthdirect.gov.au — Lifeline (13 11 14) offers 24-hour crisis support and Beyond Blue (1300 22 4636) is available 24/7; if someone is in crisis and needs help now, call triple zero (000).

Sources were last checked on 5 October 2026. See all sources used on this site on our Sources page.