ADHD and PMDD: Why Symptoms Can Get Worse Before Your Period

Short answer: PMDD (premenstrual dysphoric disorder) is a severe form of premenstrual syndrome that causes intense mood symptoms in the second half of the menstrual cycle.¹ One study found PMDD symptoms were more common in women with ADHD than in the general population,² and many women with ADHD say their ADHD symptoms also change across the cycle, often getting worse before a period.³⁴ The research is still limited,⁵ so a good first step is to record your symptoms over at least two cycles and show your doctor.¹

What is PMDD?

PMDD stands for premenstrual dysphoric disorder. It’s a severe form of premenstrual syndrome (PMS) that affects about 8 in every 100 women.¹ Compared with PMS, it causes more intense mood-related symptoms, such as anxiety, depression, insomnia, thoughts of self-harm and suicidal thoughts.¹ As with PMS, the symptoms come in the second half of the menstrual cycle, in the lead-up to a period.¹

PMDD can affect women and people who menstruate, and it’s a real, treatable condition, not something you should just put up with.

Is PMDD more common in people with ADHD?

It may be. A 2021 study of 209 women with ADHD, aged 18 to 71, found that symptoms of PMDD were more common than in the general population, and so were symptoms of postpartum depression (depression after having a baby).² It’s a single study, though, so it can’t tell us exactly how many women with ADHD have PMDD.

The finding fits a wider pattern. Up to 80% of adults with ADHD have at least one other mental health condition, such as a depressive or anxiety disorder.⁶ When conditions overlap, their symptoms can be hard to untangle,⁷ and one condition can be missed when the other is present.⁸ If you’ve been diagnosed with PMDD and wonder whether ADHD is also part of the picture, read about undiagnosed ADHD in women.

Can ADHD symptoms get worse before your period?

For many women, yes. An article in the RACGP’s newsGP notes that ADHD symptoms in women often worsen before a period.⁴ Here’s what research has found so far:

• Hormones and symptoms: a study of young women found their ADHD symptoms varied with ovarian hormone levels across the menstrual cycle.⁹
• What women report: in an Australian survey of 600 females with ADHD, 88.6% of those who were premenopausal and not using hormonal therapy said their symptoms changed across the menstrual cycle.³ The survey relied on self-report at a single point in time.
• The bigger picture: a 2025 systematic review found just 11 studies on sex hormones and ADHD symptoms in females, often with small samples. It concluded that hormonal phases may be associated with changes in ADHD symptoms, and that more research is needed.⁵

So the link is commonly reported and plausible, but not yet well understood. In everyday terms, you might find your usual ADHD difficulties, such as distractibility or forgetfulness, harder to manage at certain points in your cycle.

This isn’t the same as PMDD, which is a separate condition centred on intense mood symptoms. You can have cycle-related changes in ADHD symptoms, PMDD, or both.

Other hormonal life stages

Other life stages that bring big hormonal changes are worth knowing about too. A Swedish study found that 16.8% of women with ADHD were diagnosed with postpartum depression, about 5 times the rate in other women, and 24.9% with postpartum anxiety.¹⁰ In the Australian survey, most participants perceived their ADHD symptoms as worse after having a baby (70.4%) and at menopause (97.5%), although the symptom severity measured in the survey was similar across life stages.³ ADHD symptoms can also become more noticeable, or be “unmasked”, at menopause⁴ — see ADHD and menopause.

If you’ve recently had a baby and you’re struggling with low mood or anxiety, talk to your GP.

PMDD vs ADHD: telling emotional ups and downs apart

Mood is where PMDD and ADHD can be hardest to separate. Emotion regulation difficulties are common in adults with ADHD,⁶ and a 2020 meta-analysis found emotion dysregulation was much more common in adults with ADHD than in adults without it, with emotional lability (quick, intense shifts in mood) showing the biggest difference.¹¹

Timing is the main clue:

• PMDD: symptoms are tied to the menstrual cycle and appear in its second half.¹
• ADHD-related emotions: these ups and downs are common in adults with ADHD generally, so they can turn up at any time of the month.
• ADHD itself: it begins in early childhood,¹² so core symptoms such as distractibility and restlessness are a long-standing pattern, not something that only appears before a period.

Sleep can blur the picture further. Insomnia is one of the symptoms PMDD can cause,¹ and studies report insomnia in 43–80% of adults with ADHD.¹³ Not getting enough sleep can, in turn, affect attention, memory and emotional regulation.¹⁴

If low mood or anxiety is there most of the time rather than following your cycle, tell your doctor, as it needs attention in its own right; see ADHD and depression. For more on big feelings, read about ADHD and emotional dysregulation and ADHD rage and anger.

Track your symptoms for at least two cycles

The healthdirect website suggests showing your doctor a record of your symptoms over at least 2 menstrual cycles, and notes that the International Association for Premenstrual Disorders (IAPMD) has a self-screening tool.¹ Keep it simple. Each day, note:

• your cycle day (day 1 is the first day of your period)
• your mood, including anxiety, low mood or irritability, and how strong it felt (for example, 0 to 10)
• how you slept
• your usual ADHD symptoms, such as focus, forgetfulness and restlessness
• how much your symptoms got in the way of work, study or relationships
• any thoughts of self-harm or suicide, and if you have them, get support straight away (see below)

A notes app, a paper diary or a period-tracking app all work. After a couple of cycles, look at whether your symptoms cluster in the second half of your cycle or are there all month. Once you can see a pattern, it’s easier to plan around it, for example by saving demanding tasks for other times of the month.

See a doctor if your symptoms are affecting your daily life;¹ you can keep tracking while you wait for your appointment.

Treatment options

For PMDD, treatments include antidepressant medicines, hormonal medicines and cognitive behavioural therapy (CBT).¹ Your doctor can talk you through the options and what might suit you.

ADHD is treated separately. The Australian ADHD Guideline recommends that co-occurring conditions get the best-practice treatment for that condition,¹⁵ and when conditions occur together, guidelines generally advise treating the most impairing one first.⁷ For an overview of ADHD medicines, see ADHD medication in Australia.

CBT appears on both lists: it’s one of the treatments for PMDD, and it can help adults with ADHD develop strategies and skills.¹⁶¹⁵

If you take ADHD medicine and notice your symptoms change across your cycle, take your symptom record to your doctor. Don’t start, stop or change any medicine without talking to your doctor or pharmacist.

Getting support

PMDD can bring thoughts of self-harm or suicide.¹ If you’re having thoughts like these, or you’re struggling to cope, please reach out now. Call Lifeline on 13 11 14 (24-hour crisis support) or Beyond Blue on 1300 22 4636 (24/7).¹⁷ You can also text Lifeline on 0477 13 11 14.¹⁸ If you or someone else is in crisis and needs help now, call 000.¹⁷¹⁸

Frequently asked questions

Is PMDD more common in women with ADHD?

It may be. A 2021 study found PMDD symptoms were more common in women with ADHD than in the general population. But that was one study, so how many women with ADHD have PMDD isn’t known for sure.

Why is my ADHD worse before my period?

Many women with ADHD notice their symptoms change across the menstrual cycle, often getting worse before a period, and one study linked these changes to shifting hormone levels. Research is still limited, so tracking your own pattern is a good place to start.

How can I tell PMDD from ADHD mood swings?

Timing is the main clue. PMDD symptoms appear in the second half of the menstrual cycle, while emotional ups and downs linked to ADHD can turn up at any time of the month. A symptom diary kept over at least two cycles helps your doctor see the pattern.

How is PMDD treated?

Options include cognitive behavioural therapy (CBT), antidepressant medicines and hormonal medicines. ADHD is treated separately, so talk to your doctor about both, and don’t change any medicine without advice from your doctor or pharmacist.

Can PMDD cause suicidal thoughts?

Yes, it can. If you have thoughts of self-harm or suicide, call Lifeline on 13 11 14 or Beyond Blue on 1300 22 4636 at any time, or call 000 in an emergency.

Next steps

Read ADHD in women and ADHD and menopause, 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. healthdirect (Australian Government). Premenstrual syndrome (PMS). 2025. www.healthdirect.gov.au — PMDD is a severe form of PMS affecting about 8 in 100 women, with intense mood symptoms; a symptom record over at least 2 cycles helps diagnosis; treatments include antidepressant and hormonal medicines and CBT.
2. Dorani F, Bijlenga D, Beekman ATF, et al. Prevalence of hormone-related mood disorder symptoms in women with ADHD. Journal of Psychiatric Research. 2021. PubMed PMID 33302160 — In 209 women with ADHD, symptoms of premenstrual dysphoric disorder (PMDD) and postpartum depression were more common than in the general population.
3. 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.
4. 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.
5. 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.
6. 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, such as depressive, bipolar, anxiety or substance use disorders, and cluster B and C personality disorders are more common; describes executive-function difficulties (working memory, planning, sustained attention, inhibitory control), brain-maturation and dopamine differences.
7. Katzman MA, Bilkey TS, Chokka PR, et al. Adult ADHD and comorbid disorders: clinical implications of a dimensional approach. BMC Psychiatry. 2017. PubMed PMID 28830387 — Adult ADHD often co-occurs with mood and anxiety disorders, with strong familial and neurobiological links; overlapping symptoms complicate diagnosis; guidelines advise treating the most impairing condition first.
8. Australian ADHD Professionals Association. Australian ADHD Guideline — Chapter 2: diagnosis. 2022. adhdguideline.aadpa.com.au — Clinicians should know which conditions commonly co-occur with ADHD, as a co-occurring condition may result in a missed ADHD diagnosis, or a missed co-occurring condition when ADHD symptoms are present.
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. Andersson A, Garcia-Argibay M, Viktorin A, et al. Depression and anxiety disorders during the postpartum period in women diagnosed with attention deficit hyperactivity disorder. Journal of Affective Disorders. 2023. PubMed PMID 36681302 — 16.8% of women with ADHD were diagnosed with postpartum depression (prevalence ratio 5.09) and 24.9% with postpartum anxiety (prevalence ratio 5.41).
11. Beheshti A, Chavanon ML, Christiansen H. Emotion dysregulation in adults with attention deficit hyperactivity disorder: a meta-analysis. BMC Psychiatry. 2020. PubMed PMID 32164655 — Meta-analysis of 13 studies (2,535 participants): adults with ADHD had much greater emotion dysregulation than controls (Hedges’ g 1.17), with emotional lability the largest effect (g 1.20).
12. 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.
13. Wynchank D, Bijlenga D, Beekman AT, Kooij JJS, Penninx BW. Adult Attention-Deficit/Hyperactivity Disorder (ADHD) and Insomnia: an Update of the Literature. Current Psychiatry Reports. 2017. PubMed PMID 29086065 — Studies report insomnia in 43–80% of adults with ADHD.
14. Better Health Channel (Victorian Government). Sleep deprivation. 2014. www.betterhealth.vic.gov.au — Insufficient sleep can impair memory, attention, emotional regulation and the speed of processing information; even short-term sleep deprivation can impair these functions.
15. 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.
16. healthdirect (Australian Government). Treatment for ADHD. 2025. www.healthdirect.gov.au — Stimulants are usually the first medicine prescribed; non-stimulant medicines are available for people who experience side effects; CBT can help develop strategies and skills.
17. 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).
18. Lifeline Australia. Lifeline home page. 2026. www.lifeline.org.au — Lifeline offers 24-hour crisis support on 13 11 14 (or text 0477 13 11 14); if life is in danger, call Triple Zero (000).

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