Finding the link between Dopamine, Oestrogen & ADHD
Dopamine & ADHD
Even though there are different forms of ADHD (the impulsive/hyperactive type, the inattentive/distractable type and the combined type), science agrees that for all three types the lack of the neurotransmitter dopamine is the root cause of the relevant symptoms. Dopamine plays a central role in regulating motivation and controls emotional, mental and motor reactions. It is also considered a “reward system” that ensures that we receive the right amount of “feel-good” emotions at the right time.
Generally speaking, when dopamine levels are well regulated, alertness, focus, and motivation come easily. With ADHD, the major problem for the executive and cognitive dysfunction is the lack of dopamine (not in production, but in supply to the relevant receptors). Therefore, most women with ADHD will find that alertness, focus and motivation do not come as easily as for neurotypical women.
The Role of Oestrogen
Oestrogen, the female reproductive & sexual hormone, regulates key neurotransmitters in the brain like serotonin (mood), acetylcholine (memory), as well as dopamine (executive functioning, motivation).
For the body to produce dopamine, one of the key hormones is oestrogen. Declining oestrogen might lead to less dopamine production. For a woman with ADHD, it could be concluded that less dopamine production causes even less dopamine supply to the relevant receptors.
Dopamine & Oestrogen
In 2001, the Yale Medicine Magazin published an article on the topic of "Estrogen deprivation associated with loss of dopamine cells", in which D. Eugene Redmond Jr., M.D., professor of psychiatry and neurosurgery and director of the Neural Transplantation and Regeneration Program highlights that “...without oestrogen, more than 30 percent of all the dopamine neurons disappeared in a major area of the brain that produces the neurotransmitter dopamine”.
In 2020, an article on the topic of "The Role of Estrogen Receptors and Their Signaling across Psychiatric Disorders" was published in the "International Journal of Molecular Sciences". Amongst their findings, the following seem crucial when thinking about a link between Oestrogen and ADHD:
👉 "Estrogens are not only crucial in sexual maturation and reproduction but are also highly involved in a wide range of brain functions, such as cognition, memory, neurodevelopment, and neuroplasticity."
👉 "Extensive literature supports estrogen and estrogen-signaling disruptions across the psychiatric illnesses of schizophrenia, bipolar disorder, MDD, ASD, ADHD, GAD, PTSD, eating disorders, and substance use disorders."
👉 "Estrogen and estrogen signaling are disrupted in multiple psychiatric disorders, with varying degrees of disruptions affecting different downstream cell cascades."
Even though no major study and research has yet clearly confirmed conclusive evidence of links between oestrogen - dopamine - ADHD, it can be assumed that women with ADHD might notice differences and signifcant changes of their ADHD symptoms when it comes to executive and cognitive functions, linked to their current level of oestrogen. These changes would be noticable during their monthly menstrual cycle, as well as pregnancy, perimenopause and menopause. In all of these phases, the rise and fall of the oestrogen level seem to have a direct impact on dopamine production, which plays a key role in supporting our working memory, motivation and ability to stay focused.
The Menstrual Cycle - Oestrogen vs. Dopamin & ADHD
During the menstrual cycle, the rise of the oestrogen level during the first phase of the cycle is often found to improve the mood and the executive functioning, as well as hyperactive and impulsive behaviour. In the second phase, leading up to menstruation, the oestrogen level decreases and the progesterone level rises, which women often experience as a time of emotional instability, brain fog, PMS, etc..
Some more recent researches suggest that ADHD symptoms and their intensity are directly influenced by these hormonal shifts. If you are a woman with ADHD, it can be worth tracking your ADHD symptoms along several cycles to see if and how you and your ADHD symptoms feel during those different phases. You might find that, depending on which phase of your cycle your in, your ADHD symptoms like mood swings, emotional regulation, cognitive functions and attention span get noticeably worse or better. And although you might not be able to change this at it’s core, it will give you some better insights and understanding for the challenges you are facing, which again can help you to work with your body rather than against it, as well as helping you to find suitable solutions and support during more difficult times of your cycle.
PMS, PMDD and PPD
Although there don't seem to be any major conclusive studies about the link between ADHD and conditions like PMS (premenstrual syndrome), PMDD (premenstrual dysphoric disorder) and PPD (postpartum depression), recent surveys by the international organisation ADDtude have given clear indications that -> not only are women with ADHD generally more likely to experience these conditions throughout their life time, but also that they often experience them on a more intense and severe level then neurotypical women.
❗If you are experiencing severe PMS or PMDD, speaking to a health professional can be beneficial to find out what options there are to ease the symptoms and agony.
The Perimenopause / Menopause - Oestrogen vs. Dopamine & ADHD
During perimenopause, oestrogen and progesterone levels decline, exacerbating ADHD symptoms. Different surveys indicate that 50% to 70% of women with ADHD notice their ADHD symptoms significantly getting worse once they transition into perimenopause.
🤨 Again, this indication shows that a link between the oestrogen-dopamine should be incorporated in further studies and must be taken into consideration for treating symptoms of women with ADHD during their perimenopause phase.
❗If you are a woman with ADHD going through the perimenopause, taking into account that the decline of oestrogen and progesterone might be having a direct impact on your ADHD symptoms might be beneficial when looking for support.
It can also help to explain the situation to your spouse, children, parents, colleagues and friends. Also, when speaking to a medical professional about the perimenopause, ensure to inform them about your ADHD condition and be clear on the fact that they need to take this into account when offering treatment.
The urgent Need for more Research
Unfortunately, there are not yet any long-term studies on the relationship between hormonal fluctuations and ADHD symptom severity over the lifetime of women.
Additionally, there is a lack of definitive research on how the female hormone system affects ADHD in women. During her 2023 ADDitude webinar titled “Hormonal Fluctuations and ADHD”, Ph.D. Jeanette Wasserstein clearly emphasized the need for more research on the impact of sex hormones on women’s health, particularly regarding cognition and ADHD, stating that “we need recognition that the relationship between hormones and cognition is an important issue in women’s health…”
Also, there is still no common understanding of how fluctuations in oestrogen, progesterone, and other hormones throughout a woman’s life impact ADHD and its associated neurotransmitters like dopamine, serotonin, noradrenalin and others.
It is therefore of great importance to continue research activities, especially to answer questions (amongst many others) such as e.g.:
🤨 how can we incorporate the information about the menstrual cycle in the diagnosis and treatment of ADHD in women?
🤨what are the reasons for women with ADHD to be more susceptible to severe PMS/PMDD symptoms, and what treatment options should be considered?
🤨 how are the symptoms of perimenopause & ADHD connected?
🤨 how can we reduce the risk of postpartum depression and anxiety in women with ADHD?
It's All About You
Until we receive conclusive and comprehensive information about the role of women's hormonal fluctuation and it's influence on our ADHD, the following strategies can support you with your struggles:
Obtaining a professional diagnosis for ADHD, PMS, PMDD, PPD, perimenopause, menopause - knowing what you are dealing with is the safest way to find appropriate and effective treatment and coping strategies.
Social network support - exchanging experiences and seeing that you are not the only one struggling can support your mental health and find out about many different options on how to tackle your issues.
Professional help – therapy and coaching can be very helpful when it becomes really difficult. Many therapists and coaches offer online support, so even if you have a very busy schedule or can’t go for a appointment, there is always an opportunity to get professional help from the comfort of your home.
If you are looking for support, don't hesitate to reach out to us, we are happy to help you finding a solution for whatever your current situation. You can find us by e-mail at welcome@its-all-about-you.ch, or use our contact form on our website.
We look forward to meeting you and your ADHD 😊!
#adhd #womenandadhd #adhdinwomen #womenwithadhd #adhdcoaching #adhdsupport #adhdstruggles #thestruggleisreal #adhdvibes #successfulwithadhd #loveyouradhd
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