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This is why women are being diagnosed with ADHD at perimenopause – and what to look out for
- Amber Middleton
Published: August 26, 2026 at 4:27 PM
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The truth about ADHD diagnoses in later life
Until the mid-nineties, medics thought that ADHD was a condition that just affects children, but it can affect people of all ages. And for a lot of women, we’re now seeing diagnoses picked up during perimenopause. We spoke to Dr Louise Newson, a hormone and menopause expert, about why this is.
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ADHD diagnoses are rising – NHS data shows recorded rates have doubled for males and quadrupled for females in the past 10 or so years.
But, contrary to what some may believe, this doesn’t mean ‘everyone now has it’ – NICE estimates that just 3-4 per cent of adults have ADHD and 5 per cent of children do.
For a long time, ADHD was considered a condition that some children have and grow out of, or even that it only affects boys. But as we’ve come to understand the disorder more in the past 30 or so years, it is clear that actually more women and girls have the condition too, but symptoms can present differently.
NICE noted in 2018 that women and girls are actually under-recognised for it. And now, the NHS is playing catch-up to get women diagnosed correctly.
So why is this? Well, “in women, symptoms are often less visible to other people,” GP, hormone specialist and menopause expert, Dr Louise Newson explains.
We often think of ADHD symptoms as being loud, interrupting, chaotic maybe, but for a lot of women (and some men), symptoms can present as looking organised on the outside but feeling overwhelmed, distracted or exhausted inside.
Among those who are receiving ADHD diagnoses for the first time are women in perimenopause.
Why are ADHD diagnoses among perimenopausal women increasing?
There are several reasons for why women and girls have been far less likely to be diagnosed with ADHD historically. “Clinicians ‘miss’ ADHD due to it being more commonly associated with boys and men,” Dr Newson explains. And so more women are being diagnosed later in life as medical science has evolved and we understand it a little bit more.
“But also the diagnostic criteria for ADHD is still oriented around a male presentation,” she adds.
In the case of some parents, an assessment may only be sought out when their child has been diagnosed themselves as there is a strong genetic component to the condition, Dr Newson points out.
“For some women, seeing their child receive diagnosis, support and treatment can be the prompt for them to seek help for themselves,” Dr Newson says.
Masking is also very common for women and girls who feel a social pressure to fit in, typically more than their male counterparts. This can lead to the condition being hidden for decades.
“Many women learn to hide their difficulties and develop coping strategies over time,” she says. This isn’t a good thing – it can lead to burn out and anxiety. For some women their brains work on overdrive to try and fit in and when they finally snap, they might realise their brain works a little differently.
This can also come to a head during perimenopause and after menopause as symptoms may be exacerbated as hormone levels change.
How do hormone changes in perimenopause affect ADHD?
Changing hormone levels can exacerbate ADHD symptoms.
“During perimenopause [and in the luteal phase of the menstrual cycle], ADHD symptoms can significantly worsen,” Dr Newson says. “If you have not yet been diagnosed with ADHD, hormone changes may trigger ADHD symptoms to become more obvious.”
A few different hormones are at play here. Levels of estradiol, a type of oestrogen, can rise and fall unpredictably and usually remain low after menopause, she says.
Estradiol can help support thinking skills, concentration and attention. The hormonal changes can see disrupted focus, motivation and emotional regulation – all of which are affected by ADHD too.
Progesterone and testosterone levels also decline with age, both of which affect dopamine activity, mood, motivation and general ability to function.
What ADHD symptoms should I look out for?
ADHD symptoms can include: difficulty managing emotions, irritability, trouble focusing, low self-esteem, fatigue, forgetfulness, anxiety, mood changes, sleep problems and changes in libido.
We might also see patterns of harmful coping behaviours, such as drinking too much alcohol, self-harming or developing unhealthy patterns around food and eating.
Many of these overlap with perimenopause and menopause symptoms.
To work out whether your symptoms are perimenopause or ADHD, Dr Newson recommends consulting “a healthcare professional with experience in hormones [who] can help you understand what may be contributing to your symptoms”.
If you do receive hormone treatments, for example HRT for your perimenopause symptoms, Dr Newson suggests keeping a record of your symptoms before and after starting it. This can help you see what improves and what does not. This may also help you decide whether to explore an ADHD assessment.
“Perimenopause changes can make ADHD symptoms feel worse and it is so important women receive the right information and treatment, especially hormone treatments.”
Getting an ADHD diagnosis, if you do seek it out, can be pivotal for women and girls to look out for as when it is missed, it can negatively affect their education, daily life and mental health, she adds.
What to do if you think you may have ADHD
If you think you may be affected by ADHD, seek advice from your GP on how to go about getting an evaluation. In the UK, there’s the Right To Choose pathway where you can pick between certain private clinics for an assessment which is funded by the NHS. You can receive a referral from your GP to the clinic of your choice.
Your GP may be able to offer support on which clinics may be best in your local area but doing your own research is also important and can help you advocate for yourself too.
Dr Newson advises preparing for any appointments by making notes on the challenges you are facing and your symptoms, and how they affect your work and daily life.
“Tell your healthcare professional what matters to you, and your preferences for how best to manage your symptoms,” she adds. “[They] should encourage this shared decision-making process.”
She suggests trying hormonal treatments (HRT) first that can improve perimenopause symptoms such as improving memory, reducing brain fog and improving cognition. Try it for a few months to see if it’s enough to treat your possible ADHD symptoms and keep a detailed symptom diary.
If you do still struggle with ADHD symptoms, a diagnosis can mean you are able to try different medications or further treatments.
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Amber Middleton
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