In a study of 5,392 women in Iceland, 54% of the women who reported an ADHD diagnosis also reported severe perimenopausal symptoms. Among the women without one, it was 30%.
That ADHD group rests on diagnostic criteria I think fall short for women, people of color, and the LGBTQIA+ community. Even so, that’s a big gap.
Then a UK study of 656 women asked a very similar question and found that an ADHD diagnosis made no clear difference.
So which is it? If you’ve been wondering about ADHD and perimenopause, here’s what both studies found, where they quietly agree, and what nobody has measured yet.
Before we go any further, you should know where I’m standing. I’m a man. I’ll never go through perimenopause, and I’m not going to pretend I know what it feels like from the inside.
What I can do is read the research carefully and report what the women in these studies described. Think of me as the guy in the back row with too many highlighters. A lot of the people who read this blog are women in midlife, and I’ve written before about why ADHD in women is so often misunderstood. This felt like the next chapter of that story.
Key takeaways
- A large study in Iceland found that women who reported an ADHD diagnosis were much more likely to report severe perimenopausal symptoms.
- A UK study found no clear difference by diagnosis, but more ADHD traits still went with more menopausal complaints.
- Each study captured one moment in time, so neither can say perimenopause causes ADHD, or which came first.
- Perimenopause and ADHD share symptoms like memory, focus, and mood changes, and questionnaires can’t fully pull them apart.
- These are group averages from two countries. They can’t predict how your own perimenopause will go.
ADHD and perimenopause: what two studies found
The Iceland study: a harder perimenopause
Perimenopause is the stretch of hormonal change in the years before periods stop for good. The bigger study of it comes from Iceland, where researchers surveyed 5,392 women aged 35 to 55. Of those, 535 reported an ADHD diagnosis.
The women reporting ADHD were nearly twice as likely to report severe symptoms: 54% compared with 30%. The gap showed up in every type of symptom the researchers measured: psychological ones like low mood and irritability, physical ones like hot flashes and sleep trouble, and urogenital ones, meaning bladder and sexual-health symptoms.
Here’s the part that jumps out. Women with ADHD scored highest at ages 35 to 39, while everyone else peaked at 45 to 49.
But the authors flag a catch themselves. Women with ADHD aged 25 to 30, included as a comparison group, scored as high as the 35-to-55 ADHD group did on average. Some items on the scale, like low mood and irritability, aren’t specific to perimenopause, so part of what it picked up may be ADHD itself.
The UK study: no difference by diagnosis
The second study, from a team at King’s College London, surveyed 656 women in the UK aged 45 to 60: 245 who reported an ADHD diagnosis and 411 who didn’t.
Once the researchers corrected for running many comparisons at once, a diagnosis made no clear difference to menopausal symptoms at any stage.
But they also measured ADHD traits on a sliding scale, in everyone. Across all 656 women, diagnosed or not, more ADHD traits went with more menopausal complaints, and memory and concentration were among the strongest links. Inside the diagnosed groups, those links were weaker.
So the two studies split on the headline question. But they agree on something useful: the more ADHD traits a woman reported, the heavier her midlife symptoms tended to be. In both studies, that’s a correlation, not proof of cause.
One more honest note. Both studies counted ADHD by asking women whether they’d been diagnosed, and both scored ADHD traits with a short questionnaire built on the DSM-IV, an older edition of the manual clinicians use to diagnose ADHD. I’m on record that I think the DSM is flawed, especially for women, people of color, and the LGBTQIA+ community. So read “ADHD group” here as “women who reported a diagnosis,” not as the whole picture.
Perimenopause brain fog or ADHD? Why it’s so hard to tell
You’re halfway through a sentence at work and the word you need just isn’t there. Then it happens again at the grocery store, and again on the phone.
Is that perimenopause brain fog, ADHD, or both? These studies can’t tell you, and they say so. Memory, concentration, mood, and irritability show up on both lists, and both research teams (in Iceland and in the UK) note that their questionnaires can’t fully separate the two.
That’s why the 25-to-30 comparison group in Iceland matters. If a perimenopause symptom scale gives high scores to women with ADHD aged 25 to 30, it’s measuring more than perimenopause.
One more thing I noticed in Google’s keyword data. People in the US search “ADHD and perimenopause” somewhere between 1,000 and 10,000 times a month. But of the 20 more specific questions I tested, like “is it ADHD or perimenopause” and “how do I know if it’s ADHD or menopause,” 17 came back with 10 or fewer searches a month, or no data at all.
The big question has words. The everyday version, the one you’d actually type at midnight, mostly doesn’t, which might be part of why answers feel so hard to find.
Estrogen and ADHD: three explanations on the table
Nobody has settled why the Iceland gap exists. Three explanations are in play, and the field hasn’t picked one.
The hormone explanation. The Iceland team points out that estrogen interacts with dopamine, a brain chemical involved in attention, and calls it plausible that shifting hormones make existing ADHD traits louder. They didn’t measure hormones, so it’s a hypothesis.
The measurement explanation. The symptoms overlap so much that questionnaires blur them, and the UK team suggests that women with ADHD may attribute their symptoms differently. That’s their interpretation, not something they tested.
The life-load explanation. In Iceland, the women reporting ADHD also reported more lifetime post-traumatic stress, more smoking, and less formal education. Accounting for those things shrank the gap, but it didn’t erase it.
It may well be some mix of all three.
Who these studies left out
The UK sample was about 90% White, and the Iceland paper didn’t report race or ethnicity. Both relied on women saying whether they’d been diagnosed, so anyone undiagnosed landed in the comparison group.
If you’re a woman of color, these numbers may not describe you well. For a perspective this research mostly missed, my podcast conversation with Vivienne Isebor about empowering Black women with ADHD is worth your time.
What to do if ADHD and perimenopause seem to be overlapping
Quick, necessary note before the practical part. Ky is a mental health advocate speaking from lived experience, not a clinician; nothing here is medical advice.
Neither study tested a fix, so none of these are tested interventions. Each one applies what the research found, and each is marked.
1. Keep a one-month symptom log. One line a day, on paper or in your phone: sleep, focus and memory, mood or irritability, physical symptoms like hot flashes, and your cycle day if you still have one. Those are the same areas both studies measured. If body signals tend to reach you late, I wrote about interoception and body signals that arrive late. An application of what both studies measured.
2. Bring both histories to one appointment. Tell your primary care doctor or gynecologist about ADHD, diagnosed or suspected, and about the changes in your body, in the same visit. With this much overlap, either one is easy to miss when they’re raised separately. An application of the overlap finding.
3. Write the question down before you go. Try: “Could some of this be perimenopause, and could some of it be ADHD?” A written question is harder to lose in a short appointment. An application of the overlap finding.
Timing, treatment, and the people around you
4. Mention timing, even if you feel too young. If things shifted in your late 30s or early 40s, say so. In the Iceland data, the gap between women with and without ADHD was widest at 35 to 39. An application of the age finding.
And if your perimenopause feels pretty ordinary? That’s in the data too. In the UK study, a diagnosis alone didn’t predict a harder time. That’s information about you, not something to explain away.
5. Leave treatment decisions with your prescriber. If anything you already take seems to be working differently, tell the person who prescribed it instead of changing it yourself. For adult ADHD support, CHADD (chadd.org) and ADDA (add.org) are good places to start. And if low mood ever tips into hopelessness, call or text 988 in the US, or call Samaritans on 116 123 in the UK and Ireland. Not from the studies. This one is a care step.
6. If you’re a partner reading this. Believe what they tell you about their own body. Offer to help keep the log, and ask whether they’d like company at the appointment. Not from the studies either. This one is just being a good partner.
Questions about ADHD and perimenopause
Does menopause make ADHD worse?
The research is split. A large Iceland study found higher rates of severe perimenopausal symptoms among women reporting ADHD, while a UK study found no clear difference by diagnosis. Both found that more ADHD traits went with more midlife symptoms.
Is it ADHD or perimenopause brain fog?
It can be either, or both, and symptoms alone won’t sort it out. The two share memory, focus, and mood changes that questionnaires struggle to separate. A clinician who hears both histories in one conversation is in the best position to help.
Can you get ADHD during menopause?
No study shows menopause causing ADHD. The Iceland authors note that ADHD starts in childhood, though they think hormonal change could make existing traits more noticeable. That idea hasn’t been tested over time yet.
Do women with ADHD go through menopause earlier?
Nobody knows yet. In Iceland, symptom scores in the ADHD group peaked at 35 to 39, but women with ADHD aged 25 to 30 scored nearly as high, so the scale may be picking up ADHD itself. Answering this needs a study that follows the same women over time.
The research is still catching up
Two careful studies, two different answers. That isn’t a failure. It’s what an early, under-studied question looks like.
What they agree on is enough to act on: if ADHD traits have been part of your life, the changes of midlife deserve a closer look, not a shrug. And whatever a questionnaire says, you know your body better than anyone else.
I’ll never know this one from the inside. But I can read the room, and the room says this: the science hasn’t caught up to what you’re living, and you don’t have to wait for it to take yourself seriously.
If you’d like the next research read in your inbox, I send one email a week. It’s called The ADHD Weekly Vibe.
Much love. Good vibes. ‐ Ky
Sources
1. Jakobsdóttir Smári, U., Valdimarsdottir, U. A., and colleagues, with senior author Helga Zoega (2025). Perimenopausal symptoms in women with and without ADHD: A population-based cohort study. European Psychiatry, 68(1), e133. DOI: 10.1192/j.eurpsy.2025.10101
2. Chapman, L., Gupta, K., Hunter, M. S., and Dommett, E. J. (2025). Examining the link between ADHD symptoms and menopausal experiences. Journal of Attention Disorders, 29(14), 1263-1277. DOI: 10.1177/10870547251355006
Leave a Reply