Does ADHD get worse during menopause?

Very often, for many women, ADHD can get worse during the menopause.

In fact, many women go into perimenopause without even knowing they have ADHD. A March 2026 study from the reputable Additude Magazine quotes how women with ADHD are seen to enter perimenopause earlier than non-ADHD women:

So, women with ADHD can approach perimenopause early, and there will be other changes to consider. Let’s explore them.

When the mask falls off

“I can’t put on a brave face anymore.” This was what one of my clients told me during a therapy session. Other women told me similar. For many women, life had been manageable until perimenopause. Or was it just that they were able to ‘mask’ better?

The mask metaphor can be used to describe what it feels like when women with ADHD are unable to hold it together as the menopause years approach. This can be a confusing and frightening time.

We wear masks for different reasons. A mask when visiting the in-laws. A mask at work. A mask within friendship groups. Sometimes we even wear a mask in our own homes. The mask enables women to fit in. But it can come at a cost, especially during perimenopause.

Masking hides our true selves. Women have shared with me that they feel unable to be themselves. If they were themselves, they might appear ‘unhinged’ or unlikable. This leads to people pleasing and, when high anxiety is involved, fawning. Fawning is a strong ‘flight’ response and is the ultimate people-pleasing trait. Continued masking is exhausting, too, with issues arising throughout the body and mind. 

During perimenopause, hormones begin to fluctuate, such as oestrogen, progesterone and testosterone. Women often cannot control these fluctuations, and this makes it increasingly difficult to mask menopause symptoms. So, the mask falls off. Now, a woman is left feeling exposed and vulnerable.

Unravelling during perimenopause

“I started to completely unravel, and I didn’t know why.” A quote from another therapy client. Why does it appear that some women ‘sail’ through menopause and others don’t?

Some women have ADHD, and they might not even know it. Perimenopause can be a time when women finally understand that their symptoms (or traits) are the reason their mental health has become so much more of a challenge. 

Menopause symptoms and ADHD traits often overlap. It can be tricky to know what is menopause and what is ADHD. This can lead to the feeling of ‘unravelling’. In a mental health context, unravelling refers to a state of emotional overwhelm, exhaustion, or a breakdown in one's ability to cope with stress, anxiety, or change.

This is where counselling can really help, especially when it is with a counsellor who has gone through the menopause and also has ADHD. We are not there to diagnose. We can support women and signpost them to the best services that meet their needs.

How can counselling help an ADHD woman approaching menopause?

Validation

The one thing I hear time and time again is when women tell me they feel misunderstood and not heard or seen.  Feeling invisible is common. For a woman going through so much change, being able to sit with a counsellor who actively listens and validates can be the most supportive experience.

Listening without fixing

We all need something different from counselling. The one thing we all tend to want is to feel heard. Really heard. When ADHD is in the picture – diagnosed, undiagnosed or not discovered yet – it’s the story that is important. The life story.

Women with ADHD may have had Adverse Childhood Experiences (ACEs). This can include trauma, abuse, bullying, humiliation and a chaotic home life. There may have been difficulties throughout the education years and at work. Friendships and intimate relationships could have been problematic. Family relationships as well.

A counsellor needs to be able to hear all of this without interruption. We women with ADHD often talk about many issues and switch from topic to topic at speed. My clients often apologise for this. I reassure them quickly that they don’t need to. I understand. I have ADHD too. I am happy to share this during therapy, and the fact that I have gone through menopause. It builds empathy and understanding.

When someone has been able to fully get out what is on their mind, the relief is there to see. Only when this has happened can any goal setting or ideas for change and improvement be discussed. 

What topics are discussed during counselling?

These are some of the women I communicated with when talking about the menopause experience. Their stories show the range of topics that counsellors are able to help with. Their experiences might be very relatable. Note that their names have been changed.

Susan: “My menopause journey started as soon as my parents died. I was in shock. Brain fog. Overwhelmed. Having to work even harder because I rent and am self-employed. Our 23-year-old still lives with me, which is great. But have to say, becoming a widower at 48 has been very, very tough. I work every day and am burnt out. However, I feel strong, so all is OK.”

Gen: “My mum has dementia, and I have a daughter who has very poor mental health. I work full-time and have terrible hot flushes, sleeplessness and memory fog. I want to run away now more than I ever did in my youth.”

Karen: “I was 50 in 2017. My mum had just died, and my dad was in remission from cancer. I must have been perimenopausal, but with so much to deal with, I blamed it on the other stuff. I had never heard of perimenopause. Was just waiting for my periods to stop and be in the menopause. Shows how much I didn't know.”

Amy: “I’m autistic, in burnout for 2.5 years and housebound, living upstairs. I hit menopause as well. Multiple losses. I have a child and horrendous guilt.”

Charlie: “The double-hitting of being a neurodivergent working mum of anxious neurodivergent pre-teens during the pandemic pushed me into burnout.”

Support for women going through the menopause

These stories are real. It’s incredible to see how much women go through, often with little support.

The onset of perimenopause, coupled with ADHD, can be complex. As counsellors, there can be a lot to unpick. Being human, with emotional issues anyone can experience, having ADHD and understanding the unique traits that each individual has to deal with and going through perimenopause, then menopause (when periods have stopped for one year). 

ADHD women are living in a world where they are in the minority. It’s estimated that around 15–20% of people are neurodivergent. ADHD women have had to constantly fit into a world that often doesn’t feel they belong in. And then add menopause.

You deserve to be heard and understood. Menopause can mean the beginning of something amazing. ADHD has many elements that are incredible. Finding a counsellor who can help meet you where you are now can mean a very different experience.

So, does ADHD get worse with menopause? Yes, it can do, but there are good counsellors out there who want to support you and help you make the most of these two natural experiences many women go through, every step of the way.