Recently, we’ve learned that ADHD affects women in some unexpected ways, often thwarting the ‘typical’ diagnostic criteria of their male counterparts. Often, women are misdiagnosed with PMS, anxiety, or depression. For many women it takes decades to realize that their ongoing struggles with organization, productivity, and forgetfulness that often manifest in self-doubt may not actually be due to a lack of motivation or a character flaw.
Now, couple ADHD with a hormonal imbalance like PCOS, and it can feel like symptoms are even harder to pin down—worse on some days, better on others, but always keeping you from feeling at ease. So do hormones affect ADHD symptoms? Or does PCOS somehow play a role in ADHD? Keep reading to learn how hormones affect ADHD symptoms in women, and what you need to know about the link between ADHD and PCOS.
Discover the benefits of truly balanced hormones alongside a network of like minded women inside the Superwoman Circle.
ADHD manifests differently in women
ADHD is a neurodevelopmental disorder that usually develops in childhood or adolescence. Many women, however, are in their mid-30s before they’re diagnosed, while most men and boys are diagnosed with ADHD in childhood. People with ADHD show patterns of an inability to focus on tasks, trouble with impulse control, and many other symptoms.
But there is no sweeping generalization for what ADHD looks like in everyone—much less for each woman—and that may be why women are more likely to go undiagnosed until much later in life. In women, ADHD is often characterized by disorganization, difficulty regulating emotions, or forgetfulness. So it’s less about hyperactivity and disruptiveness that you typically think of with young boys.
The cause of ADHD is not entirely known, but it’s likely that genetics plays a role. There are also other factors studies have shown that could be a possible cause, like (1):
- Brain injury
- Premature birth
- Exposure to certain toxins and heavy metals during pregnancy
Related: Medical Gaslighting | Why Every Woman Needs to Be Aware
ADHD & PCOS: Are they related?
Women with PCOS have been found to have higher ADHD symptoms based on self-reported tests (2). This could be because both PCOS and ADHD can cause a disruption in hormone levels as well as neurotransmitters like serotonin and dopamine. Women with PCOS have lower levels of serotonin, which is a brain chemical responsible for feelings of happiness (3). We also know that a deficit of serotonin may trigger symptoms of ADHD (4).
PCOS & ADHD are also both associated with (5):
- Increased risk of anxiety & depression
- Disordered eating
- Difficulty concentrating
Both ADHD and PCOS are associated with low levels of neurotransmitters that influence mood & motivation, and these same pathways can also affect hormones.
Related: Battling Brain Fog? Balancing Your Hormones Can Help
PCOS hormones affect ADHD symptoms
If you have PCOS, it’s possible that your hormones may either worsen or improve ADHD symptoms.
Both of the main female reproductive hormones, estrogen and progesterone, impact your behavior based on their influence upon dopamine and serotonin (6). Fluctuations in serotonin or dopamine can then impact learning, memory, emotional regulation, overall cognitive function, and energy.
Women with PCOS often have estrogen dominance, or high estrogen levels in relation to progesterone. While high levels of estrogen may actually raise neurotransmitter levels to support focus and attention, women with PCOS may be extra sensitive to low levels of estrogen. Fluctuating estrogen levels can aggravate the symptoms of ADHD, particularly during your menstrual cycle and perimenopause/menopause.
Low levels of estrogen may increase symptoms of ADHD like:
- Difficulty sleeping
- Trouble concentrating or multitasking
- Irritability or inability to regulate emotions
Learn more: The 8 Best Foods to Fight Estrogen Dominance
PCOS in pregnancy may increase risk of ADHD & anxiety
Some evidence suggests it’s the high testosterone exposure during pregnancy that increases the risk of an ADHD diagnosis, especially in girls. Newer research has compared ADHD diagnosis in children born to mothers who did and did not have PCOS. They found that children born to mothers with PCOS were (7):
- 2.3x more likely to have ADHD than a child whose mother doesn’t have PCOS
- 1.62x more likely to have symptoms of anxiety
- 2.61x more likely to have mild anxiety and related symptoms
If a pregnant mother has PCOS, studies also suggest that her baby may be more likely to have ADHD symptoms in childhood if it’s a boy. In one large study, the prevalence of ADHD symptoms was 11% in boys and 9% in girls born from PCOS mothers (8).
Learn more: 5 Steps to Get Pregnant with PCOS
Lifestyle factors that worsen PCOS & ADHD
The cause of ADHD is still unknown, as is the risk of ADHD in children born to mothers with PCOS, but it’s clear that certain factors influence the extent to which many symptoms manifest. As an integrative practitioner, I help patients identify and address their main lifestyle factors at the root, instead of focusing solely on prescribing medication to treat symptoms.
These factors may worsen symptoms associated with PCOS and ADHD.
Imbalanced blood sugar: Women with PCOS already have issues with insulin resistance, which can then cause blood sugar to dip too low or swing too high. Imbalanced blood sugar can then affect the brain by causing fatigue and a lot of trouble concentrating.
Poor gut health: An unhealthy gut microbiome, or dysbiosis, has been shown to affect behavior and hormone metabolism (9). Beneficial bacteria in the gut are also responsible for manufacturing serotonin which is then sent to the brain. Without the right types of ‘good’ bacteria, you may not be able to make enough serotonin, which can worsen ADHD symptoms.
Inflammatory foods: Gluten, dairy, added sugars, and artificial food dyes may make ADHD symptoms worse in adults and children who are sensitive to them (10).
Not enough sleep: Poor sleep interferes with executive functioning, making it harder to stay on task and regulate emotions. Not getting enough sleep can also throw the foundation of hormone balance out of whack.
A high toxic load: Environmental exposures to heavy metals, microbiome-disrupting pesticides, or other endocrine disruptors may worsen ADHD symptoms and contribute to chronic inflammation.
Nutrient deficiencies: Women who have PCOS might be up to 19 times more likely to have a magnesium deficiency, which can worsen feelings of anxiety, and cause problems with metabolism (11). Low levels of omega-3 fatty acids are also associated with ADHD diagnosis (12).
Chronic stress: Cortisol dysregulation is common in PCOS due to increased HPA activity, which controls the body’s stress response (13). In addition, many women find that ADHD symptoms worsen during stressful periods like a new job, an illness, relationship troubles, etc. This added stress can limit an already overworked executive function system—particularly if cortisol is already high.
What to remember
The root cause of ADHD symptoms in children born to women with PCOS is not yet known, but certain lifestyle factors may worsen the condition. Women with PCOS should take extra care to prioritize sleep, proper nutrition, and stress management in order to manage any potential ADHD symptoms.
Integrative practitioners can work together with patients who have PCOS to identify the root cause of their symptoms and create a personalized health plan. If you’re in need of more support, consider working in-person or virtually with an experienced functional medicine provider.