Forget hot flashes: This is the sign that can change everything you thought about menopause

There are many things that are part of our lives. So is female menopause – a natural stage in a woman’s life, one that every woman goes through. It usually comes with physical and emotional changes that can shake up daily life. However, when ADHD is added to the equation for that woman – diagnosed or not – the picture can become much more complex. Studies link the severity of certain menopausal symptoms with cognitive function.

Struggling to find the right word. Wondering why you entered a room. Forgetting meetings. These signs of “brain fog” may be common in menopause, but the number of birthdays we’ve accumulated does not necessarily tell the whole story. With menopause also comes the climacteric phase, and studies indicate that cognitive difficulties may be linked to the intensity of menopausal symptoms – especially depression and problems in sexual function such as pain during intercourse, decreased desire, or difficulty with arousal, and of course, brain fog! Although it is one of the lesser-known symptoms of menopause, it is very common.

Even though most women do not associate brain fog with menopause in the same way they associate hot flashes, people tend to think that brain fog is a result of chronological aging rather than hormone-related aging. In any case, it has a broad effect on overall well-being.

During menopause, estrogen levels in a woman’s body drop dramatically – a process that leads to a series of physical, emotional, and cognitive changes. Beyond its effect on fertility, estrogen plays a crucial role in regulating brain function, especially in areas related to concentration, memory, emotional regulation, and executive functions. These are the same areas affected by ADHD. Therefore, in women with ADHD, the decline in estrogen may worsen existing symptoms: Difficulty focusing, increased forgetfulness, impulsivity, mental fatigue, and a sense of being overwhelmed.

For many women, this is the first time in their lives that they experience a sharp decline in mental functioning, along with confusion or frustration they do not know how to connect to hormonal processes. Sometimes, it is precisely during menopause that symptoms indicating ADHD appear for the first time – symptoms that were not identified earlier, mainly because in the past the women adapted, compensated, or hid the difficulty. Now, with the decline in estrogen and its direct effect on brain activity, the mask comes off – and the difficulty is revealed in full force.

Recognition of the link between hormones, brain function, and ADHD is essential, but unfortunately, it is still lacking in public discourse and medicine. The right combination of diagnosis, tailored medication, and sometimes hormonal treatment can significantly improve women’s quality of life at this age. Despite growing awareness of the issue, many healthcare providers – psychiatrists, gynecologists, and even family doctors – still do not connect menopause with the onset or worsening of ADHD. This means that many women are not diagnosed in time, or are offered only partial treatment that does not provide a comprehensive solution to the difficulties they experience.

Women with ADHD carry with them a sensitive neurological foundation to begin with – one characterized by difficulty in emotional regulation, hypersensitivity to stimuli, and often ongoing mental overload. When they enter menopause, along with its hormonal imbalance, this foundation becomes even shakier. The drop in estrogen levels is followed by a decrease in dopamine and serotonin – two neurotransmitters that affect sharpness, pleasure, calmness, sleep, and essentially every aspect of psycho-neurological functioning.

The result is that every existing difficulty gains new intensity: Moods change rapidly, patience levels decrease, internal feelings are characterized by “emotional chaos,” and sometimes there are also crying spells, unexplained anger, or a sense of emptiness. All of these affect not only professional functioning – but also relationships, family life, parenting, and even the simplest social interactions.

Many women describe a sense of estrangement from themselves – as if they lost the abilities that defined them for years. They struggle to get up in the morning, fail to stick with tasks, and find themselves frustrated with daily existence itself. Precisely at the age when society expects them to be stable and mature – they experience exhausting inner turmoil.

The optimistic news is that once the overlap between menopause and ADHD is understood, action can be taken in a more precise and targeted way. Many women experience significant improvement when treatment is updated based on an understanding of both axes – hormonal and neurological.

First, it is important to examine the effectiveness of the existing medication for ADHD. It may be that the drug that worked until now no longer suits the current stage, or that a dosage adjustment or switch to another medication is needed – sometimes less stimulating, sometimes longer-acting.

At the same time, in suitable cases, hormone replacement therapy (HRT), intended to balance estrogen levels, may serve as an important complementary factor. It not only alleviates physical symptoms such as hot flashes and dryness – but also contributes to emotional regulation, mental sharpness, and reducing the sense of confusion and lack of focus. However, it is important that hormonal therapy be given after a comprehensive evaluation and in consultation with a gynecologist who knows the patient’s medical history.

And what can help in dealing with the intersection between ADHD and hormonal changes in menopause? First and foremost – encouraging open, knowledge-based discussion. A combination of professional diagnosis, tailored medication (including ADHD drugs, hormonal therapy when necessary), and emotional support – can significantly improve quality of life. Psychological support, CBT, or personal coaching provide tools for time management, emotional regulation, and organization. Basic habits such as sleep, nutrition, and daily planning are especially important. Personalized, multidimensional treatment is the way not only to survive this period – but to experience a sense of control, balance, and renewed self-fulfillment.