Menopause and Cognitive Changes: The Overlapping Symptoms with ADHD

By William Schroeder, LPC

In our practice, we see a lot of women coming in during their 40’s and 50’s wondering if they suddenly have ADHD and we are seeing some interesting links between menopause and perimenopause. Menopause, characterized by the end of menstrual cycles, is a significant transition in a woman’s life and with this transition, there can be a variety of things that affect attention and cognition. One of the primary drivers of the changes associated with menopause is fluctuations and eventual reductions in certain hormone levels, primarily estrogen. These hormonal changes can affect various physiological and psychological aspects, including attention and cognitive functions. It’s also important to note that the journey to menopause can be one that happens over some time, like puberty. The Menopause Manifesto might be a helpful guide for you but here’s a brief overview of how hormones, particularly around menopause, can influence attention in women:

1. Estrogen and Cognitive Function: Estrogen, one of the primary female sex hormones, plays a role in many body functions, including the regulation of certain aspects of cognitive function. Research has suggested that estrogen can impact attention, memory, and other cognitive functions.
2. Attention and Memory Changes: Some women report attention and memory issues during the menopausal transition. These complaints often include difficulty concentrating, multitasking, and retaining new information.
3. Sleep Disturbances: Hormonal changes during menopause, such as decreases in progesterone, can lead to sleep disturbances or insomnia. Poor sleep quality, in turn, can have a significant impact on attention and cognitive function.
4. Mood Fluctuations: Changes in hormone levels can also influence mood. For instance, declines in estrogen levels can be linked to mood swings and even depression in some women. Any mood disturbance can indirectly affect attention and cognitive processing.
5. Stress and Anxiety: Menopausal symptoms such as hot flashes and night sweats can be sources of stress and anxiety. Chronic stress and anxiety can release cortisol, a hormone that, in high amounts over prolonged periods, can negatively impact cognitive function, including attention.
6. Brain Structure and Function: Some research suggests that estrogen has neuroprotective effects and can influence brain areas related to cognitive function and memory. The decline in estrogen during menopause might, therefore, have direct effects on brain function.
7. Other Health Factors: Menopause is also associated with other health changes, like a higher risk for cardiovascular disease, which can impact blood flow to the brain. Optimal brain function, including attention, depends on adequate blood flow.
8. Compensatory Mechanisms: On the positive side, the brain often develops compensatory mechanisms, and many women might employ additional strategies to cope with attention or memory changes. Furthermore, not all women will experience noticeable cognitive changes during menopause.

I would also note that a woman in her 40’s or 50’s can also be in a stressful part of their life as they might be juggling teenagers and the most demanding part of their career at the same time. All of this can take it’s toll individually and collectively. It’s worth noting that while many women experience some cognitive changes during the menopausal transition, the degree and nature of these changes can vary widely. Additionally, the relationship between menopause, hormones, and cognitive function is complex and influenced by other factors, including genetics, lifestyle, overall health, and more. If you or someone you love is experiencing significant attention or cognitive issues, they should consult with a healthcare professional. All of the above might sound challenging but my hope in mentioning it to you is so you can seek support as there is quite a lot that can be done – which is good news. Make sure to find a doctor that understands your concerns and is properly supportive. All of the above said, the good news is that life tends to be in it’s most stressful place during our 40’s and 50’s and while our bodies and brains may be changing, across all languages and cultures, people report increased levels of happiness as they age.