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One of the extra challenges that women face, especially women with ADHD, is changing hormone levels. These changes impact memory, and it’s scary if you don’t know what’s happening.

In this enlightening chat with Terry Matlen LMSW, she explains how ADHD and hormones impact women, and what can be done.

Terry Matlen LMSW is a psychotherapist, and author of Queen of Distraction.

You can find her at ADDconsults.com and QueensofDistraction.com


I’m thrilled to be talking with Terry Matlen. Terry, you’re a psychotherapist, you can be reached at ADDconsults.com and you do coaching kind of group coaching at QueensofDistraction.com.

You’ve written the book Queen of Distraction (Amazon) and you have a cat, a dog, some kids and a husband or something.

I wanted to talk about the differences between or some of the challenges that women face that men may not face, or not as severe, and when you sent me that idea my first reaction was hormones, because we’ve had people talk a little bit about issues with hormones. Do you want to give me a quick coverage of what the difference is with hormones, because men have hormones too…

Hormones and ADHD

Terry Matlen:

Men have hormones but men don’t get pregnant, so that’s one big difference. I get emails all the time from women starting I’d say in their 40s asking me “Could I possibly have Alzheimer’s, some type of dementia, because my memory, my cognition has just gone out the window. I meet people, I can’t remember their name within seconds, I misplace things, I can’t get the words out easily, I’m losing it” and they get very, very frightened.

What most women don’t realize is that as our hormones change, as we get older, actually starting in puberty, so girls who are going through puberty their bodies are changing, and our bodies continue to change into Perimenopause. So our hormones are changing and women get very, very frightened because they think that there is something wrong with them and they come to me and they ask me “what could this be I’m terrified, I’m really afraid, I’m really afraid.”

So I try to reassure them that as our hormones change our ADHD symptoms typically get worse, which is a scary thought because already we are a little out of whack with our memory, and our cognitive abilities, and executive function, so to lose even more of that can be a bit striking to the woman and maybe even the people around, people that love her and care about her.

So what I try to do is reassure them that more than likely they’re not going through a dementia, to worry about that, always though if you’re worried go to your doctor and explain what’s going on. Here’s the problem, almost 100 percent of doctors or medical providers are not aware of the correlation between hormonal changes and worsening of ADHD symptoms, so we have a really big problem. For the last 20 some odd years I’ve been trying to educate women with ADHD, professionals in the field, that this is what we’re working with and we have to be very cognizant, which is a great word to use when you have ADHD I’m so proud of myself I can even say it, educate your professional team, and that’s really hard because a doctor doesn’t want to be told, generally, what they should know, though we know they should know.

So one thing I do is explain how your body’s changing, so here’s let me just go through a little bit of a segue into puberty, you know things change, some girls with ADHD during puberty you’ll see a lessening, believe it or not, of the hyperactivity, impulsivity, with some girls.

But let’s just move on to women who are in their 40s and they’re just starting into Perimenopause, what that means in part is that your hormone, your estrogen levels start to go down and when the estrogen levels go down that’s when we see the changes in our memory and cognitive behaviors and thinking.

Do ADHD Symptoms During Pregnancy Go Away?

So then what happens is, we go into menopause and post menopause and then you see that estrogen dipping, dipping, dipping, dipping, dipping, until you know we can have some problems with what I just described, however there is one bright point, for many women is during pregnancy, a lot of women will say “this is so weird, my ADHD seems to be getting better”, then I worry, are you going to start having a bunch of kids, you know, because you’re gonna be symptom free for a while and that’s because during pregnancy the estrogen level increases, but then after childbirth it takes a big drop again.

So it’s as if it weren’t bad enough with women going through their menses, and the mood and all that going up and down, you know from 13 on or whatever, then we had as ADHD women this additional dipping down of the estrogen level. So in a nutshell that’s what’s happening and women need to really understand that part of their changes in their ADHD symptomology.

Rick Green:

I think it might have even been Linda Roggli who said it was like a double dose of ADHD, or doubling down on the symptoms.

Terry Matlen:

Even if you don’t have ADHD, you know, women will notice some cognitive changes. So imagine if you’re born with some deficit, and I’m not I’m not saying that as a pejorative but our brains are challenged, you know we are challenged. So if you’re already not working optimally and then the estrogen levels go down and you’re really struggling it is a double whammy, but for a woman without ADHD she often will have challenges as well with a dip in estrogen, so it’s not just women with ADHD.

Rick Green:

And it’s interesting because the latest research, we had a conversation about this, ADHD and seniors, Gina Pera came and did one a while ago and she was talking about, she quoted the studies that said people with ADHD do not have a higher rate of Alzheimer’s or dementia, which was, because I’ve been checking these do you have dementia signs since I was probably 17, checking what’s wrong with me, until I got the diagnosis.

More recently and it’s inevitable with aging, you know, there’s things you start forgetting because it’s like, it doesn’t matter, it’s like ‘I can’t remember that kid in my class in grade nine’ there’s a reason, because I don’t need to ever think about him.

The fact is that we don’t have higher risk for dementia from the ADHD, but it appears that some of the aspects that can come along with ADHD put us at a higher risk because we tend to eat worse, we tend not to take care of our health, we don’t, there’s like a list of things that we can do, we don’t exercise regularly, which is huge for helping with, at least stave off dementia and not prevent necessarily but slow the progress.  But it’s the inevitable thing I think, isn’t it, it’s ADHD or not, that losing that faculty or losing your faculties is a frightening thing.

Terry Matlen:

It’s terrifying for women, so then they ask me “well what do I do?” and I’m taking this from the work of Dr. Patricia Quinn (Books on Amazon Understanding Girls with ADHD, 100 Questions and Answers about ADHD it Women and Girls, Understanding Women with ADHD) who really opened the door to understanding what the changes are in women as we age. You would think that the answer to helping women with their ADHD symptoms would be to increase their stimulant medication, if they’re on medication.

What she says, and I’m only going by her work so I can’t back it up with the studies or anything, but she says uh uh that doesn’t always work, and here’s the problem, she says going on hormone replacement therapy is often what helps women who are going through menopause, post menopause, but the problem is for some women they can’t take a hormone replacement, number one, number two a lot of doctors have, like I said almost 100% of doctors, you know, like gynaecologist or primary care physicians, don’t know anything about ADHD, let alone medications for ADHD when women are going through change.

So we have a big job ahead of ourselves and one of the things I recommend, but it’s so hard again, is to educate your doctor. So getting articles off of the website, looking into Dr. Quinn’s work, and now I think there are some other professionals who are looking into the hormone –ADHD thing, is pulling them off the internet and studies if I… I think there are some studies out there, showing them to your doctor and say ‘this is what’s going on with me, can we explore these different options?’

So the big problem is when I tell women, you know you need to talk to your doctor, your gynaecologist, your primary care physician, they don’t know anything about ADHD let alone hormones and how it affects ADHD. So we’re in a spot right now where we have to work hard to teach the doctors, but that can’t happen until you women out there and people who love your women out there understand first how it affects you, so that you know what to ask, and what to explain to the doctor, taking material and having them read it hopefully.

Rick Green:

And the other thing somebody said today in a webinar was that they got great treatment because they went to a teaching hospital.

Terry Matlen:

Oh yeah, yeah, yeah, it’s a great tip.

Rick Green:

Isn’t it, and then you get a doctor and six medical students eager to learn and bringing all their own perspectives, and wanting to help and so on.


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