Estrogen and Dopamine

[Anonymous]

I recently read the following and am wondering if , as a post-menopausal woman with (a recent diagnosis of) ADD, I should ask my doctor/psychiatrist about treating ADD with estrogen/hormone replacement?

“I see women — successful and smart — come into my office and say, “I’m afraid I have Alzheimer’s, and it scares the crap out of me. I have trouble coming up with words that used to come easily. I can’t concentrate as well as I did.” I do the evaluation, and they have ADD/ADHD syndrome, but they don’t have a history of these difficulties before menopause. It makes sense, though, because estrogen is one of the primary modulators for the release of dopamine in the brain. As the estrogen level drops, as it does in menopause, the result — for some women — looks an awful lot like ADD/ADHD.”

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[Anonymous]

The million dollar phrase here is… “but they don’t have a history of these difficulties before menopause.” Those of us who are female and have ADD have been struggling with it 24/7/365 throughout our childhoods, our teens, our twenties, thirties, forties etc. Having “normal” adult female estrogen levels at any point in the cycle certainly hasn’t prevented ADD for us. In our case, peri-menopause worsens a pre-existing condition.

Your diagnosis was presumably made on the basis of your lifelong history. If however, this problem is, for you, something that only showed up as recently as peri-menopause / post-menopause then maybe this is worth exploring with your doctor. Depending on your personal and family medical history, the benefits of hormone replacement might outweigh the risks. These days though, the thinking seems to be that hormone replacement can be appropriate for short term symptom relief, but generally not for long term use. In which case, you will eventually have to find another solution or learn to live with it.

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[Patte Rosebank]

So that’s why my symptoms have been getting worse lately.

As someone who’s never been pregnant, I’m one of the “lucky” ones whom Mother Nature has decided can start having the “fun” of peri-menopause many years before most women do. And I’ve been having that “fun” for the past couple of years.

UBC has an excellent facility devoted to the study of women’s reproductive health (http://www.cemcor.ubc.ca ), and they’ve found that estrogen replacement is the more dangerous form of hormone replacement therapy. Progesterone replacement seems to deal with many of the menopausal and peri-menopausal problems, and carries a much lower risk of causing cancer. I don’t know what its effect on dopamine is, though.

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[Anonymous]

Thanks so much for your responses. Yes, I vividly recall how my mind would seem to “splinter” especially before and during periods. I went through menopause very young (mid-late forties) – and although hormone replacement was offered to ease symptoms, I chose to go it without. I did OK.

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[Patte Rosebank]

As for the issue of people’s thinking, “I’m forgetful and distracted and I can’t find the right word, so maybe I have Alzheimers”, my mom raised this very issue with her geriatric specialist. Then she asked him about ADHD (which she seems to have rather strongly, albeit undiagnosed formally).

He said that, nowadays, doctors are just starting to discover that, in many cases, it’s not Alzheimers, but ADHD (often undiagnosed) that’s rearing its ugly head and acting up again. It seems to do this during years of great change & development in a person’s life. Periods like childhood, puberty, peri-menopause, menopause, and seniorhood. Between these periods of development, it seems to lie low.

Interesting, isn’t it?

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[BuxomDiva]

@Larynxa – amazing that your mom’s doctor is so up to date on ADHD!

and I’m not sure what the “normal” age for perimenopause is but I was only 46 or so when it hit me

still waiting for full-blown menopause 8 years later ~sigh~

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[Patte Rosebank]

@BuxomDiva, my perimenopause kicked in when I was not-quite-39. I’m 41 now.

I’ve been checked thoroughly for polycystic ovary syndrome (which has similar symptoms), and it’s been totally ruled out. I definitely have early-onset perimenopause.

Yay.

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