ADHD and the menstrual cycle

ADHD can be affected by your menstrual cycle. In the days leading up to your period and during it, your symptoms might worsen. But as your oestrogen levels increase after your period, you might notice an improvement in your ADHD symptoms.

Many women with ADHD also report that their ADHD medication doesn’t work as well during certain times of their menstrual cycle.

How does the menstrual cycle affect ADHD?

ADHD is influenced by your menstrual cycle, particularly because of two hormones: oestrogen and progesterone.

In short, when oestrogen levels are low, ADHD symptoms tend to worsen, but when oestrogen levels are high, the symptoms often improve.^[1] Progesterone tends to have less of an effect, although high levels of it can worsen your symptoms.

Oestrogen is a sex hormone that's involved in the female reproductive system and sexual development. It can boost dopamine, norepinephrine, and serotonin – three neurotransmitters that play a key role in ADHD. As oestrogen supports the production of dopamine, norepinephrine, and serotonin, your attention, focus, and mood can improve when you have higher levels of it.^[2]

Progesterone is termed the ‘relaxing hormone’, because it can produce calming, anti-anxiety effects. While this can help manage stress, it can show up as brain fog, reduced focus, and lower concentration in people with ADHD.

Progesterone has more of an indirect relationship with ADHD. While oestrogen supports dopamine activity, progesterone may inhibit some of these effects. When progesterone levels become more dominant than oestrogen, ADHD can worsen. ^[2]

How can ADHD meds affect your periods?

ADHD medicines are unlikely to affect your period. There are little to no reports of period-related side effects for several common ADHD meds.

A possible way ADHD meds could affect you during your period is by amplifying your mood changes. Mood swings are a common side effect of stimulant medication;^[6] this could potentially be exacerbated if you have PMDD.

While there are reports of ADHD medication prolonging menstrual periods and making them heavier, these cases are usually isolated incidents.^[7][8]

So we can’t make any definite conclusion on whether ADHD meds affect your periods. More research would be needed to confirm if there’s a direct link or another underlying issue.

If you do notice any changes in your period, it’s best to discuss this with your clinician.

How to manage your cycle with ADHD

Aligning your life to your menstrual cycle can help manage ADHD.

When your oestrogen levels are high in the late follicular phase, it’s a good time to get high-demanding housework or high-intensity workouts out of the way. Your dopamine levels will be the highest at this point, meaning you’ll have better focus and improved concentration.

During ovulation, premenstrual week, and your period, your dopamine levels will be lower. You might find it hard to pay attention or notice that your mood is low and anxiety is high. Eating phytoestrogen-rich foods (plant foods that are naturally high in oestrogen, such as tofu and tempeh) can mimic the effects of oestrogen in the body. This can potentially reduce the severity of your symptoms.

And lastly, avoid heavy exercise during your period,^[3] especially if you have PMDD. Research shows that intense exercise can increase fatigue and promote PMDD symptoms.^[9] This doesn't mean you have to completely avoid exercise, just opt for lighter workouts like walking or yoga.

Should I adjust my medication throughout my cycle?

Some women with ADHD find that their ADHD medicine is less effective during their period and the week leading up to it. This could be due to a drop in oestrogen levels, which make ADHD symptoms worse.

ADHD meds work by increasing dopamine, norepinephrine, and serotonin; oestrogen also helps boost dopamine levels. But the week before your period and during it, you might not get this ‘added boost’ from oestrogen, so your overall dopamine levels might be lower, resulting in worsened symptoms.

While the medicine is working, its effectiveness may be reduced due to hormonal fluctuations.^[10]

Some psychiatrists recommend increasing the dosage during your period and premenstrual week to counteract the reduced effectiveness caused by the hormonal changes.^[10]

But it’s important you don’t adjust the dosage on your own; doing so can be dangerous for your health. Always consult your clinician before adjusting your medicine.

Can contraception help?

You might think that hormonal contraception improves ADHD symptoms by stabilising your oestrogen levels, but this isn’t entirely accurate and largely depends on the type of contraceptive being used.

Hormonal contraceptive pills are shown to increase depression risk by up to five times in girls with ADHD.^[11] A possible reason for this is that birth control pills can make you more vulnerable to mood changes.

Additionally, if you’re using triphasic pills (which contain varying levels of hormones to align with your menstrual cycle), you might be more likely to experience side effects that could affect your ADHD. Whereas monophasic pills, which maintain a consistent hormone level, might have a milder effect.

Non-hormonal contraceptives, particularly long-acting ones, like copper IUD, show more promising results. As they’re less likely to affect you hormonally, there's a lower risk of depression. Research also shows women are more likely to use them long term, reducing the risk of unintended pregnancy, which is common in women with ADHD.^[10]

It’s best to discuss with your clinician which contraceptive option works best for you. Finding the right one may take some trial and error.

References: 

1. Zaritsky, R., et al. Changes in ADHD Symptoms and Mood Across the Menstrual Cycle in Females Treated With Stimulants: A Pilot Study. Journal of Attention Disorders.

2. Osianlis, E., et al. (2025). ADHD and Sex Hormones in Females: A Systematic Review. Journal of Attention Disorders, 29(9), 706.

3. NICE (2024). Premenstrual syndrome: How common is it? NICE.

4. Broughton, T., et al. (2025). Increased risk of provisional premenstrual dysphoric disorder (PMDD) among females with attention-deficit hyperactivity disorder (ADHD): Cross-sectional survey study. The British Journal of Psychiatry, 226(6), 410.

5. Lin, P.-C., et al. (2024). Comorbid Attention Deficit Hyperactivity Disorder in Women with Premenstrual Dysphoric Disorder. Journal of Women s Health, 33(9), pp.1267–1275.

6. EMC. (n.d.).

7. Mutlu, C., et al. (2016).

8. Özdağ, V., et al. (2022).

9. Tsuji, R., et al. (2026). Association of ADHD/ASD traits with premenstrual dysphoric disorder among full-time employed women in Japan: A cross-sectional study. Journal of Psychiatric Research, 192, 371-377.

10. De Jong, M., et al. (2023).

11. Lundin, C., et al. (2022). Hormonal Contraceptive Use and Risk of Depression Among Young Women With Attention-Deficit/Hyperactivity Disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 62(6).