17 Comments
User's avatar
Caroline Smrstik's avatar

Great summary. I was diagnosed at 58 (!) and learned all about the estrogen-dopamine relationship then. Until menopause, my superhuman ability to compensate for wonky executive function somehow kept me going— then the bottom dropped out.

Expand full comment
Kristen McClure's avatar

So many women diagnosed in their 50s and 60d these days Caroline!

Expand full comment
Nicola Bal's avatar

Absolute relate. Also, never knowing about pmdd meant that I completely felt like it was character flaw, 2-3 weeks of symptoms building until they peak, not understanding my sensitivity to the rise/fall of hormones and how it was playing a huge role alongside undiagnosed ADHD.

The lack of research is astounding but unsurprising 🙄

Expand full comment
Kristen McClure's avatar

I first heard about this connection about 7 years ago in a conference. I was stunned. It traced. I shared with my clients and there docs of course pushed back. I had them bring the research with them to their appointments.

Expand full comment
Linda Hartley's avatar

Hi, I've added this to all those things I wish I'd known long ago! I'm wondering though, what does this mean for those of us who are well past menopause?

Expand full comment
Kristen McClure's avatar

Well, it might mean you noticed it got harder? Things might level out after the well past? There hasn't ( obviously) been much research here.

Expand full comment
Linda Hartley's avatar

Yes, it definitely got harder during the actual menopause. I recognise the cycle and then the chaos of it fading. I suppose it is no surprise there's no research but it is frustrating for those of us only just finding out about this stuff now...

Expand full comment
Kristen McClure's avatar

I am about five years past. Same

Expand full comment
cig (TX)'s avatar

Diagnosed at 63 five months ago. Executive function definitely decreased post-menopausal. Already scheduled to see my PCP tomorrow and will raise this issue.

Expand full comment
Diana Fox Tilson, LICSW's avatar

I think the answer might be to consider hormone replacement therapy?

Expand full comment
Megan L. Hauser, Ed.D.'s avatar

"Expect the dip... and stop blaming yourself for it" -- yes, thank you!! Your newsletter is one of the key resources helping me navigate my ADHD that can no longer hide behind my mask because of perimenopause!! And I've just started writing about it over at Only Time Will Tell. Thanks for your writing and helpful graphics 💜

Expand full comment
Cindy Ojczyk's avatar

I don't have ADHD but my daughters do. I know what it's like to manage shifting hormones without the complications of ADHD. I now have a better understanding of the impact on them. Thanks.

Expand full comment
Zara Bogaski's avatar

I didn't find out till after menopause that I had ADHD/Giftedness/HSP. But the lower estrogen/dopamine influences doesn't stop at menopause. For me I lost focus. It's harder now. Had to and still figuring out how to rebuild anew systems that will compensate for loss of focus. My energy goes up and down and fluctuates a lot more too. But the dips are deeper. Could be the HSP too. So I'm learning how to manage my energy too.

Expand full comment
Zara Bogaski's avatar

P.S. To clarify, you loose much more estrogen and dopamine during and after menopause.

Expand full comment
hillzalive's avatar

This was really helpful, thanks. Before I re-entered school at ~38 I would never have noticed the corollary between my period and executive function because it always felt poor anyway. But now that I am literally being *graded* on it, I’ve noticed so much more how my flow interrupts my, well, flow. And I don’t get pmdd but I do get bad period flu and it takes out another level of functionality.

Safeguarding both the time for r+r and lowering my performance expectations AS WELL AS prioritizing my mental health and workflow priorities for the 2 weeks after my period both feel very important.

Expand full comment
Rita Koske's avatar

Oh my gosh! I am so glad I found you. My brain is saying, "HELP!! Please help me!!" I am fighting for my life, daily survival for two weeks each month is killing me. The slow motion of my movements is becoming a thing too. Thank you for the information. Age: 47

Expand full comment
Kate Harvey's avatar

I really relate to all this, thank you for your clarity!

Expand full comment