Open the Cage and Fly: ADHD and Peri-meno

For decades, the world told us who we were and we believed it. We adjusted ourselves, accommodated the world at our expense and performed. We smiled through the crash and burn cycles, numbed the internal chaos and kept the shiny façade polished.

When we were told we were too sensitive, too intense, too much or not enough. We worked hard to prove otherwise.

When we became brave enough to finally ask for help, the medical system handed us a label. Stressed, anxious, depressed, a personality or eating disorder. Sometimes all once. Like good girls we took the anti depressants, benzo's and therapy offered. Flattened, coping, holding it all together on the outside whilst quietly still falling apart inside.

43% of women are first diagnosed with ADHD between the ages of 41 and 50. Squarely in the window of perimenopause. In a survey of over 1,500 women, 83% reported ADHD symptoms for the first time during this transition. 94% said their existing symptoms grew dramatically worse. It is estimated that 50–75% of women with ADHD remain undiagnosed — and for those who do receive a diagnosis later in life, the average age is 43.

This is not a coincidence. This is biology.

Oestrogen plays a critical role in attention, motivation, and executive function. These are the exact same circuits implicated in ADHD. During perimenopause, oestrogen doesn't gently decline. It swings wildly, destabilising the neurotransmitters that kept us functional. And progesterone, which most doctors mention only in the context of womb protection, turns out to matter enormously for our nervous system. It supports GABA, the brain's calming signal. It stabilises mood and anchors sleep. When it drops, resilience drops with it. The warning signs were there heavy periods, mood swings, migraines, bone-deep exhaustion and a life that feels unmanageable.

This is not our fault. This is neuroendocrinology.

Perimenopause doesn't just change our hormones. It dismantles the scaffolding.

The structures we built to hold ourselves together, the routines, the roles, the relentless productivity begin to crumble. And what we've kept carefully hidden starts to surface.

This liminal space is between two worlds. The safety and familiarity of what we knew and valued and a future self who we do not know. We reach for whatever promises relief another supplement, another guru, another paywall of life hacks. We know this cycle.

We are being asked something more fundamental.

To come back to who we have always been underneath the layers we were told to be.

Those parts of us never disappeared. They were ignored, repressed and kept in the dark.

Midlife is when our darkness comes knocking.

Clarissa Pinkola Estés wrote that to grow as a free creature, we must place ourselves in occasions of "the lush, the nutritive, the light." We have kept our most alive parts in the dark for decades.

And like a rare and beautiful bird, uncaged at last...we fly.

Nadeau, K., Littman, E., & Quinn, P. (2023). Perimenopause, Menopause and ADHD. Journal of the International Neuropsychological Society, 29(S1). Cambridge University Press. https://www.cambridge.org/core/journals/journal-of-the-international-neuropsychological-society/article/2-perimenopause-menopause-and-adhd/524A51499A7B6E66808F18D9933A560D

Agnarsdóttir, S. et al. (2025). Perimenopausal symptoms in women with and without ADHD: A population-based cohort study. European Psychiatry / PMC. https://pmc.ncbi.nlm.nih.gov/articles/PMC12538516/

ADDitude Editors. (2024). Menopause Symptoms Exacerbate ADHD in Women: ADDitude Survey. ADDitude Magazine. https://www.additudemag.com/menopause-symptoms-adhd-survey/

Questions to ask yourself ...

What did you do as a child that made time disappear?

What do you need to thrive right now?

What will be your medicine over the next few weeks?

Who inspires you?

Who is your role model?

How can you build your community and your belonging?