Multiple Hormone Sensitivity Theory and ADHD

Have you ever noticed around your period your medication feels less effective? Do you tend to feel more irritable, and emotionally reactive? Do you struggle with feeling motivated? These are all complaints that I often hear from my clients who are women with ADHD. There have recently been some intriguing developments in the realm of ADHDs impact on hormones, particularly concerning women. 

It appears that the fluctuations in hormones during the menstrual cycle has more influence over ADHD symptoms than previously presumed. This notion is explained in the Multiple Hormone Sensitivity Theory, proposing that ADHD symptoms peak at two specific junctures during the menstrual cycle: around ovulation and premenstrually. The theory provides the framework to explain how cyclical hormonal changes across the menstrual cycle may trigger or exacerbate ADHD symptoms, and that individual sensitivity to hormonal fluctuations in estrogen and progesterone throughout the cycle leads to different symptom issues at different phases of the cycle.

During the mid-cycle phase, characterized by rising estrogen levels, individuals may experience heightened impulsivity and an increased desire for seeking rewards, potentially exacerbating hyperactivity and impulsivity symptoms. Conversely, as estrogen levels decline towards the end of the cycle, symptoms of low mood, avoidance behaviors, and difficulties with focus may intensify, which is indicative of inattention. 

Moreover, this hormonal ebb and flow seem to impact adolescents more than adults, coinciding with a period of substantial brain development and hormonal flux. The mix of changing hormones and bodily changes during puberty could magnify the challenges associated with ADHD symptoms, causing the teen years to seem even more challenging than they already are.  

Nevertheless, this deeper understanding holds promise for refining treatment approaches. Some practitioners are already customizing medication dosages based on menstrual cycle phases, and therapists, like myself, may offer a tailored approach to symptom management that supports the fluctuations throughout individual cycles. However, there remains a need for further research to comprehensively grasp how hormones intersect with ADHD symptoms in women across their lifespan.

References:

https://www.sciencedirect.com/science/article/abs/pii/S0018506X23001642?via%3Dihub