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We Demand Attention on How Medication Adjustments During the Monthly Menstrual Cycle and Menopause Could Improve Treatment Outcomes for Women

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A small study suggests that menstruating people with ADHD may achieve more effective and consistent symptom control by increasing the dosage of their prescribed stimulant medication in the luteal phase, when estrogen levels hit their lowest point.There is a dearth of research examining the changes in ADHD symptoms and medication efficacy during all phases of the menstrual cycle, and during other times of hormonal change.However, one 2023 study published in Front Psychiatry found that increasing a patient’s dosage of stimulant medication during the week prior to menstruation can significantly improve cognitive and emotional symptoms of ADHD during this notoriously difficult phase in the menstrual cycle.1 The study was the first of its kind to examine the impact of adjusting stimulant medication dosages during the menstrual cycle for women with ADHD and co-occurring depression and premenstrual dysphoric disorder (PMDD) – a severe form of PMS.Prior to the study, these women experienced “diminished response to amphetamines in the late luteal phase” and an “exacerbation of their ADHD and depressive symptoms in the premenstrual week” that was not helped by their regular ADHD medication.

This experience was echoed in ADDitude’s 2023 survey of nearly 2,000 women with ADHD, two-thirds of whom said they experienced intense symptoms of premenstrual syndrome (PMS) or PMDD, beginning, on average, at age 14 and lasting for up to 40 years.

The most common luteal-phase symptoms reported were:“In ADHD, we know there is low prefrontal dopamine. If you have low estrogen as well in the third and fourth week of the cycle, you have doubly low levels of the neurotransmitters and hormones that help you focus and control your mood,” said Sandra.

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