The Connection Between PMDD and ADHD in Women

The Connection Between PMDD and ADHD in Women

Premenstrual dysphoric disorder (PMDD) and attention deficit hyperactivity disorder (ADHD) are two conditions that can significantly impact a womans life. Researchers are now finding that PMDD and ADHD commonly co-occur and may have overlapping symptoms and causes.

Understanding the link between PMDD and ADHD empowers women to seek proper treatment and coping strategies for managing both conditions.

What is PMDD?

PMDD refers to a severe form of premenstrual syndrome causing extreme mood shifts, irritability, and physical symptoms in the week leading up to a womans period. PMDD affects 3-8% of women of reproductive age.

While regular PMS causes manageable discomfort, PMDD severely disrupts work, relationships, and overall wellbeing. Symptoms usually improve within a few days of menstruation starting.

Common PMDD symptoms include:

• Extreme irritability, anger, or sadness
• Overwhelming anxiety or depression
• Extreme mood swings
• Trouble focusing and concentrating
• Food cravings and overeating
• Fatigue and low energy
• Breast tenderness
• Bloating and fluid retention
• Changes in sleep habits

What is ADHD?

ADHD stands for attention deficit hyperactivity disorder. Its a condition affecting concentration, organization, impulse control, activity levels, and other executive functions.

ADHD symptoms are categorized into two main groups:

• Inattentive symptoms - difficulty focusing, disorganization, losing things, forgetfulness, lack of attention to detail
• Hyperactive/impulsive symptoms - constant motion, impatience, interrupting, excessive talking, rush decision making

ADHD tends to first appear in childhood but can persist into adulthood. Its estimated that 4-5% of adults live with ADHD.

The Link Between PMDD and ADHD

Research demonstrates that women with PMDD are more likely to have ADHD as well. Lets explore the connections between the two conditions:

Overlapping Symptoms

PMDD and ADHD share several behavioral symptoms including:

• Difficulty concentrating
• Impaired short-term memory
• Disorganization
• Restlessness
• Impatience
• Impulsivity
• Trouble managing emotions

The overlap of ADHD traits and PMDD symptoms during the luteal phase of the menstrual cycle prompted experts to consider a relationship between the two conditions.

Hormone Fluctuations

Hormone changes are responsible for PMDD symptoms emerging in the weeks before menstruation. Similarly, research indicates that hormonal fluctuations may worsen ADHD symptoms in some women.

Estrogen and progesterone rise and fall dramatically through the menstrual cycle. Scientists theorize these hormonal shifts may impact neurotransmitters and brain activity in a way that exacerbates ADHD.

Some women with ADHD report more severe symptoms before their period when certain hormones plunge sharply. The influence of hormones on ADHD offers another explanation for the PMDD-ADHD link.

Brain Imaging Studies

Brain scans show that women with PMDD display functional and structural differences in certain areas of the brain tied to emotional processing and cognition. These areas include the amygdala, hippocampus, and prefrontal cortex.

Interestingly, similar brain variations also show up in imaging studies of people with ADHD. The parallel findings led researchers to suspect brain changes accompanying PMDD may also make a woman more vulnerable to ADHD.

Genetic Factors

Twin studies reveal a genetic component to PMDD, meaning it runs in families. There are also genetic links to ADHD.

Having a close relative with severe PMS elevates your risk of PMDD. And relatives of a person with ADHD are more likely to have attention deficits.

The heritability of both conditions hints that common genetic variants could increase susceptibility.

Prevalence in Women

PMDD exclusively affects women since its tied to the menstrual cycle. ADHD is also more prevalent among women than previously believed.

Many women with ADHD go undiagnosed because hyperactivity tends to present differently in girls. But inattentive and impulsive ADHD symptoms that overlap with PMDD may prompt women to seek help.

Increased awareness of how ADHD manifests in women sheds light on the ADHD-PMDD connection.

ADHD Symptoms and PMDD Symptoms

Understanding how ADHD and PMDD symptoms intersect is key to spotting when they occur together. Heres an overview of shared symptoms:

Difficulty Concentrating

Trouble concentrating makes focusing at work or school challenging with both PMDD and ADHD. Hormone changes exacerbating ADHD could severely worsen focus before a womans period.

Impulsiveness

Impulsive behaviors like overspending, overeating, and poor self-control may uptick in the premenstrual week if ADHD is present. Impulsivity also manifests in outbursts and moodiness.

Restlessness

Agitation and restlessness frequently accompany PMDD and ADHD. A woman with both may experience intensified edginess and an inability to relax as her period approaches.

Disorganization

Disorganization and forgetfulness can skyrocket due to hormonally aggravated ADHD converging with PMDD. Missing appointments, forgetting obligations, and misplaced items may become routine.

insomnia

Trouble sleeping often occurs with both conditions. Menstrual cycle hormonal shifts may dysregulate circadian rhythms in women with ADHD, severely worsening sleep disturbances premenstrually.

Anxiety

PMDD generates anxiety while ADHD fosters chronic restlessness. Combined they can create heightened anxiety levels, panic attacks, racing thoughts, and catastrophizing premenstrually.

Low Frustration Tolerance

Irritability and anger issues are hallmark PMDD symptoms. Inability to manage frustration also accompanies ADHD. The combination magnifies irritable mood episodes and temper flare ups.

Getting Diagnosed: PMDD vs. ADHD

Since PMDD and ADHD share many behavioral symptoms, getting an accurate diagnosis involves teasing the two conditions apart. Consider these tips for an evaluation:

Track Symptoms

Prospectively tracking symptoms daily using a journal or app helps identify patterns. Note which symptoms consistently arise premenstrually. If similar symptoms persist all month, ADHD may be the culprit.

Detail Symptom History

Provide specific examples of how symptoms impair your daily life at home, work, school, and socially. Detail how long symptoms have occurred and any changes over time.

Describe Symptom Intensity

Explain how severely symptoms impact mood, behaviors, and function. This helps determine if its manageable PMS or debilitating PMDD.

Review Family History

Note any family history of PMDD, ADHD, mood disorders, learning disabilities, or other neurobehavioral conditions since heritability may be a factor.

Assess Symptom Onset

Identify when in the menstrual cycle symptoms tend to emerge. PMDD symptoms generally start in the late luteal phase around ovulation and subside shortly into menstruation. ADHD persists monthly.

Question Past Diagnoses

If previously diagnosed with ADHD or depression, explore how well treatment managed the symptoms. Worsening symptoms premenstrually can indicate PMDDs influence.

Consider Co-Occurring Conditions

Anxiety, depression, OCD, and other conditions can also accompany PMDD and ADHD. Discuss all symptoms to identify possible overlaps.

Explore Medication Effects

Some ADHD medications reportedly worsen premenstrual symptoms. Tracking changes throughout your menstrual cycle can reveal exacerbations.

Get Lab Tests

Hormone tests help confirm ovulation and premenstrual hormone changes consistent with PMDD. Thyroid and vitamin deficiency testing rules out other causes of fatigue and mood changes.

Treating PMDD and ADHD

Effective treatment strategies exist for both PMDD and ADHD. But experiencing both simultaneously may require extra care to manage symptoms. Treatment approaches include:

Lifestyle Changes

Stress reduction techniques, exercise, limiting alcohol, proper sleep habits, and a healthy diet can help minimize PMDD and ADHD episode severity. Maintaining structure through schedules and reminders also compensates for disorganization.

Therapy

Cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT) can teach women coping strategies for their thoughts, emotions, and behaviors related to PMDD and ADHD. Building a support system is also beneficial.

ADHD Medications

Stimulant medications like Adderall or Ritalin often effectively manage ADHD symptoms. But dose adjustments may be needed premenstrually if irritability or insomnia worsen. Non-stimulant options may also help.

Supplements

Some research indicates vitamins and herbal supplements like calcium, magnesium, and chasteberry could potentially improve PMDD and ADHD symptoms mildly. Speak to your doctor before using supplements.

Birth Control Pills

Oral contraceptives containing estrogen and progestin can sometimes stabilize hormones enough to reduce PMDD symptoms. The pills effect on ADHD symptoms varies individually.

Antidepressants

SSRIs like fluoxetine are first-line medications for PMDD. Low doses may relieve PMDD symptoms without fully treating co-occurring depression. Some antidepressants like bupropion also treat ADHD.

Psychiatric Medications

Anti-anxiety medications, antipsychotics, and mood stabilizers may sometimes be prescribed alongside ADHD and antidepressant medications to optimize symptom relief for co-occurring conditions.

Lifestyle Tips for Managing PMDD and ADHD

While medication and therapy treat the underlying biology, making certain lifestyle adjustments can help women minimize the impact of ADHD-PMDD overlaps. Consider these tips:

Plan Around Your Menstrual Cycle

Schedule important work meetings, job interviews, speaking engagements, and social events for follicular and ovulatory phases when you tend to feel your best.

Track Your Period

Use a calendar to note periods, ovulation, and luteal phases. Forecasting PMDD onset helps you mentally prep and adapt your schedule.

Practice Self-Care

Carve out more downtime in your calendar the week before your period. Say no to extra obligations to accommodate needing extra rest.

Adjust Exercise Routines

Doing gentle yoga and walking may feel more doable than high intensity interval training during PMDD flares. Listen to your body and adjust workouts accordingly.

Improve Sleep Habits

Keep a consistent bedtime and wake time, limit screen time before bed, and create a restful sleep environment to get on a regular sleep-wake cycle.

Eat Regularly

Meal prep healthy snacks and foods during high energy times to help maintain steady blood sugar and prevent premenstrual cravings or binge eating.

Lean On Your Support System

Let loved ones know you may need extra help and reassurance during the premenstrual week so they understand any behavior changes.

Try Supplements

Discuss supplementing with vitamin B6, magnesium, calcium, and primrose oil with your doctor to potentially mildly reduce PMDD and ADHD symptoms.

Have Coping Strategies

Keep fidget toys, headphones, and other sensory tools on hand to help calm restlessness and agitation during symptom flares.

Avoid Triggers

Steer clear of situations provoking anger and irritability like traffic jams or crowded venues when PMDD symptoms strike.

The Takeaway

Research indicates ADHD and PMDD overlap more than once thought. Women experiencing severe premenstrual mood and behavior changes or worsening ADHD symptoms before their period should discuss screening for both with their doctor.

Confirming an ADHD diagnosis alongside PMDD allows women to access proper treatment and lifestyle adjustments to manage both conditions. Understanding the connection empowers women to reclaim their health, productivity, and wellbeing.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.