Diagnosis of ADHD following menopause

[Tigger69]

The wheels are starting to come off and I have been suspecting for a while now that I have ADHD but everything seems to have unravelled after menopause with increased brain fog and generally feeling down which I think is more than just menopause. It makes a lot of sense looking back and may just be the missing piece of the jigsaw.
I have 2 DS with ADHD but don’t really know how to go about getting an assessment as an adult.
Has anyone got any advice or can you recommend any clinicians who could assess who have a particular expertise in adults / women. Happy to go privately as I think wait times will be really long but don’t know anyone that specialises in adults. Ideally in London / South East.
Thanks so much.

How did you get on? I have an ADHD DD and now realise that I have it too.. I'm really sad that it's taken til I'm in mid 50s and meno before I realised. No one ever suggested it to me but I'm text book

I haven’t started the process yet of considering a diagnosis. Still hoping to get some recommendations for professionals that see adults. Lots of useful info on Additude about the benefit of oestrogen so rethinking that too. Good luck !

HRT defo helped me lots

HRT helped me loads, though I'm still in peri not post. My initial referral through GP surgery was 2 years ago, assessment was today under Right to Choose (via video link). Only requested referral after seeking support for my child and finding out how differently it can present in girls - it seems I was fairly text book combined type looking back. When I spoke to the GP Practice nurse to discuss the referral she asked me why I needed it and said 'but everyone is like that' - I said how I believed it was impacting on my life and she agreed (reluctanrly it seemed) to send off the referral, initially to ADHD 360 but then this was changed to Psychiatry UK. The consultant psychiatrist diagnosed me immediately at the end of their assessment, said I met the criteria and would I like to consider medication as they believe I could really benefit from it. I'm in my mid 40s.

My mum amd DH had to complete a questionnaire and I had one too, whem I spoke to mum afterwards she said "but everyone is like that, I'm like that", took her a while to realise I'm just like her so she likely has ADHD too...

I am glad I requested a referral through my GP surgery even though it was a long wait. Just knowing is helpful, although I do also hope meds will work (will be a while as long waiting list for titration). It means I can stop beating myself up about being useless at writing reports until the last minute and constantly forgetting or losing things - I will continue to rely heavily on reminders, calendar notes and apps to manage day to day things. I have a good job in management role and can usually hide my deficiencies through blagging it / having a colleague proof reading emails etc, but it's draining amd I'm hoping meds can help alleviate the pressure I put myself under through endless procrastination. Good luck whatever decision you make.

I went with MyPace which is online. Got diagnosed quickly I waited about a week and a half for my appointment and paid £360. The Psychiatrist I saw was very understanding of how ADHD presents in women.

Women tend to mask a lot and overcompensate. So on the assessment it asks if you have trouble organising, I would ordinarily say no. However I did put why I didn’t have problems with organising. So to remember a basic appointment I have to set multiple reminders, I have work checklist for very basic stuff, reminders to check checklists, always early because I am so anxious about being late. This showed that I have the basic ADHD symptoms of poor memory, crappy executive function, but that I present differently (unfortunately the current assessment is designed for hyperactive little boys, but most assessors understand this).

I’m in titration but due to ADHD stock issues I am currently waiting for Elvanse to come back in stock before starting that. Again this cost £££, but I’m happy to invest in me, if you can’t spend money you’ve saved on health/mental health what’s the point in having money.

I started having early menopause symptoms at around 35 years old and the wheels really started to fall off with me too. Anxiety, social anxiety, depression, lack of motivation and what I thought was early onset dementia.

HRT has helped but it’s not really going to help the underlying ADHD. It has just bought me back to my base level, but has stopped me being worse. HRT isn’t a treatment for ADHD, but it does help alleviate the effects of menopause and therefore lack of hormones on ADHD. HRT with a good diet, sleep, exercise can be a part of a holistic approach that should help stop the ADHD being much worse than baseline.

ADHD medications do treat the ADHD as they help with Dopamine and Norepinephrine (which we lack). I’m hoping a combination of ADHD medication and continuing with HRT will help me. I’m also on testosterone too as I had thought that would be the answer to all my problems, but again it helps, but it doesn’t help the underlying baseline ADHD.

Sorry I sound so grumpy in this post, I’ve currently got Covid, so not feeling my usual upbeat self. Honestly getting diagnosed has been life changing for me and massively positive for my mental health. It’s massively helped my marriage, my husband genuinely thought I didn’t care, now he realises I’m actually trying twice as hard as everyone around me and we’ve both gained a massive amount of respect for me. There have been a lot of tears on my part, but it’s been truly enlightening for me.

Good luck!

I could have written your post - exactly my story. I was diagnosed in Sep 2020 but was able to be referred to my local ADHD clinic/service. It took a few months but then was diagnosed after a 3 hour appointment.

Menopause, brain fog, wheels coming off - so much yes! I left one job because I was making so many mistakes and thought I must be getting bored of it or something - the next one wasn't any better 😂 I was already on HRT by then.

The diagnosis was a revelation and a huge boost (after a grieving period). I tried all the meds but had some degree of palpitations with all of them, settled on a very low dose of Dexamfetamine but have been able to very slowly build that up. It really really helps at work - while it's working, I feel like a different person. I've done so much better at work than I ever thought I'd be able to - applied for a promotion in my team this year so have more responsibility. More stressful but also more rewarding and stimulating. I have struggled with work my whole life and in fact when I had my children I didn't go back to work for a very long time because I just couldn't cope with it.

A huge boost was applying for work coaching via Access to Work - game changer. I'm on my second series of sessions. I LOVE my coach and it has helped me with life outside work too - finding routines, bedtimes, self organisation etc.

I'm working full time at the moment but in late 50s now and ideally would want to go down to 4 days if finances ever permit.

I'm looking to apply for flexible working as a reasonable adjustment in the mean time and have a day off every 2 weeks - 9 day fortnight.

Good luck, I hope you are able to get a diagnosis soon.

IHatesMeecesToPieces

I’d love to hear about work coaching and any recommendations if you have them. I’m at the stage where I don’t really know how to move forward. I’ve used anxiety and shame to get things done for so long and would love to learn other ways to operate. I’m hopefully starting Elvanse when stock issues subside (hopefully towards the end of this month if the goalposts aren’t moved again), and I would be great to have someone to help me find my way.

HRT has been very helpful for me.

The psychiatrist who diagnosed me was frankly clueless about women and hormones - I was expecting that there would at least be some questions to try and pull apart the peri symptoms from the adhd. Even when I tried to discuss that I’d had an uptick in adhd issues at puberty, with pregnancy, breast feeding, and now peri-m, he interpreted that as an example of me getting off topic and tmi 🙄 Still resulted in a diagnosis

If things go tits up at menopause and HRT helps then how is it ADHD and not just symptoms of menopause?

Menopause brings brain fog, disorganisation, weakened spatial awareness, overwhelm, scattered thinking, anxiety ........ so isn't it just menopause if the issues only became apparent at menopause?

I presume this is a genuine question and not a troll, so I’ll answer.

Menopause exacerbated all these symptoms for me, they were there long before, but at a level I thought I coped with. Spoiler alert, I hadn’t coped with the symptoms before, I’d lost jobs, had to walk away from jobs, only got a degree because of ‘depression’ (extenuating circumstances), struggled with housework, but also a perfectionist, anxiety, insomnia. Masked and overcompensated, but failed again and again due to what I now know are ADHD symptoms. I thought everyone struggled like I did behind closed doors , again spoiler alert, they did not.

Menopause made everything much much worse (think early onset dementia), HRT helps me not get much worse, but I’m still ‘severely impaired’ by ADHD.

When you are assessed for ADHD the assessment looks for symptoms presenting before the age of 12 as part of the criteria.

I would suggest that any women that are especially affected by brain fog and forgetfulness during menopause to look into ADHD and how it presents in women. It is massively under diagnosed, with up to 1 in 20 possibly having it. The sad case is that most boys get diagnosed/identified at 7 years old, and most women don’t get diagnosed/identified until their late 30’s and 40’s (when lack of oestrogen well and truly fucks them up). Most women have then developed mental health problems because of their undiagnosed ADHD and are seeking help for that. Loads of women never get diagnosed or get diagnosed with something else.

@CestlaADHD yes I'm being serious. I agree if you walkways had symptoms and they were magnified during menopause then for sure ho get an assessment. My point is many many won with no previous indication of ADHD at all, ever can find they begin to experience symptoms/characteristics that are like ADHD at menopause. The affects of plummeting estrogen can cause brain fog, difficulty focusing etc. not related to ADHD but mimicking ADHD.

Ffs I really need to start reading my posts before posting. My apologies for typing gibberish. I hope you can understand me

Yes, I get ya! If you’ve never had those symptoms before then yes it’s probably just menopause - especially if those symptoms disappear with HRT.

Interestingly they have done studies where they treated menopausal women (with memory problems) with ADHD medication and it improved their symptoms. When oestrogen goes down so does dopamine - which is one of the neurotransmitters that ADHDers lack.