ADHD and Hormones in Women: Why Symptoms Change Across Your Cycle and in Perimenopause | Agnes K. Simone & Annika Joya
The Dr. Brighten Show
Masking and the Cost of Coping
Agnes K. Simone describes masking strategies, internal exhaustion, delayed diagnosis, self-doubt, and the value of appropriate support.
ADHD and hormones are deeply connected, and shifts in estrogen, progesterone, and testosterone may help explain why focus, mood, executive function, and even the experience of ADHD medication can change across the menstrual cycle and during perimenopause. View the full show notes and additional resources at https://drbrighten.com/podcasts/adhd-hormones-in-women/.
In this episode of The Dr. Brighten Show, I’m joined by board-certified psychiatrist Dr. Agnes K. Simone, MD and ADHD nutrition researcher Annika Joya, MS, for a conversation about what happens when ADHD meets the menstrual cycle, PMDD, and perimenopause. We talk about why some women feel like they have a completely different brain depending on the week of their cycle, why ADHD medication may feel less effective before a period, how estrogen interacts with dopamine, and why women can reach their 40s and suddenly feel like the systems that worked for decades no longer work.
In this episode, you’ll learn:
Why the follicular phase may feel easier for some women with ADHD
How estrogen and dopamine interact in the ADHD brain
Why ADHD medication may feel different during the luteal phase—and why you should not change your dose without speaking with your prescriber
What to track for two cycles if your ADHD symptoms or medication response change before your period
How sleep, nutrition, stress, and eating consistency can influence how your brain feels
What premenstrual exacerbation (PME) is and how it differs from simply having “bad PMS”
Why some women describe PMDD as feeling like they become a completely different person before their period
Why PMDD isn’t simply a matter of being “low in progesterone”
How masking can allow ADHD in women to remain undiagnosed for decades
Why ADHD does not suddenly begin at age 45
How perimenopause can affect focus, memory, mood, sleep, and executive function even without classic hot flashes
Why a single estrogen or progesterone blood test cannot diagnose perimenopause
Why women deserve individualized conversations about hormone therapy, birth control, ADHD medication, and their own symptoms
Simple strategies for feeding yourself when executive function is low
Practical things you can start doing now when ADHD feels harder during certain parts of your cycle
Dr. Simone also explains why an ADHD diagnosis requires looking for symptoms that were present in childhood or adolescence—not simply symptoms that suddenly appeared in midlife. Later, we discuss how masking, life demands, and hormonal changes can collide during perimenopause and make previously effective coping systems stop working.
The episode specifically moves from menstrual-cycle changes and medication response into estrogen, dopamine, progesterone sensitivity, PMDD, masking, perimenopause, hormone therapy, and finally a practical “Protocol Playground” for what listeners can start doing now.
🩺 Dr. Jolene BrightenDr. Jolene Brighten is a women’s hormone expert, naturopathic physician, Certified Menopause Society Practitioner, nutrition scientist, certified sex counselor, host of The Dr. Brighten Show, and author of ADHD and Women.
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👩⚕️ MEET THE EXPERTS
🧠 Dr. Agnes K. Simone, DO
Dr. Simone is a board-certified psychiatrist and founder of Olea Women’s Health, where her work focuses on the intersection of psychiatry, hormones, perimenopause, menopause, cognition, and women’s mental health.
Olea Women's Health https://www.oleawomenshealth.com/about-dr-agnes-simone
🌐 Dr. Agnes Simone: https://www.simonepsych.com/
🌿 Olea Women’s Health: https://www.oleawomenshealth.com/
🍓 Annika Joya, MS — Nutrimind Lab
Annika holds a master’s degree in health psychology and specializes in translating ADHD nutrition research into practical strategies for neurodivergent people. Nutrimind Lab https://nutrimindlab.com/about-annika
🌐 Nutrimind Lab: https://nutrimindlab.com/
📸 Instagram: https://www.instagram.com/thenutrimindlab/
🔗 Annika’s Links: https://linktr.ee/nutrimindlab
📕 ADHD AND WOMEN
🧠 Get ADHD and Women by Dr. Jolene Brighten: https://drbrighten.com/adhd-and-women/
The book dives much deeper into how hormones, the menstrual cycle, perimenopause, nutrition, sleep, stress, and other factors can influence the way ADHD presents in women.
🎁 RETREAT GIFT: If you get ADHD and Women and enter by October 9, one person will receive a gifted spot at my May 2027 retreat. Details and entry are here: https://drbrighten.com/adhd-and-women/
🌿 SPONSOR + RESOURCES
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📚 Dr. Brighten Books & Resources: https://drbrighten.com/books
🎧 The Dr. Brighten Show: https://drbrighten.com/podcast/
📝 More women’s health education: https://drbrighten.com
💬 JOIN THE CONVERSATION
👍 LIKE this episode if it helped you understand your brain differently.
💬 COMMENT with the biggest thing you recognized in yourself—or tell me whether your ADHD feels different depending on where you are in your cycle.
📲 SHARE this with the woman who keeps saying, “I swear my ADHD gets worse before my period.”
🔔 SUBSCRIBE to The Dr. Brighten Show so you don’t miss the rest of the ADHD in Women series.
⚕️ Medical Disclaimer: This content is for educational and informational purposes only and is not individualized medical advice. Always work with a qualified healthcare professional regarding diagnosis, medication, hormone therapy, supplements, or treatment decisions.
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