Nurse Maureen‘s Health Show
Welcome to Nurse Maureen's Health Show Podcast where we dive deep into all things health, sex, menopause, relationships, parenting, communication and more! Hosted by a passionate nurse with years of frontline experience, we bring you expert interviews, real-life stories, and the latest insights on staying healthy aging. Nothing is off limits as we delve into overall health, sexual health, mental health, and sexual health. Whether we’re breaking down medical myths, discussing cutting-edge treatments, or chatting with top health professionals, this show is your go-to for practical advice and inspiring conversations.
Nurse Maureen‘s Health Show
Attention Deficit Hyperactivity Disorder (ADHD) in Women (Part 1)
Unravel the complexities of ADHD and perimenopause with us as we feature insights from Dr. Anita Parhar, a leading authority in women's health and ADHD. What happens when the challenges of ADHD meet the hormonal whirlwind of menopause? Dr. Parhar sheds light on this often-overlooked intersection, breaking down misconceptions and emphasizing the importance of awareness and proper diagnosis.
We explore how hormonal shifts can exacerbate ADHD symptoms, leading to increased struggles with brain fog, disorganization, and self-esteem. This episode is an essential listen for those navigating these dual challenges, offering a roadmap to understanding and managing ADHD during the transformative years of menopause.
Join us as we also delve into the striking overlap between ADHD and menopause symptoms, and how fluctuating estrogen levels impact dopamine and serotonin, intensifying issues with attention and mood regulation. Learn why it's crucial to differentiate between menopause and ADHD symptoms for effective management.
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Speaker 1:Good evening and welcome to another episode of Nurse Maureen's Health Show Podcast. I'm Maureen McGrath. I'm a registered nurse, nurse, continence advisor, sexual health educator. This month we're focusing a little bit on or putting our attention to, I should say, a disorder that affects approximately 4.4% of adults. We think of this particular condition as being associated with children, in particular, little boys fidgeting in classrooms, but the truth is is that men and women, as they age, can continue to have ADHD or attention deficit hyperactivity disorder symptoms, and that can affect their lives, their professional lives, their personal lives, their interpersonal relationships, their self-esteem and quality of life.
Speaker 1:In my clinical practice, I see a lot of women coming into the practice and we're focusing on women today but I see a lot of women coming into my clinical practice at midlife, during the perimenopausal years, the years leading up to menopause, and feeling like they were able to cope with some of the symptoms that they had been living with their entire lives, such as brain fog and disorganization and low mood and self-esteem issues and that type of thing. And then, all of a sudden, perimenopause hits and life is entirely different for them. This is in part because the hormones fluctuate during the perimenopausal years and then drop at postmenopause, and this can impact a person's vasomotor symptoms. It can impact their organization, because they start to get brain fog. Well, people with, or women with, adhd actually can get worsening symptoms.
Speaker 1:So joining me on the line to talk about all of this is Dr Anita Parhar. She's the educational director of the ADHD Center and the director of women's health at the ADHD Center for Women. In all of her educational endeavors, her focus has been on working with communities who have been under-recognized. In working as a university instructor who trained teachers, she recognized the need for a greater awareness of ADHD and the importance of diagnosis and treatments of adults living with ADHD. Dr Parhar has extensive experience in understanding the many ways ADHD presents in adults and the challenges many living with ADHD work through on a daily basis. Good evening, dr Parhar. How are you Great? Thank you, maureen. Good evening, good evening, and thanks so much for joining the program to talk about this really important subject.
Speaker 1:Because you know, menopause is difficult. A lot of women don't know a lot about it. All of a sudden their lives start to become, you know, in a bit of a disarray. They're not sleeping that well, they're tired, they may have hot flashes and night sweats, urinary incontinence, vaginal dryness, to name a few, and they're thinking what is going on. I used to sort of have it together. I may have had some coping strategies that allowed me to perform in a certain way, and all of a sudden my life feels significantly worse. And they often seek out ADHD treatment during this time, during the perimenopause, causal years. We'll get to that shortly more closely. But what are some common misconceptions about ADHD and perimenopause or menopause?
Speaker 2:Great question, maureen. So one common misconception is that ADHD doesn't affect adults, hence the reason why we work with adults, and especially women. So it's a childhood condition and a lot of people thought that it could improve with age. But we know that ADHD is a neurodevelopmental condition, related, of course, to brain development, and so thus it persists into adulthood. Another misconception is that symptoms of women in menopause and those of ADHD are distinct, that there is no overlap, when there actually is. So our own anecdotal research supports the idea. For many women, adhd symptoms become pronounced, not less, with age. So women that had mild ADHD symptoms throughout their life, their 20s, their 30s, they report worsening symptoms around the age 40, 45, 50. So for some, the symptoms that had previously been able, that they had been able to manage, are no longer as manageable and cause significant difficulty.
Speaker 1:You know it's interesting Women may not realize that ADHD symptoms tend to be milder at times when estrogen levels are higher in your body, like during and shortly after one's menstrual menses or period, and you might notice more ADHD symptoms when levels are lower, like when you're having PMS, for example. And something else is that medication may not work as well if you were taking ADHD medication. So how does menopause in general affect ADHD symptoms?
Speaker 2:Everything that you've said is absolutely correct, and so when estrogen levels drop, symptoms of ADHD are elevated, and that's because dopamine and serotonin which are important for attention, working, memory, mood regulation they are also affected. So with the drop of estrogen, dopamine and serotonin are impacted, which lead to the worsening of the ADHD symptoms, and so the changes can also worsen mood disorders such as anxiety and depression. And how common is it for women to experience worsening ADHD symptoms during menopause? Does it affect everybody? Menopause? And they say that they've always had challenges with executive functioning but have found ways not always healthy to manage or cope. But with the hormone changes, they find their symptoms significantly increase and so it makes their daily struggle even more difficult, and sometimes they'll say it's not even tolerable. I can't understand why that is such a significant difference. So it is common, but the recognition of the symptoms has been one important key for women to start considering ADHD as possible coexisting with menopause.
Speaker 1:And they may not have realized that all along they've been living with ADHD and now perimenopause comes along and things are on fire, literally between the ADHD and the perimenopausal symptoms, plus the fact that the ADHD is worsening because the estrogen levels are decreasing. Is that, was that a fair statement?
Speaker 2:Absolutely for sure. The ADHD related symptoms are often attributed instead to menopause alone, when in actual fact they have been symptoms that have been related to ADHD all along, and because of the menopause or premenopause. Now things are worse.
Speaker 1:So many women may actually have been living with ADHD, and you know, what I'd like to do right now is just to define ADHD and what exactly it is, and there's different types of ADHD, but it's a common neurodevelopmental condition that affects attention, impulse, control, executive function like you mentioned planning, organization, judgment, mood and emotional reactivity, to name a few. And it's not a behavioral disorder, a mental illness, a learning disability or a matter of personal disability or discipline a learning disability or a matter of personal disability or discipline. In fact, it's a brain developmental impairment, and individuals with ADHD will struggle with a range of regular activities and perimenopause comes along and all of a sudden, they are experiencing worsening brain fog. They may have been able to live with it, but things are getting worse because the estrogen levels are decreasing and so it's adding insult to injury. Basically, and you know, their lives might become unmanageable and they may seek menopausal help. And how common is it for women to experience worsening ADHD symptoms during menopause, experiencing to experience worsening ADHD symptoms during menopause?
Speaker 2:It actually is common for women to experience these symptoms, and one of the reasons why we have an increased number of women in the 40s 50s who are seeking a possible explanation for their symptoms, seeking a possible diagnosis for ADHD, is because they are finding these symptoms of daily functioning attention, time management, organization, memory, mood regulation more difficult to deal with.
Speaker 1:And you know it's an important question, then, for general practitioners, who often see patients with perimenopausal symptoms, to ask the question have you been experiencing these symptoms prior to perimenopause? Are they worsening during this time of your life? Would that be a fair statement? Absolutely, absolutely, because I can imagine that diagnosing ADHD during perimenopause or menopause or post menopause can be challenging ADHD during perimenopause or menopause, or postmenopause can be challenging.
Speaker 2:It can be, especially if women haven't considered ADHD as a possible underlying condition. So the symptoms occur and they attribute the symptoms to menopause only and not the overlap between menopause and ADHD.
Speaker 1:For sure yes, and so it's really important to tease out the differences between the two, the overlaps between the two, the similarities. So it requires a very particular assessment, I would imagine.
Speaker 2:Yes, that's right, and part of it is talking about past experiences and ADHD related symptoms.
Speaker 2:So, for example, we could have women who, during perimenopause, menopause, say I've decreased focus, my mood has gone down, I'm feeling more down, I'm lacking motivation, but then I also am feeling down, but then I have times in which I'm really really irritable, I find stress harder to manage and one could think, okay, yeah, absolutely, those are symptoms of menopause, but those overlap with ADHD.
Speaker 2:So, in addition to looking at the symptoms that could be related to menopause, asking the important questions about executive function, about attention, about lack of being organized, losing things, avoiding tasks that require a lot of tension, having difficulty switching tasks always have had those difficulties with switching tasks, switching tasks and then being irritated that somebody interrupted me because I may find it hard to switch back to a task. I zone out during conversations. I'm thinking of so many different things in my head all at the same time. I'm constantly feeling overwhelmed by the amount of things that I'm asked to do, required to do, that I think I need to do tasks, projects. That all, of course, leads to emotional instability and the kind of the roller coaster of emotions, but those more are related to ADHD.
Speaker 1:So one can see there are actually differences and it's asking those questions that are related to ADHD, that could overlap with menopause, that is key to sorting out what is related to what and what the overlap is Patients they will come into the doctor and they will have perimenopausal symptoms hot flashes, night sweats, the classic ones musculoskeletal issues, urinary incontinence, vaginal health issues but they'll also have brain fog or worsening brain fog and they can be prescribed menopausal hormone therapy, but it may not work and they attribute that to perimenopause, when it could be ADHD. So can treating ADHD during menopause be particularly challenging.
Speaker 2:It can be challenging if ADHD isn't considered. So if we're going with the treatment for menopause, that's wonderful, but that may not address the brain chemicals I could say memory, mood regulation, those of dopamine and serotonin which are key to being able to function and use those executive functions in the maximized ways that one needs to in order to get through life and to get through the daily struggles.
Speaker 1:And I would imagine that medical history you know that you know. And school history, educational history, relationship history you know that you know. And school history, educational history, relationship history you know. What are some of the struggles that you've been having your entire life is a very important question as well for doctors who are assessing patients presenting with perimenopausal symptoms. What strategies can help manage ADHD symptoms during menopause?
Speaker 2:ADHD symptoms during menopause? Great, great question. We know both medical. You've spoken about hormone replacement therapy, medication for ADHD. Those are all medical paths, medical approaches one could take. But we also know that lifestyle approaches are important Maintaining as much as you can a healthy lifestyle with exercise, a balanced diet, good sleep hygiene.
Speaker 2:That can overall improve the brain health. Cognitive behavior therapy and while a lot of women say we use mindful practices, but in particular cognitive behavior therapy has been anecdotally totally women have told us has helped and they help individuals. Women develop coping strategies if they haven't already developed some new ones, if they have some and are looking for others. Improve organizational skills and really address the negative thought patterns that women have over time come to take on as part of their identity. And that's one thing that I speak about. When I speak to women. I said you have an accumulated history of living with ADHD and all of those things in your head that have told you you're not good enough. Or you might say I've tried this so many times and it's never worked, so therefore I'm not good enough. What I'm doing is not good enough. Or you might say I've tried this so many times and it's never worked, so therefore I'm not good enough. What I'm doing is not good enough. Those negative thoughts can be addressing. The negative thoughts are really crucial as part of treatment.
Speaker 1:I would. I can imagine and also I wanted to mention. You mentioned exercise and people may or may not realize that that helps with balancing the neurotransmitters of the brain, correct?
Speaker 2:Yes, indeed it does.
Speaker 1:And so which can be very helpful in treating perimenopause ADHD at perimenopause and menopause and postmenopausally, because really a person could be diagnosed at any time of their life. There's no age limit for this, correct?
Speaker 2:That is right. There is no age limit, right correct, that is right.
Speaker 1:There is no age limit Right, and it's worth it. It's worth getting the treatment.
Speaker 2:Can hormone replacement therapy which you mentioned, or menopausal hormonal treatment help with ADHD symptoms during menopause. Many women have found it is beneficial by stabilizing the hormone levels. Hormone replacement therapy can reduce the severity of menopausal symptoms that overlap with ADHD, such as the mood swings and the cognitive difficulties. But it's important to discuss, of course, the potential risks and benefits of the treatment with a healthcare provider to determine if it is the right option for you.
Speaker 1:Absolutely, and I would imagine that you know people will get some help and they might think, well, and a doctor might even say, well, you can't expect 100% help here. But doctors I think need to start considering is this ADHD? Is this attention deficit disorder? How can women advocate for themselves when seeking treatment for ADHD during menopause?
Speaker 2:Oh, wow, that's a great question. Well, we know that women have started to keep diaries and that's a good way to track changes. Some women have made calendars and they note their symptoms on a daily basis. They find that when tracking, it does actually lead to some patterns which can be helpful in bringing it to a medical professional during the consultation to show that you know what. This is what I've noticed happens, and it's important to seek out healthcare professionals who are knowledgeable about both ADHD and menopause. We know some women have joined support groups.
Speaker 2:There are a lot of online groups, kind of you know, have to pick one that you think might, if that's the way you want to go, might work, you might join one. Find it's not useful, seek out another one. But also, you know what you know. Stay informed of the latest information that's out there from a reliable source, not necessarily research per se, but someone who or a place where you know you can understand the information that's based on good evidence. That can empower women to make more informed choices, decisions about their treatment. And you're absolutely right being proactive and discussing all of the symptoms and treatment options with your health care provider is absolutely key.
Speaker 1:It is certainly critical. Dr Parhar, I really appreciate you coming on the program and to the listeners. Do you suffer with attention issues, impulse control, executive function, or do you know somebody who does? Do you, or somebody that you care about, have issues with planning, organization, judgment? Has somebody told you that your mood or your emotional reactivity to certain situations is over the top or a bit excessive? You'll want to share this episode with somebody that you care about that might be suffering through life because it could be ADHD, adult ADHD, attention deficit, hyperactivity disorder. We often don't associate that with adults, and certainly with female adults, but it can happen, and perimenopause and menopause is a critical time in a woman's life and it's also a time where you may notice the symptoms are worsening, as Dr Parhar said, and it's so important to talk to your healthcare provider about this and perhaps even mention both. My periods have changed, perhaps, and I'm noticing some increased brain fog. Do you think this could be perimenopause in addition to worsening ADHD? Very important conversation, dr Parhar. I really appreciate you coming on the program.
Speaker 2:Where can people get more information about ADHD and menopause? Well, for resources they can come to our webpage ADHDcenterforwomencom, and we have a resources page in which they can find more information about there and some further links to reliable resources to help them understand the symptoms and the condition a bit more.
Speaker 1:That is awesome. Thanks so much for joining the program, Dr Parhar.
Speaker 2:Thank you so much, Maureen.
Speaker 1:You're very welcome. That was Dr Anita Parhar, educational Director of the ADHD Center and the Director of Women's Health at the ADHD Center for Women, and I am Maureen McGrath, and thanks so much for tuning in to another episode, and please share this episode with somebody that you think might benefit. Thanks for tuning in and have a great evening. Thanks so much for tuning in. I'm Maureen McGrath, and you have been listening to the Sunday Night Health Show podcast. If you want to hear this podcast or any other segment again, feel free to go to iTunes, spotify or Google Play or wherever you listen to your favorite podcasts. You can always email me, nursetalk at hotmailcom or text the show 604-765-9287. That's 604-765-9287. Or head on over to my website for more information. Maureenmcgrathcom. It's been my pleasure to spend this time with you. Ladies, are you looking for a natural way to support your fertility journey? At the Ivy Health Center, they have the ultimate solution for you Introducing Acupuncture for Fertility, a holistic approach designed to transform your reproductive health. This non-invasive therapy can help balance your body's energy and enhance your fertility in just a few sessions. Imagine reclaiming your hope, confidence and sense of well-being. With Acupuncture for Fertility, you can experience a natural boost to your reproductive health and feel empowered on your path to parenthood. Visit theivca to schedule your consultation today. That's theivca. Don't wait. Nurture your fertility and transform your life at the IV Health Center.
Speaker 1:Ladies, do you leak urine? With cough, sneeze and or exercise? Leaking urine is never normal. Hi, I'm Maureen McGrath, registered nurse and nurse continence advisor. Ladies, it's time to stop letting bladder leaks hold you back. Say goodbye to embarrassing moments and hello to Moxipatch, the revolutionary solution for stress urinary incontinence. Moxie Patch is ultra-discreet, effective, reusable and eco-friendly, empowering you to live life to the fullest without worries or limitations. So, ladies, ditch the bulky pads and embrace freedom with Moxie Patch. Experience unstoppable confidence today. For more information or to order your Moxie patch, visit MoxiePatchcom. That's MoxiePatchcom, because you deserve to feel great again. Moxie Patch is also available online at select retailers and on Amazoncom. Get your Moxie Patch today. You'll be glad you did.