ADHD is characterised by inattention, hyperactivity and impulsivity. Although originally considered a childhood condition, it is now known to impact all ages (Song et al., 2021), meaning taking a lifespan approach to ADHD is critical. Whilst this is increasing, research has identified that women are often undiagnosed, untreated and more likely to have depression and anxiety (da Silva et al., 2020; Groß-Lesch et al., 2016; Young et al., 2020). This has led to calls to examine the role of female hormones in ADHD.
The most significant hormonal fluctuations in women occur during the menopause transition which can last over a decade. This transition brings physical, endocrine and psychological changes (Hilditch et al., 1996) and is divided into stages. Premenopause is characterised by regular menstruation and stable oestrogen. Perimenopause is characterised by irregular menstruation and fluctuating hormones causing hot flushes, anxiety, disrupted sleep, depression, and poor memory (Talaulikar, 2022), many of which continue postmenopause and overlap with ADHD. The menopause refers to the last menstrual period, and 12 months after that women enter the postmenopause stage (Peacock et al., 2024).
There is little research into the menopause in ADHD. We recently conducted survey of women with and without ADHD and found that in all women ADHD symptoms correlated with menopausal complaints. However, we also found that women with ADHD receiving stimulant medication struggled with wellbeing and psychosocial symptoms in peri- and postmenopause. This research is a good starting point but its quantitative nature does not allow us to understand how women feel about these experiences, something historically neglected in menopause research (Rubinstein & Foster, 2013). Furthermore, it is important to recognise the wider healthcare context. The menopause is under-researched and under-treated with evidence suggesting GPs and registrars don’t feel equipped to advise and treat women appropriately (De Giovanni et al., 2018; Dintakurti et al., 2022). However, to date, no research has examined the views of psychiatrists involved in the diagnosis, treatment and review of adults with ADHD.
Understanding menopausal experiences in ADHD is critical but it is equally important to develop support to manage symptoms. Whilst hormone therapy is an effective treatment for specific symptoms, it is not indicated for all women and may interact with stimulant medications for ADHD (Zovkic & McCormick, 2019). An alternative approach is Cognitive Behavioural Therapy (CBT) which considers the impact of hormonal changes but also a women’s attitudes, expectations, appraisals and past experiences (Hunter, 2021). It is effective when delivered via group or self-help approaches (Ayers et al., 2012) but has not been examined in those with ADHD, and it is possible that adaptations would be required to make it suitable for this cohort (William et al., 2024).
This project will further develop understanding of the menopause in ADHD by conducting qualitative research with both women with ADHD and psychiatrists to investigate their knowledge, attitudes and reactions to the menopause. Additionally, a preliminary study of CBT for the menopause in women with ADHD will be conducted to better inform menopause management in this key group.
How to apply:
- Details on how to apply can be found in here: https://www.findaphd.com/phds/project/attention-deficit-hyperactivity-disorder-adhd-and-the-menopause-from-understanding-to-management/?p181480
- Applicants should also complete the online LISS-DTP Diversity Monitoring Form
- The closing date for applications is 19/02/2025
- Interviews will be held on 10/03/2025
- This project is offered as full-time only
- For any queries contact eleanor.dommett@kcl.ac.uk