“Hormones rule me”: A qualitative exploration of the impact of perimenopause on women with ADHD

Background Perimenopause appears to be a particularly complicated period for women with Attention-Deficit Hyperactivity Disorder (ADHD), who report increased physical, sexual, and mood-related symptoms compared to neurotypical women. Objectives The present study sought to investigate qualitatively how women with ADHD experience perimenopause. Design The present study employed a qualitative, phenomenological design. Methods Nineteen cisgender women with ADHD residing in Ireland (age range = 29-62, M = 47.17, SD = 6.59) participated in semi-structured. Interviews were conducted online, via Zoom or email, and transcribed verbatim. Data were analysed using Reflexive Thematic Analysis. Results Four themes were developed. “It literally just hit me like a punch in the face”: Navigating emotional and cognitive changes showcased the impact on ADHD and mental health. “I ache and I feel old”: Navigating physical changes explored how the physical symptoms of perimenopause affect women relationship to their bodies, especially sexual symptoms. “Whatever I’m searching for perimenopause, it should be within the light of ADHD”: Navigating healthcare highlighted the importance of integrated care for ADHD and perimenopause. “It’s like going through a fire that burns off all that you don’t need anymore”: Finding the positives suggested that while challenging, perimenopause could bring new compassion and understanding for ADHD. Conclusion These results highlight the complications and difficulties experienced by women with ADHD during perimenopause, and the importance of supporting them with integrated, affirming healthcare.