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Layla Kornota, a teaching assistant living with ADHD, manages her daily routine with the help of multiple phone alarms. She relies on four reminders to wake up, one to get dressed, another to pack her work bag, and several more throughout the day. “There’s a million different ones. Different times of the day,” the 30-year-old explains as she scrolls through the many alerts on her device. While this barrage of alarms might seem excessive to some, Layla finds these structured prompts essential for maintaining focus and keeping her ADHD brain on track.
However, this fragile sense of control tends to slip away as Layla approaches the peak of her menstrual cycle. “It’s like you’re clinging on, for dear life, onto the ball that is continuing to roll, and sort of cursing yourself and the world the entire time,” she shares. ADHD, as defined by the NHS, is a condition characterized by differences in brain function that can cause challenges with concentration, emotional regulation, and hyperactivity. Numerous conversations online highlight how menstrual cycles appear to amplify ADHD symptoms in many women, a connection now being examined through a pioneering study conducted by Kings College and Queen Mary University in London. This research involves 50 women with diagnosed ADHD who are on medication; they track their menstrual cycles alongside their symptom fluctuations and overall daily functioning.
In the UK, approximately 2.5 million people are estimated to have ADHD, with many still waiting for formal diagnoses through the NHS. Recent years have seen a surge in demand for ADHD assessments, partly driven by increased awareness about the condition—especially in women. NHS data from December 2023 indicate a 23% rise in the prescription of stimulants and other ADHD medications compared to the prior year. Nonetheless, a government taskforce report from November 2023 notes that ADHD remains widely underdiagnosed and undertreated. Moreover, some regions in England have had to close their NHS waiting lists as they struggle to cope with the overwhelming demand for services.
One of the women participating in the study, 19-year-old university student Héloïse, describes how her ADHD medication, Ritalin, typically provides a crucial window of focus lasting about three hours. But during her period, she experiences a frustrating absence of this effect. “It feels like losing a walking stick or something you use to support yourself. All of a sudden it’s broken,” she says. By mapping her symptoms alongside her menstrual cycle for the Kings College study, she identified a clear pattern connecting hormonal fluctuations to increased ADHD challenges. Similar sentiments were echoed by other participants, some of whom described feeling “disabled” at certain points in their cycle. The women maintained electronic diaries tracking hormone levels and the severity of symptoms such as anxiety, depression, and impulsivity. Researchers are exploring how these cycles correspond not only to symptom intensity but also to the effectiveness of medication.
Psychiatrist Sally Cubbin, a neurodiversity expert involved in the study, explains the biological mechanisms that may underlie these monthly shifts. She points out that during phases when oestrogen levels dip—such as just before menstruation—dopamine, the brain’s ‘feel-good’ neurotransmitter, is also affected, leading to heightened ADHD symptoms. These hormonal fluctuations contribute not only to difficulties in concentration and task management but also to increased impulsivity and risk-taking behaviors. “Women are also more likely to make dodgy decisions and take risks,” including binge eating, overspending, or neglecting contraception, she notes. Layla herself experiences these urges, such as cravings that push her to overeat even when she knows it will make her feel unwell. “It’s this impulse to do it and then once it’s in your head it’s really difficult to shut it down or turn it off,” she admits.
Dr Jessica Agnew-Blais, lead researcher on the Kings College project, emphasizes that ADHD in women—particularly adults—is a critical and emerging research area. Historically, ADHD was viewed largely as a childhood condition affecting mostly boys, but current awareness has shifted significantly. Dr Catherine Durkin from the Royal College of Psychiatrists remarks, “Thanks to increasing awareness of how ADHD symptoms can present in women, more are recognising where they have struggled throughout their lives and are now asking for help.” Women involved in the study are also interested in understanding how major hormonal transitions like menopause and peri-menopause influence their ADHD symptoms; Dr Agnew-Blais sees the ongoing research as a starting point for addressing these important questions. She stresses that this knowledge isn’t about changing who people are but rather about finding ways to better integrate ADHD management into their lives.
For Layla, participating in the study has been both “validating and freeing.” She shares that she has often felt frustrated by not meeting expectations, but realizing that many women experience similar monthly challenges has offered a sense of community and relief. “Understanding that this is something that a lot of women are going through every month for most of their life. It’s good to have kind of community and feel like that it’s okay, this isn’t just me.”
Read the full article from The BBC here: Read More
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