Why Your ADHD Feels Worse Some Weeks And What Hormones Have to Do With It (Here’s What You Can Do)

You’re not imagining it.

Some weeks, you're on top of things. Your medication and/or strategies work, you're checking off tasks, and life feels manageable. Then other weeks? It's like someone unplugged your brain. Your meds feel useless, executive function disappears, and even simple tasks feel impossible.

If you menstruate and have ADHD, this monthly roller coaster isn't random—and it's definitely not your fault. Your hormones are directly impacting your ADHD symptoms, and finally, science is catching up to what women have been experiencing all along.

The Truth Nobody Told Us

Here's what should have been part of your ADHD diagnosis: If you have a menstrual cycle, your symptoms are going to fluctuate throughout the month. Not a little. A lot.

Your ovaries produce estrogen and progesterone, and these hormones don't stay below the neck—they cross into your brain and affect everything, especially dopamine. And since we're already running low on dopamine with ADHD, when estrogen drops, our dopamine takes a nosedive with it.

Recent research published in the Journal of Attention Disorders confirms what we've been living with: hormonal fluctuations significantly impact ADHD symptoms, skill use, and medication effectiveness throughout your cycle.

Your Monthly Reality (Explained)

Let's break down what's actually happening in your body and brain each month:

Week 1-2: The "I've Got This" Window (Follicular Phase)

Right after your period starts through ovulation, estrogen is rising. For many women with inattentive-type ADHD—those dealing with brain fog, low energy, and anxiety—this is the power window. You might notice:

• Your medication actually works

• Skills and Strategies are easier to use

• You can remember why you walked into a room

• Starting tasks doesn't feel as overwhelming

• Your anxiety and intrusive negative thoughts slow down

If you're more hyperactive or impulsive, this high-estrogen phase can actually increase impulsivity. That dopamine surge might lead to late-night online shopping or saying yes to commitments you'll later regret.

Week 3: When Things Start to Shift (Early Luteal Phase)

After ovulation, progesterone rises and estrogen begins declining. You might notice:

• Increased restlessness or impulsivity

• Irritability that seems to come from nowhere

• A creeping sense that something feels off

Week 3-4: When Everything Gets Harder (Mid-to-Late Luteal Phase)

As estrogen plummets, so does your dopamine. This is when:

• Executive function vanishes. Meal planning, decision-making, task-switching—all impossible.

• Your medication stops working. That dose that was perfect last week? Suddenly ineffective.

• Everything feels harder. Emotions are intense. You're irritable, anxious, tearful, or numb.

• ADHD symptoms peak. Inattention maxes out. You're forgetting everything. Time blindness worsens.

  Remembering to use skills feels impossible. You may think “Do I have skills? When should I use them?” Forgetting skills is so common!

  One woman described it: "The entire week leading up to my period, my ADHD symptoms get even more intrusive than usual. My executive functioning dips even lower… It's like my body overrides my meds."

You're not alone in this experience.

Why Your Medication Feels Different

Your stimulant medication works by affecting dopamine in your brain. But when estrogen drops during the premenstrual phase, your baseline dopamine is lower. The same dose that helps you function during high-estrogen weeks suddenly isn't enough.

It's not that your medication isn't working—your brain chemistry has fundamentally changed. You're trying to fill a bigger hole with the same tools.

And most doctors never told us this. We're left thinking we're failing, our meds are failing, or something's suddenly "broken" once a month.

The PMS/PMDD Connection

Women with ADHD experience PMS and PMDD (premenstrual dysphoric disorder) at significantly higher rates—nearly two-thirds of us deal with these conditions. PMDD symptoms include difficulty concentrating, mood swings, feeling overwhelmed, irritability, and anxiety. Sound familiar?

Layer that on top of already-intensified ADHD symptoms, and it's no wonder these weeks feel unbearable.

What You Can Do About This

Medical providers and research are still catching up, but here's what you can do right now:

1. Track Your Cycle and Symptoms

For 2-3 months, track:

• Where you are in your cycle (Day 1 = first day of period)

• Your ADHD symptoms each day

• How well your medication seems to work

• Your mood, energy, and ability to focus

Use whatever method works for your brain—an app, bullet journal, or sticky notes. Once you see the patterns, everything clicks into place. You'll stop blaming yourself and start working with your biology.

2. Talk to Your Doctor About Cycle Dosing

Bring your tracking data to your psychiatrist or prescriber and discuss adjusting your medication based on your cycle. Options that work for some women include:

• Increasing stimulant dosage during the premenstrual week

• Adding a short-acting booster during the luteal phase

• Adjusting medication timing

You may need to advocate for yourself—some doctors aren't familiar with this approach yet. Come prepared with your tracking data and research. You deserve treatment that works for your body.

3. Plan Your Life Around Your Cycle

Once you know your patterns, work with them instead of against them:

During high-functioning weeks:

• Schedule important meetings, presentations, or deadlines

• Tackle big projects requiring focus

• Batch tasks that need executive function

• Do meal prep for the month

During challenging weeks:

• Lower your expectations (survival mode is okay)

• Pre-prepare easy meals or give yourself permission for takeout

• Cancel non-essential commitments

• Ask for help

• Build in buffer time for everything

4. Replace Shame with Understanding

This is crucial: You're not lazy, broken, or failing when your symptoms worsen before your period. Your brain chemistry is literally different.

The woman who crushed her to-do list two weeks ago and the woman staring at the same list unable to start? Same person, different hormones. Stop comparing yourself across your cycle.

Try this instead: "I'm in my low-hormone phase. My brain needs more support right now. This is temporary."

5. Build in Supportive Strategies

While we wait for better medical solutions:

• Move your body (even a 10-minute walk helps)

• Protect your sleep (crucial, though difficult)

• Reduce caffeine and sugar during the premenstrual phase

• Increase protein intake

• Consider omega-3 supplements (some evidence suggests they help)

• Give yourself permission to do less

You Deserve Support That Fits Your Reality

For decades, women's cyclical experiences were dismissed as "just hormones" or "in our heads." ADHD research was mostly done on boys and men. We've been trying to manage our ADHD with strategies and medications designed for people whose brains don't go through monthly hormonal fluctuations.

But change is happening. More women are speaking up. More research is being done. The conversation about women, hormones, and ADHD is finally gaining traction.

You're Not Alone in This

If you've been beating yourself up for "not trying hard enough" during certain weeks, here's what you need to know: It's not you. It's your hormones affecting your dopamine system. That's not an excuse—it's an explanation backed by science.

You're not broken. You're not weak. You're not failing. You're navigating ADHD while your brain chemistry shifts monthly, often without adequate medical support or understanding.

But now you have information. And information creates possibilities.

Track your cycle. Advocate for medication adjustments. Connect with resources to increase ADHD knowledge and Executive Functioning skills. Plan around your patterns. Be gentle with yourself during hard weeks. And know that you're not experiencing this alone.

Some weeks will be easier. Some will be challenging. Both are valid parts of your experience as an ADHD woman who menstruates.

Ready to Get Support That Actually Gets It?

At Flourish & Focus, we understand the unique challenges women with ADHD face—including how hormones impact your symptoms. Whether you're looking for individual counseling to build strategies that work with your cycle, “Ladies Let’s Unmask Therapy Group” support with other women who understand, or ADHD testing to get clear answers, we're here to help you thrive on your own terms.

You deserve a safe, non-judgmental space where your experiences are validated and your struggles are understood. Let's work together to help you flourish.

This article is based on research published in the Journal of Attention Disorders and reporting from ADDitude Magazine. Always work with qualified healthcare providers before making changes to your medication or treatment plan.