How Do Puberty and Menstruation Affect Girls with ADHD?

Hormonal changes connected with menstruation can increase ADHD symptoms

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"My 12-year-old daughter, who has ADHD, has been more and more difficult - dramatic and moody - over this last year. She has also started her menstrual cycle and is a major challenge right before her cycle. Can hormonal changes affect ADHD symptoms?"

Managing and regulating feelings is hard for any child. Add the challenging of puberty, and it gets tougher. Through in a healthy dose of ADHD, and the situation can become overwhelming.

What's going on?

ADHD and Puberty: A Perfect Storm

ADHD can make girls more emotionally hyper-reactive. So can pre-menstrual symptoms. With both at work, many girls are especially vulnerable and likely to explode, melt down, or otherwise lose emotional control.

ADHD can make girls more self-conscious. So can puberty. Menstruation, of course, is also a reason for anxiety related to body image. All of these elements work together to create a "perfect storm" of self-consciousness and plummeting self-esteem.

Pre-menstrual symptoms such as depression, cramping, and fatigue are often more intense for girls with ADHD. ADHD symptoms are made more intense by challenges such as stress, fatigue, and pain. Thus, girls going through puberty may be caught in a vicious cycle of increasing emotional distress.

How Parents Can Help

What can parents do to help?

If symptoms escalate to the point where your daughter experiences such extreme frustrations that she reacts with rage, depression or anxiety, talk with her doctor right away. There are medications that may be used to help your daughter if the PMS issues become too intense.

Educate yourself and your daughter. It is important for girls with ADHD and their parents to be aware of how these hormonal changes can impact daily life. With this understanding, parents are apt to be more tolerant of the struggles and vulnerabilities their daughter is facing and girls are more likely to proactively identify the stresses that can worsen reactions and ADHD symptoms and develop positive coping strategies to get through these difficult times.

Help your daughter to manage stress and fatigue by taking time away from school and social pressures to simply relax and recuperate. Make sure your daughter is getting enough sleep, is eating well, and is not overwhelmed by academic or social pressures.

Be supportive. Your daughter may be moody or irritable, but these feelings will pass. Meanwhile, your support and encourage can help her develop strategies to manage her emotions. Maturity, too, will make a positive difference.

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Article Sources

  • Kathleen G. Nadeau, PhD, Ellen B. Littman, PhD, Patricia O. Quinn, MD. Understanding Girls with AD/HD. Advantage Books. Washington, DC. 2006.