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ADHD Chatter Podcast

How Hormones and Menopause Impact ADHD Women | Dr. Louise Newson

Dr. Louise Newson is a physician, menopause specialist and member of the UK Government’s Menopause Taskforce.

Dr. Louise NewsonguestAlex Partridgehost

Apr 7, 20251h 4mWatch on YouTube

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CHAPTERS

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Chapter summaries

Why Hormones Matter for the ADHD Brain
Alex Partridge welcomes Dr. Louise Newson and asks what listeners will gain. Newson wants people to think differently about hormones and the brain, explaining that estradiol, progesterone and testosterone are neurosteroids made in the brain. She also outlines her background as a general physician with a pathology degree.
- •Newson wants listeners to see hormones as affecting brain function, not only periods
- •Estradiol, progesterone and testosterone are made in the female and male brain
- •These neurosteroids work with other neurotransmitters
- •Newson is a general physician, not a gynecologist, with a pathology degree and 25 years as a GP
- •She describes her practice as patient-centered and evidence-based
How the Hormone Cycle Affects ADHD Symptoms
Newson explains how ADHD often worsens with hormonal change, and that perimenopause and menopause mainly cause brain symptoms such as brain fog and poor concentration. She says that in her clinic the right dose of hormones, especially testosterone, improves ADHD symptoms. She criticizes the lack of connection between psychiatry and menopause care.
- •Menopause symptoms are mostly brain-related: brain fog, poor memory, irritability, poor sleep, low mood and anxiety
- •Symptoms often worsen in the second half of the cycle and improve once a period arrives
- •Testosterone in particular helps ADHD symptoms in her clinic
- •Psychiatrists treat ADHD and gynecologists treat menopause, so there is no connection
- •Many women with symptoms starting in their 40s are given amphetamine-type drugs
Hormones Missing from ADHD Assessment and Treatment
Partridge asks whether it is a travesty that hormones are not raised in ADHD assessments. Newson describes training psychiatrists who said they were only commissioned to prescribe certain drugs. She says hormones should be rebalanced first, then lifestyle looked at, and explains the difference between natural hormones and synthetic contraceptive hormones.
- •Newson describes psychiatrists restricted by commissioning to ADHD drugs
- •Referral back to a GP is hard because of access and GP knowledge
- •She says treating the underlying cause is a core principle in medicine
- •Telling exhausted menopausal women to exercise and sleep better often fails until hormones are rebalanced
- •Synthetic contraceptive hormones can block natural hormones, while body-identical hormones replace like for like
How Women Have Been Kept in the Dark
Partridge asks how in the dark women have been kept about hormones. Newson says doctors have been kept even more in the dark, citing the exclusion of women from studies, the normalization of PMS and fear of HRT. The conversation covers the lack of research on hormones and ADHD medication, and a colleague's transformation on HRT and testosterone.
- •Women were excluded from drug studies; Newson says guidance to include them came the year she qualified, 1994
- •Early research on hormones was forgotten in favor of marketing around periods
- •PMS has been normalized and trivialized
- •Partridge notes the first study of hormones and ADHD medication response in women was only in 2024
- •Newson shares a colleague with ADHD who found HRT and testosterone transformational
When in the Monthly Cycle ADHD Is Most Manageable
After the Tiimo sponsor break, Newson walks through the 28-day cycle and the hormone peaks and drops. Symptoms most classically worsen just before a period because of the sharp decline in hormones, which affect energy production and neurotransmitters. Responses vary between women, but many notice a cyclical pattern.
- •Estradiol and progesterone rise in the first half; a peak around ovulation includes testosterone
- •Progesterone and estradiol fall off a cliff before a period
- •The brain likes homeostasis, so change triggers symptoms
- •Hormones affect mitochondria, serotonin, dopamine, glutamate and melatonin
- •Women commonly notice cyclical variation
Why Late-Diagnosed Women Need to Understand Their Hormones
Partridge asks how important hormone understanding is for late-diagnosed women. Newson says it is crucial and neglected, explains perimenopause, and shares that she missed her own symptoms until her daughter diagnosed her. She stresses that women should recognize symptoms themselves rather than wait for a doctor to diagnose.
- •Perimenopause can last about 10 years, often with regular periods
- •Without knowledge or tracking, women blame other things
- •Newson's own symptoms lasted months until her middle daughter identified them
- •About 1 in 30 women under 40 have early menopause
- •Women should recognize symptoms and seek help rather than expect doctors to diagnose
Contraception and Its Effect on the Brain
Asked which contraception she means, Newson says all types are synthetic, including the combined pill, progesterone-only pill and implants. Using a lock-and-key analogy, she explains they block natural hormones and may lower serotonin and dopamine. She says younger people's symptoms are often blamed on youth or student life.
- •Newson includes the combined pill, progesterone-only pill and implants
- •Chemically altered hormones fit receptors like a dodgy key
- •Contraceptive pill users may have lower serotonin because estradiol is blocked
- •Few good studies exist on this in women
- •Young people's symptoms are often put down to immature brains or student life
Menopause as a Trigger for Overwhelm and ADHD Assessment
Partridge asks whether menopause symptoms make life overwhelming and lead to ADHD assessment. Newson agrees that hormone changes can cause catastrophizing, anxiety and memory problems, with misdiagnosis of depression and turning to alcohol or drugs. She then gives advice for women who feel menopause is coming, including tracking symptoms and being proactive.
- •Changing hormones can cause catastrophizing, anxiety and poor recall
- •Women are often misdiagnosed with depression and given the wrong medication
- •Low dopamine can lead people to alcohol or drugs; Newson cites an addiction survey
- •Newson recommends tracking symptoms, for example with her free Balance app
- •Earlier treatment is better, and testosterone and progesterone can help the brain
Misdiagnosis, Labels and Treating the Underlying Cause
Partridge asks whether hardship from menopause can lead to an ADHD diagnosis. Newson says many people are misdiagnosed and that she would not rush an ADHD diagnosis in someone with hormonal changes. She shares a WhatsApp group of ADHD specialists seeing similar effects and worries about labels and false expectations.
- •Perimenopausal chaos in the brain can produce symptoms misdiagnosed as ADHD
- •Newson favors treating the cause first, then seeing what is left
- •Women could ask whether they can consider hormones first
- •Specialists in her WhatsApp group report similar benefits, especially from testosterone
- •She worries a diagnosis is seen as a transformation and that doctors set false expectations
Emotional Dysregulation, Cortisol and Trauma Versus Hormones
Partridge raises emotional dysregulation and its link to menopause. Newson explains how hormones derive from cholesterol and how stress hormones trade off against progesterone. She argues too much emphasis is placed on past trauma over hormonal balance, and Partridge asks where the line falls between hormone therapy and talking therapy.
- •Hormones derive from cholesterol, and progesterone also forms cortisol
- •More stress hormones means likely less progesterone, in a seesaw
- •High adrenaline, noradrenaline and cortisol make the brain hypervigilant
- •Newson says trauma matters but is worsened without hormonal balance
- •Partridge asks where to draw the line between hormone therapy and therapy
Menopause, AuDHD and a Beacon of Hope
After the Hallowell sponsor read, Partridge asks how menopause interacts with AuDHD. Newson says neurodivergent women often worsen, with more hyperfixation, rumination and ritualistic behavior, and that she sees improvement with hormone rebalancing. She stresses that natural hormones differ from contraceptives and says long-term hormones can be a source of hope.
- •Neurodivergent women often get worse in perimenopause and menopause
- •Fluctuating symptoms are a telltale sign to think about hormones first
- •Bad experiences with implants reflect synthetic hormones, not natural ones
- •Some women are more testosterone deficient than estrogen or progesterone deficient
- •Hormones can be continued or stopped if they do not work
The ADHD Item: Diary, Yoga and Staying Present
Newson reveals her ADHD item, a daily diary she uses for to-do lists, and says she is sure she has ADHD though undiagnosed. She and Partridge compare notebooks, whiteboards and sticky notes. Newson adds that yoga and focusing on the present help clear her mind.
- •Her diary holds daily to-do lists, and ticking items off or moving them forward helps her
- •Writing things down empties her brain
- •Partridge uses whiteboards and fridge notes against out of sight, out of mind
- •Newson does Ashtanga yoga and meditation to clear her mind
- •Everyone needs to find tools that work for them
ADHD Agony Aunt: Teenage Girls, Hormones and ADHD
In the Washing Machine of Woes segment, a listener asks what to expect as her daughter with ADHD goes through adolescence. Newson says mood swings should not be normalized, cites a 1961 study on exam performance before periods, and suggests progesterone for older teens, nutrition, calming activities and open conversation.
- •Adolescence is a taste of perimenopause
- •Newson cites a 1961 study showing girls do worse in exams just before their period
- •Giving a little progesterone can be transformational for some 18 and 19 year olds
- •Nutrition, exercise and calming activities like walks help with cortisol
- •Talking while driving or walking can help teenagers open up
Closing Thoughts and a Letter with Three Rules
Newson reflects that without hormones she would not be working as a doctor. Partridge delivers a letter from the previous guest with three rules to live by, and Newson reads them. They discuss what might not be figureoutable, and Newson reflects on meanness she encounters around women's health.
- •Newson says she would not be working as a doctor without taking hormones
- •The previous guest's rules: people will judge you, everything is figureoutable, be nice to yourself
- •Newson struggles to understand why people are mean
- •She links meanness around women's health to misunderstanding and fear of change
- •She says the criticism comes mainly from women

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