Attention Magazine June 2024

When girls with ADHD enter puberty, the changes they experience extend beyond the descriptions offered to them in health class. The fluctuations and physical changes brought on by hormones in adolescence can make managing ADHD symptoms difficult. These, in turn, affect executive functions like focus, motivation, impulsivity, and the ability to regulate emotions.

Period-tracking smartphone apps are one tool available to teens and young women to help them manage some of their new challenges. The awareness they gain through tracking can help them understand how monthly cycles in their hormones affect ADHD symptoms.

Tracking their menstrual cycles can help girls predict when they will have their period and the days when their ADHD symptoms may get worse. Apps can also record when they experience fatigue, backaches, cramps, headaches, as well as increases in anxiety, changes in mood, and disruptions to sleep that are tied to their cycle. Awareness can help them plan for possible changes in ADHD symptoms during their menstrual cycles. Knowing when their symptoms may get worse can better equip them to handle upcoming executive function and emotional challenges.

Puberty, hormones, and ADHD symptoms
The number of girls diagnosed with ADHD increased dramatically when the diagnostic criteria for onset of symptoms was increased from seven to twelve, says Ellen B. Littman, PhD, a clinical psychologist. “This surge,” says Dr. Littman, “occurred because most girls with ADHD exhibit more prominent symptoms after puberty, following the release of estrogen.”

This may explain why ADHD symptoms seem to increase during certain times of a girl’s menstrual cycle, along with an increase in co-occurring conditions like anxiety or depression. The fluctuations in estrogen have been shown to affect executive functions, says Linda Roggli, an ADHD coach and author of Confessions of an ADDiva: Midlife in the Non-Linear Lane. “For some women with ADHD, this drop in estrogen at ovulation can mean ADHD symptoms increase and executive functions take a nosedive,” she says. Girls should be aware that it’s not only during ovulation—the midpoint of one’s cycle—but the week before her period when she may see the biggest increase in ADHD symptoms.

Awareness can help girls plan for possible changes in ADHD symptoms during their menstrual cycles. Knowing when their symptoms may get worse can better equip them to handle upcoming executive function and emotional challenges.

Many adult women also find it helpful to use an app to track those same hormone-related executive function fluctuations throughout the month. Apps like Flo, Clue, Cycles, and M. Calendar can help track days during the month when women might feel more anxious or find it harder to focus or accomplish tasks. Some apps can even send reminders on days when it’s likely they may experience dips in mood or energy or have feelings of frustration and fatigue. That way she is not caught by surprise if she’s feeling more irritable, anxious, or tired.

Young women do need to know that tracking their period alone doesn’t act as contraception. Some apps can help them keep track of whether they’ve taken prescribed birth control, however, which may be useful if they have a hard time remembering to take medication. And if you and your daughter look for tracking apps together, it can become an opportunity to discuss your family’s values and expectations with regard to dating and possible sexual activity and safer sex.

Keep in mind that some apps do have costs, especially if you’re looking for ones without advertising attached. Some apps share de-personalized information with researchers or advertisers that may make them poor choices for use by your daughter. Be aware that some of these apps also record location data, so be sure to research thoroughly any app you plan to use.

Isabella, a young teen with ADHD, OCD, and anxiety, has been using the Clue app for two years to track her period. She finds it helpful to have a free app on her smartphone to track her physical symptoms along with any increased anxiety she experiences. “It’s such a relief to have [the app] because I haven’t had my period for long and I wouldn’t know when it’s coming.” She says that the variety of things she can keep track of—daily menstrual flow (light, medium, heavy), skin changes, cravings, and the ability to rate her feelings—has been helpful for managing her complex ADHD symptoms. Since she also takes medication as part of her ADHD treatment plan, Isabella uses the app to set reminders to stay on top of taking her medication.

Becoming in tune with one’s body
Using an app, a smartphone calendar, or recording symptoms in a period diary is a great way for girls to learn their body’s signals throughout the month. These apps provide an opportunity for a girl to connect how she feels, physical changes, and ADHD symptoms throughout the month. She can then plan to exercise more, limit time on devices, get more sleep, and include more protein, fruits, and vegetables in her meals. Knowing when her period will most likely occur can help her to be aware of any increased irritability, difficulties focusing, or trouble completing assignments.

One young woman with ADHD shared on social media how a period app helps her manage executive function difficulties brought on by fluctuations in hormones.

“I now know what week of the month is going to be harder, so I can prepare for it and be easier on myself because I know it will pass,” she writes. “I can’t stop it, but knowing how it affects me and when my period is coming helps me feel ready for the challenges.”

If you are a mother who has ADHD, it might also be helpful to talk with your daughter about how ADHD affects you. Let her know what things help you and what things you’ve learned to avoid because they don’t help. Your daughter will also be better able to care for herself and understand how her body works if she can follow the example of someone she knows well.

“Have empathy for what your body and brain are going through,” advises another woman who opened up on social media when discussing her calendar app. “If you are getting distracted or tasks are taking much longer than usual, give yourself grace that you are even trying at such a hard time.”

Jami Demuth is coordinator of CHADD’s Midwest Regional Center and health information team manager at CHADD’s National Resource Center on ADHD. She holds a master’s degree in teaching from Drake University. In her spare time, she is a freelance writer whose writing has been featured in the Des Moines Register, the Gazette, HuffPost, Motherly, The Mighty, Scary Mommy, and Attention magazine.

ADDITIONAL READING: CHADD RESOURCES

ADHD in Women and Girls | chadd.org/for-adults/women-and-girls

Symptoms of ADHD in Women and Girls | chadd.org/for-adults/symptoms-of-adhd-in-women-and-girls

Those Lovely Mones: The Intersection of ADHD and Hormones | chadd.org/attention-article/those-lovely-mones-the-intersection-of-adhd-and-hormones

The Gender Myths and ADHD | chadd.org/attention-article/the-gender-myths

Why ADHD Is More Challenging for Women | chadd.org/attention-article/why-adhd-is-more-challenging-for-women

Girls with ADHD Internalize Struggles | chadd.org/adhd-news/adhd-news-caregivers/girls-with-adhd-internalize-struggles

The Secret Lives of Girls with ADHD | chadd.org/wp-content/uploads/2018/06/ATTN_12_12_Littman_Attention.pdf