Negative Mood, ADHD Symptoms Intensify with Menstruation: Study

January 29, 2026

Women with ADHD who report significant negative mood symptoms just before and during menstruation tend to experience similar-magnitude increases in ADHD symptoms at this time, found a new study in Journal of Attention Disorders.¹ Building upon a modest foundation of previous research that found ADHD symptoms vary across the menstrual cycle, the researchers studied women of reproductive age with ADHD treated with amphetamine salts, the most commonly used medication among members of this demographic, 60% of whom use Adderall of Mydalis.²

The 30 study participants were required to complete daily surveys measuring their ADHD symptoms as well as the severity of 17 mood symptoms. Participants reported their total daily dose of amphetamine salts, as well as use of other medications, alcohol, tobacco, or cannabis.

The study found:

• ADHD symptoms were most severe in the menstruation phase of the monthly cycle
• Negative mood symptoms were most severe in the menstruation and luteal phases
• The magnitude of increase in ADHD symptoms and negative mood was similar, leading researchers to conclude that mood and ADHD symptoms co-vary between menstrual cycle phases

These findings validate the anecdotal experience of many women with ADHD.  “Fluctuating estrogen and progesterone across the menstrual cycle invariably impact ADHD symptoms, emotions, and functioning. We know this to be true, but there is almost no research validating this relationship,” explained Lotta Skoglund Ph.D., in her recent ADDitude article, “The Menstrual Cycle Impacts ADHD Symptoms in Disparate Ways.”

“The entire week leading up to my period is where my ADHD symptoms get even more intrusive than usual,” says Chloe, an ADDitude reader. “My executive functioning dips even lower, distractibility and difficulty focusing is increased, and my mood/energy level is much lower, causing me to feel badly about all the things I’m not being successful at that week.”

Charlie, a reader in Australia, echoes this experience: “A week before I am due for my period, my brain goes to complete peanut butter. It is an utter mission to focus and stay on task. Sensory overload is at its peak. Impatience rules the days, and I get so overwhelmed.”

In addition, many women report lower efficacy of ADHD medication during the luteal and menstrual phase. One ADDitude reader shares “My ADHD meds are significantly less efficacious for about 10 days per month; two days before menstruation I am a barely functional zombie.” Norma, an ADDitude reader in Wisconsin, describes a similar experience, “The week leading up to my cycle, I might as well not even take my ADHD meds. It’s like my body overrides them.”

Based on similar anecdotal reports, the study’s researchers sought to uncover whether women with ADHD were exploring cycle syncing, increasing their dose of stimulants during the late luteal and menstruation phases to address intensified ADHD symptoms. They found, however, that women maintained constant daily medication dosing throughout their menstrual cycles.

“This may reflect prescribing practices for stimulant medications, which often do not encourage ‘flexible’ or ‘symptom-based’ dosing regimens, as well as potential inexperience of providers or patients regarding the effects of menstrual cycle phase on medication metabolism and efficacy,” the researchers reflect. The authors refer to an earlier study that found many women with ADHD were hesitant to ask doctors about the effect of their menstrual cycle on ADHD medication and often reported invalidating responses from their practitioners when they did inquire.³

Skoglund advises women to use a menstrual cycle tracking log to record and report specific data to aid these conversations with doctors: “Tracking your cycle will give you powerful insights into how hormonal fluctuations influence your ADHD symptoms, medication effectiveness, and overall functioning. With this data, you’ll be in a better position to talk to your doctor about enhancements to your treatment plan to improve your health and wellbeing.”

The study had several limitations, including its small sample size; 16 of the 46 initial participants were excluded for failure to complete daily surveys, leaving 30 participants, and the authors note it is possible the individuals who successfully completed the surveys had milder ADHD symptoms. In addition, unlike other studies,⁴ the researchers did not measure ovarian hormone levels, relying on participants’ reporting of menstruation for this information. Individuals who were taking other psychiatric medications were excluded, thus excluding women who receive medication for mood disorders and/or Premenstrual Dysphoric Disorder, both of which are significantly more likely in people with ADHD.

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