An ADHD and Menopause Toolkit: What Actually Helps with Dr. Sasha Hamdani

**Sasha Hamdani** (0:00)
If you talk to any woman who has ADHD, I will guarantee you that 60, 70 percent of them will tell you that emotional dysregulation is one of the most difficult parts of this to me. My emotions feel out of control. I feel like things, because everything else you can delegate, you can work around, you can hack. You can't hack your emotions.
You got to deal with them. And so when they feel big and scary and intense and too much and overwhelming, as they often do around transitions and hormonal changes and all of that, then we're left with what, okay, here's an antidepressant.

**Mary Claire Haver** (0:51)
The views and opinions expressed on unPAUSED are those of the talent and guests alone, and are provided for informational and entertainment purposes only. No part of this podcast or any related materials are intended to be a substitute for professional medical advice, diagnosis, or treatment.
In part one of my conversation with Dr. Sasha Hamdani, board certified psychiatrist, ADHD clinical expert, and author of Self Care For People With ADHD and Too Sensitive, we talked about why so many women reach perimenopause, feeling like their brains have suddenly stopped working, and why for many of them, the answer isn't simply hormones. Perimenopause can expose ADHD that has been quietly compensated for for over a lifetime, leaving women wondering why the strategies that once worked no longer do. In this episode, we'll address what you can actually do about it. We'll talk about how ADHD symptoms fluctuate across the menstrual cycle, why sleep may be one of the most powerful treatments we have, and how exercise, nutrition, hormone therapy, medications, and even GOP-1s fit into the conversation. Dr. Hamdani also explains why emotional dysregulation deserves far more attention than it gets, introducing concepts like rejection-sensitive dysphoria and the hidden role it plays in anxiety, relationships, and the overwhelming emotional reactions so many women experience during hormonal transitions. Whether you've been diagnosed with ADHD, suspect you might have it, or simply feel like your brain has changed in midlife, this episode offers practical tools, self-compassion, and a roadmap for moving forward. I'm Dr. Mary Claire Haver, a board-certified obstetrician and gynecologist and certified menopause practitioner. I'm also an adjunct professor of obstetrics and gynecology at the University of Texas Medical Branch. Welcome to unPAUSED, the podcast where we cut through the silence and talk about what it really takes for women to thrive in the second half of life.
Lots of talk about this on the Internet, around menstrual cycles. So we're going to back it up.

**Sasha Hamdani** (3:08)
Okay.

**Mary Claire Haver** (3:09)
We're going to back it out of menopause, into peri, and into pre-menopause. Do ADHD symptoms and medication effectiveness? So it's a two-part question.
Change across someone's menstrual cycle.

**Sasha Hamdani** (3:20)
Yes. But again, you track it back to the estrogen, right? When you get that dip in estrogen in that luteal phase right before your period, all of a sudden that, and it's kind of two-fold, right? Because that estrogen is coming down and then that progesterone is climbing up a little bit. So you get this fogginess and confusion with it. So your functional window right before your period feels like, okay, this is just a lot harder because it doesn't feel like my medication is working. The other thing that's happening at the same time is because of that drop of estrogen, you also are more inclined to get mood dysregulation.

**Mary Claire Haver** (3:58)
I'm well-versed in the mood issues.

**Sasha Hamdani** (4:00)
Yes.

**Mary Claire Haver** (4:00)
I also, I talked to patients about if you had postpartum depression, especially if it was severe, or if you have PMDD, which was premenstrual dysphoric disorder, and that's kind of a continuum. You know, this is a red flag for me, or a warning for me to be very, very attentive to your symptoms.

**Sasha Hamdani** (4:21)
Yes.

**Mary Claire Haver** (4:21)
In PERI, and then menopause, because your body has told you, you failed the stress test. Your body has told me what's going to happen times 10

**Sasha Hamdani** (4:30)
Yeah.

**Mary Claire Haver** (4:30)
You know. You're hormonally sensitive. When this hormonal chaos starts, you're hormonally sensitive. Yeah.
So what is Stratera?

**Sasha Hamdani** (4:38)
It's a non-stimulant.

**Mary Claire Haver** (4:40)
Okay.

**Sasha Hamdani** (4:40)
So it's Adamoxetine. It's a non-stimulant that is a 24-hour acting agent. I like it because it's kind of in the middle. It's not. It's a non-stimulant. So it, but even within the non-stimulants, there are things that are very stimulating. There's things that aren't. It's kind of right in the middle. So it's something that you could kind of, some people take it in the morning, some people take it at night. The reason people typically like it is because it does have some properties to help with anxiety and depression at the same time.