#23 The Unmasking: When Perimenopause Strips Away What Was Holding You Together

If your brain has felt unfamiliar in recent years, this episode is for you.

Dr Kristy Goodwin unpacks the ADHD and perimenopause collision: why so many high-performing women hit their late thirties and forties and find that the strategies that carried them for decades suddenly stop working. Estrogen is one of the brain’s most powerful neuromodulators, and when it starts to fluctuate, it destabilises the very dopamine circuits that govern attention, working memory and emotional regulation.

Drawing on a 2025 population study of more than 5,000 women published in European Psychiatry, plus new analysis from King’s College London, Kristy explains why women with ADHD experience severe perimenopausal symptoms at nearly double the rate of other women, why nearly half are not diagnosed until midlife, and why perimenopause can unmask, worsen or mimic ADHD.

You will learn how to build a coherent symptom picture before your next medical appointment, why this is the season to protect rather than strip back your support systems, and how to advocate for yourself when you are told everything looks fine.

This episode is not medical advice. If you recognise yourself here, please speak with a medical professional who understands both ADHD and perimenopause.

Relevant Links

Speaking enquiries: https://drkristygoodwin.com/contact/ 

Ovum app: https://www.askovum.com/ 

Episode References

Chapman, L., Gupta, K., Hunter, M. S., & Dommett, E. J. (2025). Examining the link between ADHD symptoms and menopausal experiences. Journal of Attention Disorders. https://doi.org/10.1177/10870547251355006

Jakobsdottir Smari, U., Valdimarsdottir, U. A., Wynchank, D., de Jong, M., Aspelund, T., Hauksdottir, A., Thordardottir, E. B., Tomasson, G., Jakobsdottir, J., Lu, D., Nevriana, A., Larsson, H., Kooij, S., & Zoega, H. (2025). Perimenopausal symptoms in women with and without ADHD: A population-based cohort study. European Psychiatry, 68(1), e133. https://doi.org/10.1192/j.eurpsy.2025.10101

Eng, A. G., et al. (2024). Cyclical hormonal fluctuation and ADHD symptom severity across the menstrual cycle. Hormones and Behavior. 

Osianlis, E., Thomas, E. H. X., Li, Q., Bellgrove, M., May, T., Chapman, D., Kulkarni, J., & Gurvich, C. (2026). ADHD in females: Survey findings on symptoms across hormonal life stages. Journal of psychiatric research, 193, 208–215. https://doi.org/10.1016/j.jpsychires.2025.11.035