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ADHD, Women and Hormones: What you need to know — Transcript

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0:10Hello everyone.
0:13Just going to give you all a few minutes
0:15to join us.
0:28Okay. Um
0:31so um I'd just like to welcome you all
0:34to our webinar. Um I am Sam Spaven. I'm
0:38a consultant psychiatrist and I'm the
0:40ADHD clinical lead. Today we're doing a
0:44webinar on women's health through a
0:47neurodeivergent lens.
0:52Next slide please.
0:56Um just before we start um I just want
1:00you to uh to welcome you all to um um
1:04our team. So we've got a wonderful crew
1:06in the background who are going to be
1:08present today. Um that's Rachel Elen who
1:12is our senior marketing and patient
1:14experience manager and Beverly Nulka who
1:18is our neurodiversity education and
1:20engagement manager.
1:22Our speakers today um are Dr. Anown
1:26McKenzie who is a consultant
1:28psychiatrist who specializes in women's
1:31health and nutritional mental health. Um
1:35and we have two wonderful experts by
1:38experiences Elena Elena sorry and Wendy
1:42uh who are going to talk to you after um
1:46Dr. McKenzie today.
1:49Um just to give you a little bit of
1:51background information. Um we are um
1:55your your privacy is really important to
1:57us. Um so uh cameras and microphones are
2:02switched off for all attendees. Uh this
2:05is protect your private privacy. So
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2:10Um the webinar has been configured to
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2:15However, um if you choose to post a
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2:23Um in the chat, please do not share any
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2:30information both um in the chat or or
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2:37Um to get the most out of today's
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2:54Um and just a a reminder which I'm sure
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3:12After the webinar, um we will post um
3:15all the um the the recording onto
3:18YouTube so it can be re-watched and
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3:23the slides on um our blog page um on the
3:28website psychiatry UK.
3:31We do um we have done many past webinars
3:35which are still accessible on the
3:37psychiatry UK website and we will plan
3:40to be doing many more. So please do
3:42follow us on Evan Brightite.
3:46I'm now going to hand over to Dr.
3:48McKenzie who is going to speak to us
3:51about women's health.
3:53Thank you very much.
3:57Hi and uh apologies for not doing the
4:02slides quite right there. Sorry. Um hi.
4:05Uh so yes, I'm Dr. McKenzie and uh I'm
4:09delighted to welcome you all here today.
4:12Um, and I wanted to start just by
4:16acknowledging that likely you are here
4:19today because you have had some
4:21difficulties yourself um, in terms of
4:23managing with ADHD and with hormonal
4:27changes. And um what I wanted to do was
4:31first of all upfront acknowledge that we
4:34are talking today about how your body
4:38and your mind responds um and how your
4:42ADHD is affected by what happens
4:45hormonally in your body. And I think
4:48really important to recognize that
4:51hormonal changes affect ADHD symptoms
4:55very significantly. And it's not all in
4:58your mind. This is real and it is
5:00important to be able to talk about it,
5:03to understand it, and to be able to to
5:06share it with people who are looking
5:07after you from a clinical perspective.
5:10Um, we are lucky tonight that uh once
5:13I'm finished that we will also have um
5:17Ella and uh Wendy talking about their
5:20own experiences. And I think it's really
5:22really helpful to hear other people talk
5:24about the experiences how they've
5:26managed with these difficulties.
5:29So first of all the big question um why
5:33do hormones matter?
5:36So um we all know that ADHD uh involves
5:43disregulation of some crucial
5:46neurotransmitters very specifically
5:49dopamine and also noradrenaline.
5:52[clears throat] So this underlies ADHD
5:55symptoms and why they exist. But what's
5:58not often talked about is how our sex
6:02hormones as they were previously known
6:04but now we know they are actually neural
6:06hormones so brain hormones estrogen and
6:10progesterone that they can have a
6:12profound effect on all of these systems.
6:16So I want to talk a little bit about the
6:19biology behind this because um it is
6:22important to understand that uh estrogen
6:25specifically affects dopamine
6:28production, how dopamine functions in
6:30the brain, how much of it is available,
6:32how sensitive receptors are and that
6:35basically means it affects very
6:38crucially um how how well your brain can
6:42respond to what you are demanding of it.
6:46So whether it's needing to concentrate,
6:48whether it's needing to help with
6:50emotional regulation, with um
6:53motivation, all of those things are
6:56affected by estrogen. So when estrogen
6:59is nice and high in your body, at that
7:01stage, your dopamine will work better.
7:06But then when your uh estrogen drops as
7:09happens every month during your period
7:11or then um as those of us who've been
7:14through permenopause or menopause um
7:16will know when estrogen drops dopamine
7:21becomes less available and that can have
7:24profound effects on how we experience
7:26our ADHD symptoms. Um and then
7:30progesterone is also um you know really
7:34important in this uh whole process. So
7:37progesterone works on our GABA system
7:40and GABA is what is responsible for a
7:43calming effect. So when um progesterone
7:46goes low, we really lose that calming
7:50effect of this hormone. So I'll talk a
7:53little bit about how that then um
7:56affects how we experience our um our
7:59monthly cycles and how that affects um
8:02our ADHD symptoms.
8:05So I think what is important to
8:07understand is that basically every
8:11person who has a monthly cycle or has
8:14had it will have had some experience of
8:17um their ADHD symptoms being affected in
8:20some way by these hormonal changes.
8:24So just thinking about um the menstrual
8:29cycle and ADHD.
8:32So in a typical cycle you basically have
8:35the first half of your cycle which is
8:38called your the follicular phase and
8:42during this um part of your cycle the
8:44estrogen is rising and estrogen is uh is
8:47is pretty good. There's a good level of
8:49estrogen and so most people will find
8:52that in that first part of their um
8:55their period. As the estrogen is at a
8:58good level, they will feel that they are
9:00functioning a little bit better. And if
9:03you're on medication, you might find
9:05that your medication is is working well
9:07and you're able to do your job. Then in
9:10the middle of that um that graph, that
9:14uh image, what you can see is there's a
9:16peak and that's when ovulation happens.
9:19That's kind of in the middle of your um
9:21menstrual cycle. Now, when ovulation
9:23happens, people can often find that
9:26because of the high estrogen, they can
9:28feel amazing. Sometimes just for a day,
9:31sometimes for a couple of days, but
9:33that's when people are often functioning
9:35at their very best from an ADHD
9:38perspective. And then we get into the
9:41second half of the cycle, and that's
9:43called the lutal phase. Now, at the
9:46start, you still have moderately high
9:49estrogen,
9:50but what happens the closer you get to
9:52your period, so about the 7 to 10 days
9:56um before your period, what can happen
9:59is that um as the estrogen drops, you
10:03might find that you're you're finding it
10:05really hard to concentrate. You might
10:07find the tasks that normally you do
10:09without effort suddenly become really
10:12really effortful. And you might find
10:14that you you quite irritable. Um that
10:17you struggle with your emotions, that
10:19you're feeling overwhelmed, that you
10:21can't really concentrate um very well.
10:24You might even feel um more sensitive to
10:28to uh sensory stimuli. So things like um
10:32noise, sounds, and um people can get
10:36quite irritable, can feel as if if they
10:38are on medication that the medication
10:40just isn't really working. Um, and
10:43people can make bad decisions during
10:45this time as well because that dopamine
10:48uh that's less accessible in your brain
10:51can also um cause difficulties with
10:55impulsivity. So people can feel more
10:57impulsive. And because that progesterone
11:01also drops towards the end of um your
11:04cycle, towards the end of your uh cycle,
11:07just before your period, um you also
11:10have that uh less of the calming effect.
11:12So all of that irritability, everything
11:14is just so much harder. People can
11:17experience brain fog, real fatigue, even
11:20if they're still sleeping well, they can
11:21feel really, really tired. And I think
11:24just incredibly important to know that
11:26this is normal. It is a real experience
11:30and it is just because of the biological
11:33changes that the hormones are affecting
11:36in your brain. And um now as you go as
11:41you start your period very often people
11:43will find that uh that their symptoms
11:46become better and that's because of the
11:49estrogen that starts being recycled at
11:51that stage and you it starts getting uh
11:54higher.
11:56Now these cycle changes can affect
12:00people in very different ways. So
12:02sometimes people can find that their um
12:05their symptoms are mildly worse, but for
12:09some people it can be a really really
12:12big um issue. And so for some people
12:16they also in addition to having um the
12:19ADHD that can become worse, they can
12:23also have a condition that is known as
12:26premenstrual dysphoric disorder.
12:29and premenstrual uh dysphoric disorder
12:32is something which is more commonly
12:35associated with ADHD.
12:37So um there a lot more people with ADHD
12:42have uh PMDD than people without ADHD.
12:48And PMDDD is not the same as PMS or
12:52premenstrual syndrome. It is a very very
12:55severe cyclical form of a mood disorder
12:59and people can uh in the leadup to their
13:03period. So the uh the symptoms start in
13:05that 7 to 10 days before um people have
13:08a period very intense irritability,
13:12anger. People can often do and say
13:14things that they wouldn't otherwise do
13:16or say at all. People can feel extremely
13:19low. They can feel tearful.
13:22um very overwhelmed. People can get
13:25physical symptoms as well. Um so
13:28significant pain, bloating, breast
13:30tenderness.
13:32Often people can have a sense of feeling
13:34disconnected. So even if there's support
13:36around them, they can't actually access
13:39it because they just can't feel it. And
13:43um the symptoms usually improve once u
13:47their period starts. But I think what is
13:50important to know is that PMDD can be a
13:53very very significant um disorder to
13:57struggle with. And if you think that you
14:00might have these uh this experience,
14:03it's really important to speak to um to
14:06someone about it because it is treatable
14:10and it is also something that is you
14:14know people who have got PMDD have got a
14:17much much higher um risk of feeling
14:21suicidal.
14:22So you know up to about 75% of people
14:26can at some stage in their life feel
14:28suicidal when they have um PMDD
14:32and um so it is something that is
14:35important to take extremely seriously
14:37and to get um support with it. And when
14:41people have got both ADHD and PMDD, it
14:46can be really really devastating and
14:48have a very um profound impact on
14:51people's quality of life. So very
14:54important to realize that it is
14:56treatable and um that there is help
14:59available. Um unfortunately it does take
15:02a long time mostly for people to get
15:04diagnosed and so if you are aware you
15:09need to advocate for yourself to get
15:11help with this. And then the next
15:16transition is when women start going
15:19through permenopause.
15:21Now typically that is um what happens
15:26around your 40s.
15:29Recent research has shown that um women
15:31with ADHD are likely to start
15:34experiencing permenopausal symptoms
15:36earlier and that's up to 10 years
15:39earlier. Now pmenopause is basically
15:42that period where your hormones
15:46are in chaos and it can last anywhere
15:49between about 5 years to 10 years
15:53typically around um well 4 to 8 years is
15:56is kind of typical for these symptoms to
15:59last. And in that time, estrogen and
16:03progesterone, whereas for all the the
16:05years where you have a menstrual cycle
16:07that's quite predictable, it becomes
16:10much more unpredictable and you get lots
16:13of peaks and troughs of your hormones
16:16and that can affect people in lots of
16:18different ways. And with ADHD, ADHD
16:22symptoms can often become very, very
16:25difficult during this time. And it's
16:27often a time when women get diagnosed
16:30with ADHD. So women who have had coping
16:33strategies throughout their lives um and
16:36have managed with work, even with kids,
16:39even though they knew they were
16:41struggling, when they hit permenopause,
16:44often things become much more
16:46unmanageable.
16:48So um typical symptoms within per
16:52menopause um is that people can have
16:54more uh forgetfulness, word finding
16:57difficulties, brain fog. Um
17:00traditionally people have often thought
17:02about things like um having hot flushes
17:05or night sweats and those are very
17:07common but not everybody experiences
17:10them. Um and mood instability and
17:14anxiety are two of the main uh things
17:17that we see in per menopause. Um
17:21about 63% of women going through
17:24pmenopause will develop anxiety, a
17:27diagnosible anxiety disorder. And I
17:30think when ADHD is in the mix, that
17:33sense of overwhelm and anxiety is just
17:36that much more prevalent. Um but
17:39important to realize firstly that it is
17:42temporary. It will pass but the other
17:46part of it is that there is support
17:48available so you don't have to suffer so
17:51much. Um
17:54so
17:55what I'd like so just in terms of the
17:58ADHD I think what is important is as I
18:01said about the coping mechanisms often
18:03things will just um feel very
18:07unmanageable and I think what
18:10I hear a lot of women say to me when
18:13they um are with ADHD going through
18:16pmenopause
18:18is that they feel that things become
18:21very cha chaotic and having previously
18:24managed a home that often things become
18:27very messy. They struggle to plan meals,
18:29their motivation becomes more difficult.
18:32There are so many factors that affect
18:35their ADHD much more. And I think it's
18:39important to really understand that this
18:42is because of the biological changes
18:44that underpin permenopause and that your
18:48experience of things getting worse is
18:50very real. Yeah. And very often women
18:54will be offered anti-depressants
18:57um during this time and I think
18:59important to note that you know if you
19:02are in this kind of age group and you
19:04are finding things are really really
19:06overwhelming to just remind your
19:09clinician could this be permenopause.
19:14Now I want to say a little bit about the
19:18treatment options for what we've spoken
19:20about. So just thinking about monthly
19:25cycle. So with ADHD medication with
19:28hormonal changes, ADHD medication is
19:31still effective.
19:33But I also think really important to
19:35know that it can feel that the
19:38medication is less effective. And very
19:41often in that leadup to the time before
19:44your period, so that 7 to 10 days, it
19:48might be that you could do with a
19:50slightly higher dose of your medication.
19:53And another option is that maybe you
19:57need just a a a short release
19:59medication, the same type as the
20:01medication that you're already on, but
20:03actually that just having a little boost
20:06for when you feel that you're going to
20:07need it on that day. That might be how
20:10you manage if you're finding that your
20:12symptoms get so much worse uh in the
20:14leadup. But what is really essential is
20:20that you need to have um you need to
20:24have data to be able to tell people what
20:28your experience is. So being able to
20:31track your symptoms and being able to
20:34tell people what your experience is is
20:36incredibly important. There are lots of
20:38um apps available. Uh there's one called
20:41clue, there's one uh maybe PMDDD and
20:44I'll say a little bit more uh in a
20:46moment, but even just writing on a
20:48calendar and
20:51just checking in on yourself on a
20:54regular basis, seeing are there times in
20:58the month when my mood is lower, when I
21:01feel that I'm just not coping at work,
21:04where I sit down to read a book, I just
21:07can't do it. actually just make a note
21:09of those things. And over time,
21:13especially if you can document things,
21:15you can see that there are patterns that
21:18start emerging. And finding those
21:21patterns is just so important and
21:23helpful because not only will it help in
21:25terms of how you might um approach the
21:28medication side uh of treatment of ADHD,
21:32but it can also help in other ways, and
21:34I'll say a bit more in a moment. Um and
21:38I think again with the medication if
21:41there are um changes that are required
21:45in how you do the medication or how you
21:47manage with your medication it can take
21:50a little bit of time and I think it's
21:53important to be patient with that and if
21:56the first thing doesn't work to not
21:58think to not feel help hopeless about it
22:02but to just understand that it's
22:03sometimes a bit of a journey to get to
22:05the point the the right uh treatment for
22:08you.
22:10And then when we think about um
22:13permenopause and menopause,
22:16um
22:18HRT,
22:20hormone replacement therapy or um
22:22menopausal hormone therapy as it's also
22:25known,
22:26is something that for some people can be
22:30absolutely transformative.
22:32Um, and what that HRT does is it kind of
22:36just stabilizes your progesterone and
22:39your estrogen.
22:40And so it increases the the level, but
22:43also stabilizes it. So you're not
22:46getting those massive fluctuations
22:48that's so typical. This is in
22:49parmenopause.
22:51Um, and by stabilizing it, it can really
22:54help with stabilizing your mood, with
22:58helping with sleep, with reducing
23:00physical symptoms. Um, but also with
23:04ADHD,
23:05people often find that they have less
23:07brain fog, they have less of that
23:09cognitive fatigue. Um, they feel less
23:11overwhelmed when once they go on to HRT.
23:15And sometimes women who are diagnosed
23:18late with ADHD will choose to not go on
23:22to medication once they stabilized on
23:25hormones. I must say it's not always the
23:28case and sometimes you need both HRT and
23:31medication and that is also okay because
23:34everybody's brains are different. Um and
23:37it is a bit of a journey to try and and
23:39just find what what works. And important
23:44to know that um not everybody can take
23:48HRT. If you can't take HRT or if you
23:51don't want to take HRT, there are other
23:54things that can be done. If you do
23:57decide to go on to HRT, again, um it can
24:02take a little while to get to the right
24:04place. Don't give up on it too quickly.
24:07If you're getting side effects with it,
24:09make sure that you speak to somebody
24:11who's well-versed in how to manage um
24:14hormone therapy because uh there are so
24:19many different options and different uh
24:21solutions available.
24:25I wanted to just mention about um
24:28contraceptives because for some people
24:32they can be sensitive to contraceptives
24:35and specifically some of the
24:37progesterrogens
24:38that are in uh in contraceptives.
24:43some people with ADHD, well people in
24:46the population, but a higher percentage
24:48of people who have got this hormonal um
24:51sensitivity
24:53are people who have also got ADHD.
24:56So um just be aware that contraceptives
25:00can sometimes worsen mood and can also
25:03affect ADHD symptoms negatively. And if
25:07you have noticed any of that, so either
25:09mood changes, changes in your anxiety
25:12levels, changes in your ADHD symptoms,
25:17then it becomes really important to go
25:19and speak to whoever is prescribing your
25:22medication and actually explain that. Um
25:25because very often people don't make
25:27that association. They're feeling more
25:30anxious. They're feeling a bit low. The
25:33ADHD has worsened. And so just make that
25:36connection between if you've started the
25:39oral contraceptive or even had a Marina
25:42coil that it might be that you've got
25:45this um sensitivity to uh to hormones to
25:48those specific type of hormones. And
25:51again, important to know that if you
25:54have the sensitivity to uh contraceptive
25:57hormones, it doesn't mean that you'll
25:59have that same sensitivity to um HRT
26:02because the hormones are different.
26:06And then just a little bit about what
26:10else you can do. So, we've talked a bit
26:13about the medication, but as I
26:16mentioned, the data is just so
26:19incredibly important. So, put a few um
26:24uh apps here. There are lots of apps
26:27available. Um these are just some that
26:29um that I use uh with with my clients.
26:33One is uh Clue, which is much more about
26:36kind of just monitoring your own cycle.
26:40MIV PMDDD if you think that there is a
26:43chance you might have that and um if you
26:45are experiencing those very significant
26:47mood fluctuations
26:49or um very significant pain and uh I
26:54should say and uh significant pain
26:58important to track it because in order
27:01to get the diagnosis you need to
27:04prospectively track for two months that
27:07you are symptomatic
27:09And as with everything, as soon as you
27:12start tracking, you'll probably find
27:13that you have a month where everything
27:15is going much better. That's not the
27:17month to use the data. So you want two
27:20months that is months where things are
27:23really tricky for you and take that
27:26information to your GP and explain to
27:30them what what is happening with you. So
27:32that's for the PMDD and the balance app.
27:36Um again, it's a it's a free app. There
27:38is a paid section but the free part
27:41within that you can actually look at
27:43what symptoms of per menopause you are
27:45experiencing and you can actually um
27:48monitor uh what's happening with those
27:50different symptoms and what you'll find
27:53is that there is a very very very long
27:55list of symptoms many things that people
27:58don't always associate with um
28:01menopausal symptoms or permenopausal
28:03symptoms um but that can get better with
28:07treatment. ment.
28:09So what it helps is when you are
28:13tracking is it helps you to be able to
28:16understand your ADHD better
28:20start to plan things around how hormones
28:23affect you and your ADHD.
28:26And then once you know what your pattern
28:29is like then you you can actually um
28:32adjust to that
28:35and
28:38important
28:39as as always lifestyle is always
28:43incredibly important. So regular
28:45exercise is helpful for everybody
28:48incredibly important um for people with
28:50ADHD. And when we're having um hormonal
28:54fluctuations, exercise can often be
28:57hard. But at the same time, really
29:00important to continue to do exercise.
29:02And if you can do it in a green
29:04environment, even better. But not only
29:07regular exercise, but also to try and
29:10build in strength training because we
29:12know there are very, very specific brain
29:14benefits when you do strength training.
29:16And um it is kind of like a buffer
29:20against ADHD symptoms but also uh helps
29:23with that mood regulation, helps with uh
29:26with memory as well. So strength
29:29training twice a week and then um
29:32additional exercise as you can uh more
29:34of the cardio of cardio nature.
29:38So sleep is essential for everybody but
29:44when there is ADHD and when there's um
29:47hormonal fluctuation sleep really
29:49becomes non-negotiable
29:52and especially um in your uh lutal phase
29:56so the last part the second half of your
29:59um cycle sleep is even more important
30:02and you actually need a little bit more
30:04sleep than in other times uh of the
30:06month and so make sure that you listen
30:09to your body and that you prioritize
30:11sleep.
30:13Nutrition always matters. Um, and it's
30:16not about restricting food. It's really
30:19about making sure that um you're eating
30:23a wide variety of foods, that you're
30:25getting all of your um nutritional needs
30:28met, and important to start your day
30:31with protein, especially if you're
30:33permenopausal or menopausal. But um
30:37making sure that your blood sugar
30:39remains a bit more constant. So you're
30:41staying away from fizzy drinks, anything
30:44that spikes your sugar, sweet um snacks
30:49and making sure that you uh take enough
30:51protein throughout the day. So early in
30:54the morning, make sure you get protein,
30:56but make sure you have uh a bit of
30:58protein at least at uh at every meal.
31:01And then caffeine and alcohol need to be
31:04limited. Um both of them can worsen your
31:08mood uh but also uh affects your sleep
31:11and even more so in the lutal phase. In
31:16pmenopause and menopause, our liver
31:18enzymes change and alcohol becomes much
31:21more difficult to manage. And so, um,
31:25alcohol can have a much more profound
31:28effect on, uh, both our sleep, but also
31:31our ADHD symptoms as we go through per
31:33menopause.
31:35And then stress reduction is actually
31:38incredibly important because stress also
31:41affects our hormones. So it's a bit of a
31:45a cycle between those. So um you know
31:48the hormones protects against stress but
31:50when there's a lot of stress our
31:52hormones actually dip. So we get less of
31:55that protection that our hormones uh
31:58estrogen and progesterone provide to us.
32:01So ADHD we know is associated with just
32:05a much higher baseline level of stress.
32:08So really important to build in those
32:10ways of reducing stress. It might be
32:13breath work. It could be um mindfulness.
32:16Something like that. Whatever it is that
32:19um that works for you and it's the
32:22stress reduction technique that you're
32:24going to do on a regular basis, that is
32:26what um you need to uh to focus on.
32:30And
32:31then supplements can be helpful. Um, we
32:36know that omega-3s
32:38can be helpful for some people,
32:40especially when they're not taking
32:41enough healthy fats in their diet. It
32:45can be helpful for mood, inflammation.
32:47Magnesium can help with um sleep. Um,
32:51creatine really uh is none of these are
32:55in the guidelines, but um creatine
32:58itself can really help with uh cognitive
33:01energy. So just having energy to think
33:05and um it it does have other protective
33:08effects as well. Um and then making sure
33:11that your vitamin D and B vitamins are
33:14at a at a high enough level. Now when to
33:18seek help? So definitely at any stage if
33:22you find that suddenly your ADHD um
33:25symptoms are much worse beyond what you
33:29would normally expect with um with your
33:31normal cycles.
33:33If your mood symptoms are extremely um
33:37significant
33:38and if you find that any of the hormonal
33:41changes that you're experiencing is
33:43affecting your daily functioning, how
33:46you manage on a day-to-day basis. Uh
33:49obviously if you've got any concerns
33:51about your medication experiencing side
33:53effects um or worried about the um the
33:58effectiveness,
34:00low mood uh when you start hormonal
34:04contraception or anxiety when you start
34:06your hormonal contraception,
34:08then make sure that you you speak to
34:11your doctor. And really important just
34:15to remember, you're not alone in this.
34:18And um there are a lot of people having
34:21this experience.
34:22There are lots of people who would want
34:25to help and support and sometimes people
34:28can get frustrated at the first um port
34:31of call. So let's say if they see a GP
34:34who might not um be supportive, there
34:37will be another GP who is. And I think
34:40it's really important to find um those
34:42people that uh that first of all know
34:46about hormones and secondly um who can
34:49empathically and uh and wisely help and
34:53support you with this. And also when it
34:58comes to um just uh there's some
35:02resources um there for you to think
35:04about. But I think really important just
35:07to remember that once you understand how
35:11your hormonal changes either through
35:14your cycle through permenopause or in
35:16menopause affects your ADHD symptoms,
35:19you can have an informed conversation
35:22with the clinicians looking after you. I
35:25think very important um if you're on a
35:27waiting list before being seen if you
35:30can track your cycles and get a sense if
35:32there is this pattern um if you're
35:35waiting for your medication to start
35:38please track your symptoms have that
35:40conversation when you have your next
35:41review
35:43or um if there is an annual review
35:45coming up. Make sure that you go with
35:48this information so that the clinician
35:50who sees you can actually help you to
35:54manage these times uh if you are having
35:57those uh exacerbations of your ADHD
36:00symptoms that they can support you with
36:02the ADHD medication appropriately.
36:06All right. Um so I am ready to hand over
36:11and so I would like to um hand over to
36:16Ella in the first instance to talk about
36:19her experience.
36:24>> Hello everyone. Um
36:28>> can we have the first slide please?
36:35like I need to wave a magic wand.
36:40Um Oh, I don't quite know where to
36:42start. Excuse me if I get a bit nervous
36:44or blab on, but um I am going to blame
36:46the ADHD on that one. Um so, a little
36:51bit about me. Um I
36:55actually got diagnosed with ADHD about a
36:58year and a half ago. Um so it was quite
37:03late on. I'm How old am I now? 28. Um,
37:06but prior to that, I spent a lot of time
37:09um in and out of um sort of mental
37:13health services um in hospital. Um I was
37:17sectioned for a number of years. Um and
37:22[sighs]
37:23I I was I got many many labels, many
37:25many diagnosis.
37:27Um it kind of started with anxiety,
37:30depression, kind of built on from that.
37:33Um, I then got diagnosed with a
37:36personality disorder. Um, had a few
37:40things thrown at me. I think someone
37:42told me once that I had um, treatment
37:45resistant depression. Obviously hearing
37:48that is a bit scary because you think,
37:49"Oh dear, well, what are we going to do
37:50with this?" Um
37:53uh and yeah, I I think on many of my
37:56paperwork it always tended to say a
37:58complex
38:00can't remember the exact wording, but
38:02yeah, basically I got the vibe that
38:05people thought I was complicated. So
38:07that's what I started to believe and I
38:08thought I don't actually know quite
38:09what's going on here. Um I did also
38:13develop an eating disorder. Um so that
38:16became something I majorly struggled
38:18with. Um, and I think looking back now
38:21kind of disguised a lot of the ADHD.
38:25Um, so I actually got diagnosed when I
38:29was um, an impatient um, in hospital
38:34which was a personality disorder and
38:36eating disorder unit. Um, and it was my
38:40who was it? It was my
38:43it was my psychologist actually that
38:45first picked up on something. She kind
38:47she said something along the lines of um
38:51you ever considered um that maybe your
38:54brain's a little wired a bit
38:55differently? I said, "Well, I've always
38:57known that. Don't know quite how it's
38:58wired. I think it needs rewiring. Can
39:00you help me?" Um but she she's the one
39:03that first she suggested doing an autism
39:06assessment, which they did, and it came
39:09up. I've got traits of autism, but not
39:11enough to kind of get a diagnosis. So
39:15then ADHD was mentioned and the first
39:17time it was mentioned I kind of thought
39:20why why is she suggesting that? No
39:23because in my head kind of the
39:25stereotype of ADHD I thought was naughty
39:29school child running around not able to
39:32sit still. That that's what I thought
39:34ADHD was. I've not got that. No, I sat
39:36still at school um most of the time. Um,
39:41but I started doing a bit of reading up
39:43on it and how it can potentially present
39:45differently in girls, um, and also in
39:48just different types of people. And I
39:50was like, "Oh my goodness, this this I
39:52think explains my brain." Because I
39:55didn't quite realize how much ADHD had
39:58an impact on
40:00emotions, emotion regulation, things
40:02like that. And so all of a sudden for me
40:05it was a bit like
40:07yeah I I think that that's what it is.
40:10Um so
40:13in a way I think that was the turning
40:14point in my recovery to be honest
40:16because I I started to think actually
40:20maybe I should stop being so frustrated
40:22at my brain. Maybe I should just think
40:25it's wired differently.
40:27Okay, how can I cope with this? Um,
40:32next slide, please.
40:35I'm going to chuckle now. Um, so now we
40:37move on to how
40:40kind of I started noticing that my
40:42periods were affecting my ADHD. Um, so
40:47for for a while I didn't have periods.
40:50Um, probably due to it was around the
40:52time that I was struggling a lot with my
40:54eating disorder. Um, so because I didn't
40:57physically have periods, I kind of I
41:00never linked the whole sort of my
41:04symptoms of ADHD and my hormone cycle
41:08because I wasn't seeing my period. I
41:10kind of thought, well, well, I didn't
41:12think about it. Um, I think to be
41:15honest, it's only been since I've
41:18started on ADHD medication and I've
41:21actually started to experience what it's
41:24like to live with a brain that's
41:25slightly quieter and it's wonderful. Um,
41:29now that I've experienced that,
41:32when my period does come, well, it's
41:35normally kind of just a few days before,
41:39I kind of almost feel like my brain
41:41reverts back to how it was before I
41:42started medication.
41:44So then
41:46when I was when I was just starting the
41:48medication, I I kind of was thinking,
41:50"Oh, it's not working. Why is it stopped
41:51working? It was working last week. Why
41:54why is it not working now?" And I kind
41:56of I thought, "Oh, maybe I'm
41:57overthinking this." Oh, not sure. Um
42:02I've gone down a rabbit hole now. I'm
42:03not sure what I was talking about there.
42:05Um
42:07where was I going with that? I know. Um
42:11but my personally, my periods are quite
42:15erratic. They're kind of there's not
42:17really too much of a
42:20um a plan for them. like that. Sometimes
42:22they will come monthly. Some months
42:25they'll be like tada three times a month
42:27and then I'll go a month without. So
42:31it was it was really interesting
42:32actually. I enjoyed listening to you
42:34earlier um Anone when you were saying
42:36about kind of tracking periods and I was
42:39sat there like oh that would be
42:40wonderful. Yes, I'm going to start
42:41tracking my periods. I'm going to do
42:43this this this and then the little ADHD
42:45snuck into my brain and thought are you
42:47going to remember to do that? I am going
42:49to try. I'm going to try. [snorts] Um,
42:52but also I think because um my periods
42:58aren't regular
43:00um that kind of makes it hard.
43:03I guess now that I've been learning more
43:05about it, I kind of there is an element
43:07of frustration I have now and I'm just
43:09like, oh well, even if I do kind of
43:13manage to like learn how periods affect
43:17ADHD, how am I going to do anything
43:19about that? because I have no idea when
43:20my period is going to come. Like I can't
43:22think, oh, actually I know that my most
43:24productive day in my cycle is going to
43:26be this. So, I'm going to plan a meeting
43:28for that day cuz I I just don't know.
43:31Um, but that's something I'm working
43:34through and kind of learning myself if
43:36I'm honest. Um, which I'm finding quite
43:38interesting.
43:40Um, next slide please.
43:44So
43:46for me um when I had my period sort of I
43:51guess a few days before the main thing I
43:54notice is
43:57well I don't I don't know I now start to
44:01potentially link it to my period but
44:02I'll get very emotional sort of get
44:05quite tearful be crying over things that
44:07I'm thinking why thinking it's the end
44:09of the world then a few days later my
44:11period will start and I think oh god
44:13Gosh, I was being a bit silly, wasn't I?
44:15And I like I'll drop a teaspoon on the
44:17floor and I'll be crying about it and I
44:18think, what what what is wrong with me?
44:20Then my period will start two days
44:22later. That's what's wrong with me.
44:24Well, it's not wrong. It's just what's
44:25happening. Um, so in in a way,
44:29maybe the way that my ADHD sort of
44:32reacts to my periods does give me
44:34warning signs. Like when my brain starts
44:37to go a bit more wacky, I'm like, "Ah,
44:38maybe I should be prepared. Maybe I
44:41should be prepared. Um
44:44I think
44:46sort of just before and while I'm on my
44:48period, I do physically my body does
44:51ache a lot. um which I think then has a
44:55knock-on effect um
44:58to
45:00sort of my motivation, energy levels,
45:02which is something people with ADHD like
45:05we we do struggle with like sort of the
45:08getting started with tasks like actually
45:10doing things. I think when you've got
45:12the added, oh, you know what, I'm tired,
45:16my stomach hurts, my legs ache.
45:19No, I just don't want to do it. So I
45:22think I think that's an element of it as
45:23well. Um
45:26but
45:28I think before I knew about sort of my
45:31diagnosis with ADHD, I used to then get
45:34frustrated at myself and think, well,
45:35why am I not why am I doing this? Like
45:37why can't I do it? Like my friends can
45:39do it. Like there's somebody like
45:41everybody goes to work and they still
45:43like why why can't I do it? But I think
45:46having the diagnosis for me has um yeah,
45:50don't get me wrong, I still get
45:51frustrated and I at myself, but I
45:56it's definitely lessened um in that
45:59aspect. Um
46:02let me just I think we're ready for the
46:04next slide.
46:07Oh, there we go. Thank you. Um so yeah,
46:10medication. Um I'm now I think finally
46:15on one which is um working cuz like I
46:17said my brain is ever so slightly
46:19quieter. It was a bit disconcerting
46:21actually. Um at first I I remember I
46:24rang rang my friend cuz I was sat there
46:27on my sofa and I was like where have my
46:30thoughts gone?
46:33It like it was just kind of felt quiet
46:35and I was like I don't know if I like
46:36this. So, at I think probably because
46:39I've been so used to just living in
46:40chaotic land, um it was almost just
46:44like, "Oh gosh, I don't know what to do
46:45with this." I then had the most
46:48productive day ever. I cleaned like my
46:50entire house. I sorted out cupboards. I
46:51was like, "Oh my god, this is amazing."
46:54But then was exhausted. So, I kind of
46:57had to sit down with myself and I was
46:58just like, "Right, okay."
47:01brain. I'm aware that you are able to be
47:04more productive, but we do also need to
47:06consider the fact you're going to get
47:07exhausted. So, I'm I'm I'm learning and
47:10I think I'm getting that balance now.
47:13Um, so yeah, I think I don't really know
47:18what else I was going to say to be
47:19honest. Um,
47:21that's me and if anyone has any
47:23questions, please feel free to put them
47:26down in the chat. Um, and I'll now hand
47:29over to Wendy.
47:36Hello. Thank you. Um, I'm Wendy. Um,
47:41have I got my first slide up?
47:46Is that Yeah.
47:48[snorts] So, yeah, I'm Wendy. Um, I
47:51reached the great age of 50 this year in
47:55May.
47:57um which are celebrated in a paddling
47:59pool drinking procco because we're
48:02having a heat wave.
48:04Um yeah, and my journey um through
48:11per menopause, which I didn't actually
48:14know it was per menopause. Um
48:18yeah, it sort of
48:20sort of came up like a a train and hit
48:23me in the face really. um out of the
48:26blue. But I think it was because
48:29I mean even 10 years ago that
48:32menopause and it was certainly wasn't
48:35per menopause was not a word 10 years
48:37ago. It was not a word. Um I was
48:41obviously at university. I'd um
48:46done my mental health nurse training. Uh
48:49decided um in my late 30s to try and
48:53become a mental health nurse.
48:55um because of my own experiences with
48:57mental health um like Ella I I've been
49:00sectioned in hospital
49:02um in my early 30s um I was told I had
49:07bipolar disorder uh
49:10and I often wondered
49:13why don't why aren't I getting these
49:16like severe depressive
49:19kind of you know but anyway I took the
49:22diagnosis yeah fine and I'll I'll I'll
49:24take the medication. Um,
49:27but then yeah, I decided to I thought,
49:29yeah, I want to I want to understand a
49:32little bit more about bipolar. And you
49:35know, it's like you sort of become an
49:37expert in in your in what scares you.
49:40And I think because my my um episode in
49:44hospital had become it had sort of come
49:46completely out of the blue and I always
49:49had this fear in the back of my mind
49:50that that that was going to happen again
49:52and I was going to have no idea. So I
49:55thought right I'm going to become an
49:57expert and knowing the signs. So yeah um
50:01started uni and you know started
50:03training. we did start learning about
50:06ADHD and autism, neurodyiversity, and I
50:10remember sat with um one of my um the a
50:15lady who I got really close with. We we
50:18trained together at uni and we were sat
50:20together in the the lecture theater and
50:21and um they were saying, "Oh, this you
50:23know this can happen. It can affect
50:25females different males and blah blah
50:27blah." And I just kept looking at my
50:29friend and going, "That's like me." And
50:32she was going like me as well. But um
50:37yeah, I mean back then it was just like
50:40well yeah if what's the point in getting
50:43a a diagnosis really you you know you
50:46knew that the the NHS waiting times were
50:49extremely sort of long and I just
50:51thought no it's fine. I was fine you
50:54know nothing was sort of bothering me at
50:56the time. Yeah, I had some, you know,
50:58quirky little traits of um, you know,
51:01what we were taught at university, but
51:03that was fine. I was trundling along
51:06fine, single parent, two children,
51:10paying my mortgage on a student nurse
51:13bery, which I'm still quite proud of
51:16that. Um, and yeah, studying for a
51:19nursing degree, absolutely fine. Um and
51:23then
51:24I got into my job. Um obviously
51:27graduated at the age of 43
51:30and started working, everything fine.
51:35Um but then I started to notice that all
51:38of my sort of what I would call now
51:42masking
51:44strategies,
51:46I could no longer do them. like or not
51:50that I could no longer do them but I it
51:53was becoming I was becoming less skilled
51:56in be able to like you know act normal
52:01keep calm and carry on while you know
52:05screaming inside and keep smiling um and
52:09I did find that it was getting more and
52:12more difficult still didn't have a clue
52:14about per menopause and things like that
52:16I thought menopause hit you when you're
52:18about 55, you had loads and loads of hot
52:21flushes. Um, your periods just stopped
52:24and then that was it. That that was my
52:29outlook on an idea of menopause even
52:34when I was 43 in the early 40s. Um,
52:38but like I say, I had a uni friend who
52:40was in a similar situation. She'd now
52:43graduated. She was struggling as well.
52:45Um,
52:47and it was it was her that said, "I've
52:50heard about this menopause, per
52:52menopause. Uh, I've been watching such
52:56and such on YouTube and things like
52:58that." And um, I was like, "But I
53:02haven't had any hot flushes.
53:06I haven't had any symptoms of it, so I
53:09don't understand." Like my periods had
53:12always been I would literally my period
53:15would start within the same hour
53:19of the same day every four weeks. They
53:22were that much of a clockwork. It was
53:23dinner time on a on a Monday period
53:28would come every four weeks and that was
53:30still the same. That was another thing
53:32that I thought happened in menopause.
53:34You your periods became very erratic and
53:38you know nothing like that. I had no
53:40symptoms whatsoever.
53:43Um
53:44but my friend, she had decided to try
53:48HRT. She was um about three years older
53:50than me. Um she decided to go to the
53:53doctors and try HRT and it was really
53:56really working out for her. Sorry, have
53:59we gone on to the next slide? I forgot
54:01to say.
54:04Yes, I needed to be on the next slide.
54:06Sorry.
54:08Um
54:10yeah, so the HRT was really really
54:12working for her. Um and we both kind of
54:16built up before that these sort of like
54:20toolbox of strategies like oh we need to
54:24you know get more exercise that that's
54:25meant to be really good for you. Um so
54:28we joined the gym
54:30we became gym buddies you know. Um, and
54:35yeah, we
54:37we did find Yeah, I mean exercise cuz I
54:39mean I'd always um I was always a like a
54:43runner. Um, I still went on me runs and
54:46stuff like that, but it was nice to just
54:47have somebody
54:50as company, you know. It was it was
54:52because I would either I would always be
54:55either all or nothing. like I would run
54:58every day for 6 months, you know, and
55:01try and train for a marathon or then I
55:04would just be no,
55:07I can't be bothered. But it was nice to
55:10just have a friend there
55:12that would, you know, um but yeah,
55:15things weren't quite getting any better.
55:18Um
55:20and so I thought, "Oh, well, I'll I'll
55:22try HRT." Um, so I'd gone to the GP and
55:28asked for the blood tests and stuff like
55:30that. Um, and anyway, I wasn't quite
55:34suitable for the HRT. So, they offered
55:38me the contraceptive pill
55:41um, until me whatever hormone levels
55:46were low enough to the threshold to have
55:48it. Um but it
55:53I knew from when I was in my younger
55:55years I've also got um
55:59hyper mobility
56:02um which I know now is the it's kind of
56:04linked with neurodeiversity and things
56:06like having hyper mobile joints. Um, and
56:10during my pregnancy with my son, who's
56:14now 20,
56:15um, I unfortunately got the, um, the
56:19pelvic dysfunction where my pelvis
56:22started to separate and I had to hold it
56:25back together with a, like a, a belt
56:28corset thing. And I'd actually gone back
56:33on to on to contraceptive after he was
56:37born. and the contraceptive was causing
56:42pain in my pelvis. Um, but I thought,
56:45"Oh, well, you know, that was like 16
56:47years ago. It'll be fine now." But it
56:49straight away it's it started again and
56:52I thought, "No, this isn't helping." I
56:54persevered with it for about 9 months
56:58and then I started to get hot flushes
57:03while like taking this pill and I
57:06thought it's done nothing for my brain.
57:08I'm getting hot flushes anyway. I think
57:11I'm just going to leave it and then see
57:14where I am with the the hormone level
57:17thing and see if I can go on to like
57:18sort of proper HRT. [snorts] Um but it
57:22just sort of didn't work out like that
57:24so I just kind of left it. Um but yeah
57:29cuz it the physical side got better but
57:32things to do with my brain just seem to
57:34just keep getting worse and worse and
57:36worse and um it was like
57:41I don't know kind of more or less like
57:43overnight
57:45I just felt like a nuclear bomb had just
57:47gone off in my brain. Um, I was sensit
57:50sensitive to light. I walked into a
57:53supermarket one day and I literally
57:56couldn't see. I I the the lights that
57:59were shining down were just horrendous.
58:01Um, all I could hear was the supermarket
58:05beeping. There was just like sensory
58:07overload like constantly.
58:11>> [clears throat]
58:11>> Um, and then I found that the word
58:14finding difficulties were um were there
58:18as well. Um,
58:21I could literally see if I was talking
58:24about something like would would you
58:26like a cup of tea?
58:29I could literally
58:31see the image of a cup in my mind, but
58:36the word just wouldn't come. I could
58:38literally see cup of tea with the steam
58:41coming out of the top of it. I literally
58:44couldn't and I just thought, is this
58:46dementia?
58:49Is this really dementia? Like, is this
58:52it? You know, um
58:56and yeah, it was a really, really,
58:58really scary time. Um, and I think I'd
59:01started to sort of like do me own
59:03research on YouTube and um, I'd come
59:06across this lady who was like, well,
59:10if if you have struggle with word find,
59:13I think it was something about long co,
59:15it was it was just I was just sort of
59:17like, you know,
59:20do looking at anything and everything
59:23possible. What is wrong with me? Um,
59:26and she she'd explained in this in this
59:30sort of video thing that when you're
59:33having word finding difficulties,
59:36panicking about it will make it worse.
59:39And a strategy that was suggested was if
59:43you can't think of the word, keep
59:45describing it until
59:49the word will just come to you.
59:51So um I mean by this time as well I was
59:54a a qualified nurse and uh it would
59:57happen quite a lot and um so um a wet
1:00:02floor cone you know the yellow wet floor
1:00:04cone that became a yellow upside down
1:00:07trumpet put out when the floors wet. Uh,
1:00:11I remember couldn't I couldn't think of
1:00:14the word for wind
1:00:16like you know the wind the the weather
1:00:20and I described it as fast air.
1:00:24Um, yeah there was there was lots and
1:00:26lots of other things and I just thought
1:00:28to myself this isn't sort of
1:00:32this just isn't getting any better. Um,
1:00:35obviously HRT
1:00:39I was I was quite skeptical as to
1:00:41whether or not it would work. So I just
1:00:44thought, do you know what? I'm just
1:00:46going to go and see if I am a bit
1:00:50neurodeiverse, if if what I, you know,
1:00:54spotted in myself at university
1:00:57is is that. So I uh went and got a uh
1:01:03went and got the right to choose thing
1:01:05um and diagnosed in 2025
1:01:09which did make a huge
1:01:12um did make a huge difference
1:01:16and
1:01:18yeah I just it was quite a relief really
1:01:20like no I don't have early onset
1:01:22dementia no I'm not lazy no my brain
1:01:26isn't broken
1:01:29it's just
1:01:31going through a few hormonal shifts and
1:01:34and that's all right. That's this is
1:01:38going to happen. And I think as well I
1:01:41think what helped me as well was
1:01:45um I don't know there's a lot of what
1:01:48I'm finding in the media and stuff like
1:01:50there's a lot of scaremongering around
1:01:53menopause
1:01:54like you need to take this supplement
1:01:56and do this and do that. And I'm like,
1:02:01my my mom went through it. My grandma's
1:02:04went through it. Like,
1:02:06it's it's a natural
1:02:09transition in a way. It's not it's not
1:02:12the end. Like, you know, I mean, me nana
1:02:15must have gone through it when she was I
1:02:16don't know, probably my age. Like, I
1:02:19mean, my period stopped when I was 48.
1:02:22Like, coming up to two years ago, they
1:02:24just stopped. Like, that was it.
1:02:29I think the last one was a little bit
1:02:31heavy and it lasted for about a week. It
1:02:33was a bit like the grand finale and then
1:02:37you know um but I just remember thinking
1:02:41to myself like it isn't the end. It's
1:02:43just a transition,
1:02:46you know. I mean, me nana, me nana lived
1:02:49till she was like 91 years old, like
1:02:53you know. Um, and I'm just I think that
1:02:57helped me a lot that I didn't no longer
1:03:00had this impendent sense of doom, you
1:03:03know, oh god, me youth's all gone and
1:03:06this and that and the other. I think
1:03:09once I got the the diagnosis of um
1:03:14all three I've got um so I've got
1:03:17inattentive
1:03:19impulsive ADHD and autism.
1:03:25Yeah, that's that's just me really if if
1:03:27you're going to have the whole shebang,
1:03:29you know. But I think what it meant for
1:03:32me to get that was Yeah, I am. It
1:03:35answered a lot of questions as to,
1:03:39you know, why I am why I am. Um, and
1:03:42yeah, it's it's you don't need to feel
1:03:45ashamed. You don't need to mask it
1:03:47anymore. Well, I mean, cuz me is
1:03:49estrogen and progesterone have all gone.
1:03:50I think they were like me masking powers
1:03:53went, you know. Um, but it's okay. Yeah.
1:03:58And, uh, the medication really, really
1:04:00helps.
1:04:01Um cuz like I say the HRT wasn't for me.
1:04:06Um but my friend who I mentioned who you
1:04:10know uh was a uni with she got diagnosed
1:04:13at the same time around the same time.
1:04:16Um, I remember Instagram reels. I found
1:04:20this uh little video uh of uh a clip
1:04:23from the Undatables where there's um
1:04:26couple and they get introduced and then
1:04:29the guy says, "Right, Alice, um it it it
1:04:32appears that we both have autism, don't
1:04:34we?" And she's like, "Yes." And he's
1:04:36like, "Well, that's good to know." And I
1:04:39sent it to my friend and she was like,
1:04:41"This has made my uh like this is us."
1:04:44And I was like, "Yeah, I know."
1:04:45Unfortunately, my friend has got a heart
1:04:48condition. She can't have any ADHD meds.
1:04:51Um,
1:04:53but HRT has really really helped her.
1:04:56And yeah, so we're we're swimming along
1:04:59nicely now.
1:05:01Um, yeah. So,
1:05:06that sums it up for me. Thank you for
1:05:08listening.
1:05:10>> Oh, thank you, Wendy, Ella, Anon. We've
1:05:13got so much love in the chat for all of
1:05:14you for for the fantastic. I've been
1:05:17frantically making notes. I wish this
1:05:19information had been available for me
1:05:21years ago. So you it's just absolutely
1:05:23fantastic and your authentic your
1:05:26authenticity really shines through and
1:05:28really brings it to life. And we've got
1:05:30some amazing questions. I'm going to
1:05:32start off. I don't know if we'll get
1:05:33through all of them, but I'm going to
1:05:34try. Um so I think this one for you is
1:05:38there any advice for us ladies who
1:05:39aren't having periods? I was on the
1:05:41contraceptive pill for 30 years and took
1:05:44it continuously so I don't have periods.
1:05:46Told to come off the pill prior to
1:05:48taking HRT and have since had the Marina
1:05:51coil fitted but don't have periods just
1:05:53a bit of spotting.
1:05:58I think it depends really on what your
1:06:00experience is because um what these
1:06:04medications so the oral contraceptive
1:06:06and uh then HRT can do is it can prevent
1:06:11those fluctuations and the fluctuations
1:06:14are really the things that make our
1:06:16symptoms much worse. So apologies.
1:06:19[music]
1:06:20Um so when uh when people are on HRT it
1:06:26can it without those fluctuations it
1:06:29might not actually be affecting your
1:06:31ADHD.
1:06:33So um it might you know it might be that
1:06:36you need something that if your ADHD
1:06:39symptoms are still problematic that that
1:06:42might need to be looked at kind of
1:06:44independent of your hormones. But at the
1:06:47same time making sure that your hormone
1:06:49levels are optimal. Um so that you are
1:06:53you are feeling okay, your pain is
1:06:55managed. Uh you're not getting your hot
1:06:57flushes, you're sleeping all right,
1:06:59you're not too anxious, all of those
1:07:01things.
1:07:02Lovely. Thank you, Anon. Um Ella, when
1:07:05you say about aching in your legs, I get
1:07:07that it feels like a headache. Uh but
1:07:10it's all in this person's calves and
1:07:12shins. Is that similar to what you get?
1:07:16It really is. And that actually I read
1:07:18that comment and I was like, "Oh my
1:07:19gosh." Yeah, it kind of is. And I mean,
1:07:22the way I cope with it when it happens
1:07:24is I literally lie on my sofa here with
1:07:27my legs up in the air. Um, just a little
1:07:30tip for you. It kind of feels like it
1:07:32I'm like draining out the ache. Um, but
1:07:35yeah,
1:07:37>> it's the same. Brilliant. Um, okay. Uh
1:07:40Wendy, uh what ADHD what ADHD medication
1:07:44helps you with the brain fog?
1:07:47>> Uh so I take the stex and fetamine.
1:07:52Um
1:07:53and it it takes a little while. It takes
1:07:58about an hour and a half
1:08:01to sort of start working after I've
1:08:04obviously first taken it in the morning.
1:08:08Um, and it really really does help. It
1:08:11really really does. It just I feel when
1:08:15with brain fog, I think when your brain
1:08:19is ADHD as well,
1:08:22um, the brain fog, it just seem because
1:08:24I think your brain is working quite
1:08:26quickly when you've got a neurodeiverse
1:08:29ADHD brain.
1:08:31And when the sort of permenopause brain
1:08:36fog comes in, you just find it you it's
1:08:40far too fast. You cannot [clears throat]
1:08:42focus on anything. There's like not one
1:08:45of the little thoughts that's going
1:08:46around in your head can you focus on.
1:08:50And then I find that the
1:08:53the least exciting that helps a lot. I
1:08:56can then yeah I focused. So, I find that
1:08:59I need to have I need to have made a
1:09:01to-do list
1:09:03before the meds kick in. Um, and I have
1:09:07that that is my to-do list. That is what
1:09:09I'm doing. And I can tick things off.
1:09:12Done done. If I don't do that and I sit
1:09:17and play, I mean, I've actually gotten
1:09:19rid of my smartphone. I don't have it
1:09:20anymore. Um, but what I was finding is
1:09:26if I'm sitting on my smartphone when my
1:09:29meds kick in, that's it for me for the
1:09:32rest of the day. I'll be kneede in Candy
1:09:36Crush, Instagram,
1:09:39just dopamine
1:09:42central. We're having a dopamine
1:09:45festival.
1:09:46Yes. So, the Lisa Dex and Fetamine, but
1:09:49I've got to I've got to sort of be
1:09:51mindful how I work with it
1:09:54cuz then I'll just hyperfocus on
1:09:58ruining me life in me. [laughter]
1:10:00>> Chipping in quickly, Wendy. I'm exactly
1:10:02the same.
1:10:04>> I still can't believe you haven't got a
1:10:05smartphone, but I'm I'm All praise to
1:10:09you. I think that's amazing.
1:10:10>> It was a big step. It took me about six
1:10:12months to get rid of my smartphone, but
1:10:15it's the best thing I've ever done.
1:10:16We'll have to do a webinar just on not
1:10:18having smartphones.
1:10:20>> Have you got a phone you could play
1:10:21Snake on now, Wendy?
1:10:22>> It does have Snake on it.
1:10:24>> It does. Yeah, it does.
1:10:27>> I just wanted to mention uh with with
1:10:30brain fog and all of all of the
1:10:32symptoms, even the leg ache um that was
1:10:35mentioned. Um I think just really
1:10:37important to note that um women with
1:10:40ADHD are much more likely to have low
1:10:43iron levels and low iron levels can also
1:10:47contribute to um aches and pains
1:10:49especially leg pain um kind of a sense
1:10:52of a feeling of bone pain um people can
1:10:54experience and anything to do with um
1:10:58concentration fatigue all of that. So
1:11:00just one other thing especially if you
1:11:03um have heavy periods or are
1:11:05permenopausal where women often um
1:11:08become anemic and not even before you
1:11:11get to a stage of anemia just having low
1:11:13iron can really affect um ADHD symptoms
1:11:17as well. So just keep that in mind with
1:11:20um with all of these.
1:11:22>> Brilliant. Thank you and I've got one
1:11:23more question for you. the other
1:11:25questions, we'll collect them and send
1:11:27them out with the next uh patient
1:11:29newsletter. But someone's asking, "What
1:11:31about after menopause? Once you plateau,
1:11:34do people with ADHD feel more calm and
1:11:36settled?"
1:11:39>> Yeah, it's a it's a very good question.
1:11:42And on the whole, people do find that
1:11:44things become a little bit more
1:11:46manageable. Um and very often as women
1:11:50go into that post-menopausal
1:11:53um or menopausal phase that actually um
1:11:56because the fluctuations are less um
1:11:59symptoms can definitely improve. Um but
1:12:03at the same time I think uh important to
1:12:06know that your estrogen is going to be
1:12:08low in that time if you're not on HRT.
1:12:11So although you're not getting the
1:12:12fluctuations
1:12:14with low estrogen, you are going to have
1:12:16lower dopamine and you are going to um
1:12:19have more difficulties with both your
1:12:21dopamine and adrenaline systems and your
1:12:25serotonin which is all to do with mood
1:12:27and anxiety and all of that as well. So
1:12:30although the fluctuations will be less
1:12:32and your ADHD symptoms will be more
1:12:35stable, they likely to be a bit worse
1:12:38than before you went through per
1:12:40menopause.
1:12:42Brilliant. Thank you, Anon. But this
1:12:44this has been utterly amazing. We'll
1:12:46collect all these questions, send them
1:12:48out with our our patient newsletter. Um
1:12:51but you can watch this recording. It
1:12:53will be uploaded onto YouTube tomorrow
1:12:55so you can look at it all again in its
1:12:56glory. Um there will be a summary of the
1:12:59slides on our blog as well. Please do
1:13:01follow us on Eventbrite. I know many of
1:13:03you do and you've got your links through
1:13:05there. And I apologize for some of the
1:13:07the connection problems getting in
1:13:09today, but um we we'll we're getting to
1:13:13to a point where we can get that
1:13:14resolved. Our next patient newsletter
1:13:17will be with you on the 12th of October.
1:13:19Um and there'll be lots more information
1:13:21in there. But if you're having any
1:13:23problems um connecting, do go to our
1:13:26live chat. um and connect through our
1:13:28our patient support center. Our next
1:13:31webinar is going to be on the 6th of
1:13:34October and this is about creating a
1:13:36workplace that works for everyone. So
1:13:38lots of tips and advice and support for
1:13:41those wonderful neurode divergent brains
1:13:43of ours. So thank you for joining us. Uh
1:13:46we went a little bit over but thank you
1:13:48enormously to Dr. to Ron McKenzie to
1:13:51Ella and to Wendy and of course for Sam
1:13:53for for getting us starting off th this
1:13:56evening. Thank you.
1:14:02>> Thanks everyone.

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