2. ADHD & Hormones
Page 1
[Title] NARRATOR: “ADHD & Hormones”
[Intro Caption] NARRATOR: “I experience worse ADHD symptoms before and during my period. As hormone levels fluctuate throughout my cycle, so does the severity of my ADHD symptoms.¹”
[Panel 1] NARRATOR: “The brain fog gets worse”
[Panel 2] NARRATOR: “I have more trouble concentrating, understanding and memorizing”
[Panel 3] ALIEN: “The kitten is full of milk!”
[Panel 3] NARRATOR: “I get emotional faster”
[Panel 4] NARRATOR: “I feel more overwhelmed and less able to motivate myself”
[Panel 5] NARRATOR: “I keep forgetting what I’m doing”
[Panel 6] NARRATOR: “I get more impulsive and make more rash decisions”
[Bottom Banner] NARRATOR: “During my period, it often feels like my medication isn’t working as well.² Lower estrogen levels can affect the effectiveness of ADHD medication.³”
Page 2
[Title] NARRATOR: “Estrogen affects executive functioning⁴”
NARRATOR: “Our estrogen levels are lowest before and during our period, and highest during ovulation (the middle between periods).”
[Scale Label] NARRATOR: “ADHD Symptoms increase”
[Scale Label] NARRATOR: “Estrogen levels sink”
ALIEN: “Ovulation — I usually am most productive and concentrated here”
NARRATOR: “Estrogen / Executive functioning”
NARRATOR: “6 days before / during period — Concentration, working-memory and other symptoms become worse.⁵”
Page 3
[Title] NARRATOR: “ADHD symptoms can feel worse with age⁶”
NARRATOR: “Estrogen continuously decreases during and after menopause, which can affect all kind of executive functioning like working memory, concentration etc.”
NARRATOR: “During pregnancy, estrogen levels rise and then drop significantly after birth.⁶”
NARRATOR: “Be gentle with yourself and don’t plan the most complex work into your lower functioning phases.”
Page 4
[Title] NARRATOR: “Relevant studies”
NARRATOR: “1.) 5.) “I experience worse ADHD symptoms before and during my period.” “ADHD symptom risk increases at times of rapid declines in estrogen.” Eng, A. G., Nirjar, U., Alderson, A., Garsow, M., Subramaniam, J., Kudin, T., … Martel, M. M. (2024). Attention-Deficit/Hyperactivity Disorder and the Menstrual Cycle: Theory and Evidence. Hormones and Behavior, 158, 105466. https://doi.org/10.1016/j.yhbeh.2024.105466”
NARRATOR: “2.) “During my period, it often feels like my medication isn’t working as well.” de Jong, M., Wynchank, D. S. M. R., van Andel, E., Beekman, A. T. F., & Kooij, J. J. S. (2023). Female-specific pharmacotherapy in ADHD: premenstrual adjustment of psychostimulant dosage. Frontiers in Psychiatry, 14, 1306194. https://doi.org/10.3389/fpsyt.2023.1306194”
NARRATOR: “3.) “Lower estrogen levels can affect the effectiveness of ADHD medication.” Justice, A. J. H., & de Wit, H. (1999). Acute effects of d-amphetamine during the follicular and luteal phases of the menstrual cycle in women. Psychopharmacology, 145(1), 67–75. https://doi.org/10.1007/s002130051033”
NARRATOR: “4.) “Estrogen affects executive functioning.” Shanmugan, S., & Epperson, C. N. (2014). Estrogen and the prefrontal cortex: toward a new understanding of estrogen’s effects on executive functions in the menopause transition. Human Brain Mapping, 35(3), 847–865. https://doi.org/10.1002/hbm.22218”
NARRATOR: “Needs more research!”
NARRATOR: “6.) “Estrogen levels continuously decrease during and after menopause. For many of us it feels like ADHD symptoms worsen with age.” Antoniou, E., Rigas, N., Orovou, E., Papatrechas, A., & Sarella, A. (2021). ADHD Symptoms in Females of Childhood, Adolescent, Reproductive and Menopause Period. Materia Socio-Medica, 33(2), 114–118. https://doi.org/10.5455/msm.2021.33.114-118”
NARRATOR: “7.) “During pregnancy, estrogen levels rise and then drop significantly after birth.” Hedges, V. L., Staffend, N. A., & Woolley, C. S. (2020). Estrogen withdrawal increases postpartum anxiety via oxytocin signaling in the hypothalamus. Molecular Psychiatry, 25, 1059–1061. https://doi.org/10.1038/s41380-019-0566-5”
Part of ADHD Alien comics.