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You are listening to the Navigating Adult ADHD podcast with your ADHD coach and expert, Xena. Hello, my beautiful friend. Welcome back to Navigating Adult adhd. I am reminded that last week when I recorded the episode, which actually I only did a couple of days ago, so it's still fresh in my mind. I had said to you there are so many things I wanted to share with you and I'd totally forgotten them. Well, I am actually going to share quite a few of them in this episode with you today. Okay. So I'm just going to sprinkle them throughout because they are very relevant to this episode. If you have pushed play, you know that we are talking about ADHD and perimenopause. So I want to start by sharing a little bit of what I've experienced lately because it's very relevant to some of the things we're going to share throughout today. Ever since the Christmas New Year period. So I'm currently recording this on Monday 23rd February. So since the Christmas New Year period, my energy has declined. It took a nosedive after the Christmas break. I thought I was going to come back feeling rested and excited and setting goals. Like I'm a super driven, ambitious person. Love to set goals, love to go out and, you know, do things, challenge myself, all of this. I started back at work the second week of January and I was like, fuck this, I don't want to be here. I just want to go back to, you know, having days off, lounging around in the sun, playing games with my family, doing my puzzle, petting my animals, going for walks, et cetera. I just didn't want to be at work. Now I love what I do. So for me I was like, this is really weird. Maybe it's just that first week back, you know, part of post holiday blues, what have you, I'll get back into the swing of things. Well after a few weeks I was like, this isn't good. Not only was my energy levels declining still, like I had less and less energy. Sometimes by mid afternoon I was like, I need a nap. But also my mood was declining. I felt constantly flat. I didn't get the ambition back. If I can share a little secret with you, like I still haven't set any goals for this year. None, actually. One, like very personal one. But like normally I'm very like business orientated, want to share, set business goals and have not done that this year. I'm just going with whatever happens is happening at the moment and that's okay, right? I'm letting that be okay. But again, this was just a clear sign. Hey, like, energy's gone down, got no motivation, My mood's really flat. My ambition's gone. I just do not feel like myself. Okay, now I want to put some context to this as well because I do a lot of natural things which you've heard about here on the podcast, especially if you've listened before. I do a lot of things to support my own mental, emotional and physical well being. I do a lot of things to help my ADHD symptoms as well. So for example, I walk every single day, roughly between 8 to 10,000 steps every day. I love to get up, you know, start the day with a walk. I always feel good doing that. And I do it again in the afternoon, just a shorter walk again. It helps me kind of wind down for the day, helps with emotional regulation, you know, problem solving, all sorts of things. So I do a lot of walking, right? I eat 90% whole foods, I drink very little alcohol. I work out, lift heavy weights three times a week. I use EFT tapping and other emotional regulation support tools. So I'm very good at regulating my emotions, et cetera. I've got a great team around me, et cetera. So I do and have a lot of lifestyle supports. I'm very fortunate to be able to take care of my own mental, emotional and physical well being and also do a lot of the things that air quotes experts tell us we should do. Okay, now I, I don't say that. Gosh, what do I want to say here? I want to preface this by saying, like, I don't say that because you should do those things. Okay? I'm very fortunate that I'm able to do those things and I've been able to sort of fit them into my life and sort of build a life around them and they help me, I know how much they help my mental and emotional well being especially. Okay? So I do a lot of, like that, you know, make sure that I feel good. So I'm saying that because it can be really fucking frustrating when you're doing all the things and nothing seems to be working when you're doing the things that experts tell you to do and yet you're feeling like crap. Okay? So all of that has really pushed me to learn a shit ton more about ADHD and perimenopause combined. Right? I've learned a lot about perimenopause and a lot about hormones and how all of that relates, relates to adhd. And of course I'm going to share Some of my own stories, my own examples, as you've just learned as we go throughout. Okay, so because of all of that experience, I've been down the rabbit hole, my friends. So the first thing that I want to share, number one, is that there is now new research coming out that has shown. Proven that women with ADHD experience perimenopause symptoms earlier, and our symptoms are more severe than women without adhd. Okay, so most of us already knew that. Yeah, our symptoms can definitely be more severe. But I had this inkling. I don't know about you. I had an inkling that we start to experience symptoms earlier. But now, yes, this new research that's come out of Cambridge University is finally validating this. Our symptoms are hitting harder and faster, and the study actually showed that women aged between 35 to 39 were getting hit the hardest. So, my friend, if that is you, you have not been feeling like yourself. If lots of little things just maybe aren't adding up, this is probably why. So, myself, I am 39. I'll turn 40 in a few months. So what was suggested in this study is that perimenopause symptoms may show up up to 10, 10 years earlier for women with ADHD. Okay. And it is. It's a com. A combination of, like, the psychological symptoms and also the physical symptoms as well. So it's a real combination when I say that it's like the mental and emotional, the mood, all of that sort of stuff, as well as, like, yeah, physical symptoms, some of which I'm going to share with you because there's some weird fucking symptoms I have discovered. Okay? Trust me, you want to hear these. I was blown away to learn that it's more than just, you know, a lot of the hot flashes and the low sex drive and things like that that you'll hear about. There is so much more. Okay? So other articles that have sort of summarized this research are saying very similar things. Early onset, more severe symptoms and a lot of overlap, as we already knew, a lot of overlap between ADHD symptoms and perimenopause symptoms. Right? So basically, a lot of ADHD symptoms are also perimenopause symptoms. So we're getting a double dose. Hey. Yes, we are. So, my friend, if you are 35 to 39 especially, and if you've got ADHD, which you likely do, if you're listening to this and you feel like maybe there's a bit of a hormonal freight drain coming at you, and if people around you as well, like, this was me, people saying Even my doctor said this. You're too young for perimenopause. No, no, no, no. Which is why I'm gonna speak to that later. Okay? You are not too young for perimenopause, right? 35 to 39. That's why the majority of women typically have been diagnosed during that age range. It's because of the hormonal changes. Now the research really does back this up. Okay. All right, my friends, feeling a little fired up and feisty today. Number two, estrogen directly supports the production of both dopamine and norepinephrine. Okay? It's norepinephrine in the brain. Remember? That's a fancy ass way of saying adrenaline because when it's released into the body, it becomes adrenaline. Now these are two of the key chemicals that our ADHD brains are already really struggling to produce. Enough of. This is often what your stimulant based medication will be targeting is these levels and helping to increase these levels in the brain. Okay, Now I've definitely talked about this before, and speaking of which, I'm actually going to mention three, I think three, maybe four episodes about adhd, women, hormones, perimenopause, et cetera towards the end. So that if you want to go back and listen to them, I'll also link them in the show notes. You can do a deep dive. Right? So again, estrogen, which starts to decline when we're in perimenopause, it directly supports the production of both dopamine and norepinephrine, two chemicals ADHD brains already have lower levels of struggle to produce enough of. So when estrogen levels start to sort of fluctuate and you know, drop a lot more in this perimenopause time, we often feel even more brain fog. Okay? I feel like I was in that state in the last episode I recorded for you guys. Man, we went for a ride together. We experience more motivation tanking. Okay? Things you normally care about suddenly feel impossible. Increased even more executive dysfunction. Think. Starting, planning, organizing, finishing. All of that feels even harder, like you're trudging through mud. Worse Emotional dysregulation, a shorter fuse, more tears, bigger what the fuck is wrong with me? Moments. All of that, you can expect more anxiety, sleep disruption, and also higher risk of burnout. So for ADHD brains that were already running on lower levels of dopamine and norepinephrine, then we get these estrogen swings. It's kind of like somebody's yanking the power cord in and out of the wall sporadically. I know that's how it's felt for me recently. So in the lead up to number three, I want to let you know that I am somebody who, like I said, is very ambitious. I want fucking answers. And I love to learn. That's a key ADHD trait. Often we love to learn. And I think that we are our own biggest experiment, our own greatest challenge, but also, like, we get to really learn so much from ourselves. So I have in this process of kind of figuring out what the fuck's going on, I've run a shit ton of my own blood tests. I've done them privately, just through the path lab here in New Zealand. You just pay for each one individually. So I went through and I did iron. Now we got a whole podcast on iron because iron is something that women with adhd, or anyone with adhd, can have lower levels of, and if we do, it will significantly, significantly impact our ADHD symptoms. Okay, Specifically, we need to look for the ferritin, the little ferrets running around in the blood, the ferritin levels. Okay, So I did the iron. I did B12, I did thyroid. I did testosterone, I think. What else? I did something else in there. I did a whole bunch of different tests, and I did these gradually over time, and all of those levels basically came back in optimal range. Now, what's normal is not necessarily optimal, so I always recommend doing your own sort of Google search. I used a little bit of chatgpt to help me understand what are optimal levels for women in my age range, what are optimal levels, what's considered normal, et cetera. So finding out what's optimal and making sure that your results are in that sort of a range. Okay, I did all of that. All of that was pretty good. Then I decided to have a conversation with my doctor. And in a conversation with my doctor, we talked about a variety of different things. I shared with her all of the research, all of the data, everything that I had gathered from doing my own tests, from compiling a list of my symptoms and talking about what had been happening. And together we decided, decided that I was going to do a full hormone panel. So one of the things that specifically I was wanting to test was my estrogen levels, because I was very interested in experimenting with testosterone gel and increasing testosterone levels because my testosterone level was very low. That's one thing I did discover. Okay, now I want to preface number three. We're almost at it. Don't worry, we're getting there. But I want to preface it by saying, you guys know I am not a medical professional. And what I'm about to say, or anything I've already said, does not replace your medical advice. Okay? If you're doing this alongside, you know, a hormone expert, your GP or another professional, always listen to their advice. Always listen to the experts. This is simply me sharing what I have learned in this process because I did not know a lot of this stuff. But also I'm really hoping that me sharing this helps you with your knowledge, your understanding too, and what you choose to explore as you navigate this. Okay? So, yeah, all of that to say, number three, when it comes to testing your estrogen levels, which we want estrogen because it helps with dopamine and norepinephrine. Right. It helps our ADHD brains to function. You're testing estradiol. That's the actual name of it, of what you're testing estradiol. And when you're testing it in somebody who has a cycle, right, a somewhat regular period, the usual advice is to test early in the follicular phase. I always struggle with that word. What that basically means is day two or three of your cycle. Okay? So. And I need that broken down even more. Like I'm not somebody who learned about the female reproductive system or remembered what I'd learned, shall we say? So basically what that means is day two or three of your period, when you start bleeding, day two or three, that is when you want to get your testing done. So actually, for me, that was this morning. I walked in, I'd paid online and it wasn't cheap, my friends, but I paid online for a full hormone panel. And you can just do estradiol, you can just do that one test a lot cheaper. But I wanted to do a whole bunch of them, different hormones, and I paid online for that. Walked into my local path lab this morning, they took three vials of blood. Little side note, I was once a pin cushion when I was younger. And I literally, as I had my blood taken this morning, I was crying and hyperventilating. I felt so sorry for the women doing it. It's not. It's not a good experience for me or for them, I'm sure. Anyway, I went in, I got this testing done, and it was day three of my cycle. Now we want to do that because this is when our body's own estrogen is at its best. Baseline. Okay? It's at the baseline, the lowest and most stable before it hits that kind of mid cycle surge and typically, like, it'll rise. This makes it much easier to sort of interpret results and compare over time. We want to do it at that same time. If we're doing it monthly or whenever we're doing it, we want to do it at that same stage in our cycle. Okay? So again, if you're doing this yourself, or even if you're doing this in conjunction with your GP or, you know, your menopause doctor, potentially, this is the general rule. Now this is really good to know because first of all, people will say you can't do a blood test. That's not true. You can actually do a blood test. You just need to do it at a specific time in your cycle so that you're measuring apples with apples, shall we say. Now, again, this is not medical advice. Your GP or menopause specialist might choose slightly different timing depending on what they are looking for. Here's the key, my friend, the key is to ask, ask why they are picking a particular day so that you understand the plan, you understand what you're looking for, what you're measuring, what you guys are doing. Okay? And that leads into number four. Number four. As I said, testosterone was something I was researching myself. I was researching a lot about this specifically because I have a really good friend in the States who's at a similar place in her journey, also with adhd. Although she's a few years older, she's also going through perimenopause and she'd gone to see her hormone specialist and they gave her testosterone and she said, holy shit, I feel like I've got my energy and my mood back. Finally, she said this felt like it was the missing piece. Having used, you know, hrd, progesterone and estrogen for a while, this was the missing piece. And I found that really, really fascinating because her and I have had very similar experiences to different things that we've taken, especially like birth control wise, hormone wise, et cetera. So I know body wise, we're often quite similar. So myself, I went down the testosterone rabbit hole, started researching that, did my blood tests, et cetera. So what I've learned is that testosterone is not talked about enough here in New Zealand as it relates to women. However, it can could air quotes, could play a role in energy and mood. Okay, so what we know from the international guidelines and some New Zealand resources specifically is that testosterone therapy for women is mainly evidence based for low sexual desire. Like if you've got low sex drive, if your libido's like left the building, then they will often prescribe testosterone cream in post menopausal women. Okay, so women who no longer get a period, they're considered in menopause, right post menopausal. So and that is usually done after estrogen has been optimized. You have to have. This is one of the things I've learned. You've got to have enough estrogen in your system in order for the testosterone cream to work. Now you want to make sure you get that shit right because it's not fucking cheap. It's not yet funded here in New Zealand, I think I paid $180 for a tube of this stuff the other day. So in New Zealand and Australia, a low dose testosterone cream, so the one I got specifically was called Androfem, okay. Is sometimes prescribed alongside form of hrt. Something that's going to help to make sure you've got adequate estrogen levels. Okay. And it's usually, you're usually going to this by, you know, your menopause experts or menopause savvy clinicians. Some women do report benefits such as better energy, better focus, better mood, also increased libido. But again, that strongest research is still, at this point, it's still been done around like sexual desire and that sort of thing. There's not enough research around the energy, the mood, the focus, all of that. Yet. Okay, yet. But I just want to stress that one of the things that was really important here was understanding that you want adequate estrogen on board. So my GP said to me, 250 or above, like you want 250 or above, then you carefully dose that testosterone on top, if appropriate. Okay? Now the exact number that you take, you need to talk to your prescriber about that. They gave me this like little vial to like measure it out. This is not DIY territory, my friends. So all of this to say I'm hearing from my own gp, from menopause specialists, and my GP is working with some of the menopause experts in our area. She's now sort of training under them to become a menopause expert, I believe in, in our GP clinic. So I'm hearing this from the experts that testosterone is only part of the puzzle, right? And it's meant to be, of course, layered on top of a solid estrogen plan. And the dose, the timing, the blood test, monitoring, all of this stuff does matter. Okay? Now number five, I feel like we should have had this one earlier. Number five, you have to advocate for yourself, okay? When you're going through this, you deserve support and you're gonna need often takes multiple appointments, multiple tests to get answers. And it's gonna be helpful if you can so anything that you know, anything you understand, anything you want to try, anything you know that you want to question, any questions that you have. I always go in with this in mind. What is the outcome I want here and how can I best get that outcome? That's the question I ask, what's the outcome I want here? How can I best get that outcome? Well, I need to give them as much information as possible, right? I need to ask these questions, okay? So one thing that's so important here is gathering data. I always say stick a calendar on your toilet wall. You sit there multiple times throughout the day, keep a pen there, scribble notes. That's what I do, okay? It's super easy. It's right there in front of you. Track your cycle days. Track your sleep, your mood, your energy, your focus. Any strange symptoms, I'm gonna give you a whole bunch of those in a minute, right? Whether it's hot flashes, whether it's anxiety spikes that you etc. Write, just make scribble little notes down on that calendar, okay? Different women are going to need different combinations. I really wish this was a one size fits all thing. It's not just like adhd. Medication is not adhd. Treatment's not right. It could be a combination of stimulant or non stimulant meds. You may have something prescribed for anxiety or depression or increasing your serotonin levels. Right, Again, that's sort of speaking to the anxiety or depression. Estrogen, you might have some hrt, progesterone, possibly testosterone. There's gonna be some lifestyle stuff, the sleep, the movement, the slow dopamine, all of that sort of thing. Okay? So again, gather the data, my friends. Bring notes. Fuck yeah. Take all the notes. I said to my gp as soon as I walked in, I was like, cool. I got my notes on my phone because you know, I'm gonna forget shit, let's go. Right, Bring notes to your appointment. Don't rely on your ADHD brain to remember the things, okay? And one thing that I found specifically helpful here is talking about this with trusted people, with your friends, with your partner, with your ADHD community, your therapist, whoever. The sharing of stories, the ideas, the getting validation, the. Oh my gosh, me too. Hearing what's working for other people, all of that is really, really, really helpful. This is one of those times where I really believe that knowledge is power. The more you understand what's going on in your brain and your body with your hormones, the less likely you blame yourself for your symptoms when they are actually you Know hormonal and neurological. Okay. So all of that to say advocate for yourself, my friend. And especially when it comes to, you know, your gp, if you feel like your GP is out of the loop, doesn't understand, maybe it's a male GP and you feel like they just don't get it. Ask the clinic. Who is the GP here with the most understanding of women's hormones, perimenopause, all of this. And if need be, maybe even post anonymously in your local Facebook groups and ask for recommendations for someone. Because we are gonna be on this ride for a little while. We wanna have someone who's super supportive as we go along. Okay, Number six, I wanna share with you some weird fucking symptoms that can come with perimenopause. Okay? No one warmed me about this shit. I heard about the hot flushes, sure. The gaining weight, all of that. But I just want you to know that if you've experienced some of these, as I have, these are some of the lesser well known things that are linked with perimenopause that the studies, the literature, the patients report. Okay, Number one, changes in body odour. Yes. I have got my stinky feet back. If you are somebody who worked with me in my early 20s and you were horrified by the smell of my shoes in the workplace and you used to make me put the them outside. It's back. I'm so sad to report. It's back. Okay. Changes in body odor. I notice BO more frequently now. I'm having to, like, apply more deodorant. And what's so interesting about this, and I think that there will be research coming out about this in later years, and I would encourage you to think about this yourself, is this reminds me of my teenage years. This reminds me of when I got my period and I was going through sort of hormonal transitions as a teenager. It really did. Especially when I talk about migraines or new worsening headaches. That was something I experienced a lot of. Okay, so again, I'm getting reminded of going through that sort of getting my period, you know, the first couple of years of hormone changes in my body quite dramatically. There's a lot of similarities and overlap. Okay, so changes in body odour, migraines, restless legs and muscle twitches or spasms. Yes, that can be a symptom too. Itchy skin or finding that like your eczema, your dermatitis, your psoriasis. I get like a combination of those things. It has really flared up recently. And just like random itchy skin patches that can. Can flare up. And if you're not someone who had it before, you might all of a sudden develop it. Now, this next one, this. This messed with me. It's called formication. But what it is is feeling like you have bugs crawling on your skin. So one night I woke up in the middle of the night and I was like, there's a fucking spider on me. Oh, my God. I leapt out of bed, I ripped my nightie off, threw it over my head and started like, flicking at my, like, shoulder back area to get this bug off me. I don't actually think there was a bug on me because this became a regular occurrence that I would feel, especially in the evenings or at night. Like there were, like, bugs crawling on my skin. Like I could feel it on my arms. The weirdest thing, another common symptom is. Is it tinnitus? Tinnitus, I can never say that word. But it's the ear ringing, right? The ringing in the ears. I've had that too. Weird, huh? Air hunger. Yes. If you feel like you can't get a deep breath or, like, enough oxygen in even when, like, your stats are normal, that is also a symptom. This one here, chronic congestion. Whether it be like a runny nose, for me it's post nasal drip and like sinus pressure and kind of sometimes random allergy symptoms. Like last night, I woke up and my nose had, like, completely blocked with, like, sinus, like, pressure had completely blocked and I just couldn't breathe. I had to breathe through my mouth. It was so weird. But again, I've learned that is a symptom, a weird symptom of perimenopause, that, that congestion, GI issues, whether it be constipation, diarrhea, bloating, reflux. Holy shit. Don't get me started on the reflux. I feel like I have this constant burning in my chest or throat. I have finally, with the help of a gp, got a plan for that. But it can also be nausea, right? I had no idea that my reflux could be a symptom of perimenopause. Even the GP didn't know that. I was the one who went in with the research and said, hey, FYI, right? Itchy ears. I don't know about you, but, man, I can get some wicked itchy ears. Itchy ears. It could be weird tingling, weird sensations in your ears. That again, my friend, that's a symptom. Heart palpitations or racing heart that can just come and go. Another symptom. And phantom smells. This one is so weird. Like, the last few days, I have been so sensitive to smells. I've been sitting there doing my puzzle with the windows open, and I swear I can smell this, like, ammonia kind of a chemical smell. It's just so random. And I'm like, it's. I swear it's coming from inside my body. I don't even know where it's coming from, but just so sensitive to smells and. And. And smelling random things. Hello. Those are some of the weird symptoms that can come with. With perimenopause. Now, some of those can be scary. I just want to emphasize that, right? Some of those can be scary, and especially when you don't know that they're linked to hormonal shifts. Like, for me, I was like, I'm experiencing so many random things, like, what the hell is going on? So, of course you want to rule out anything serious, right? If you've got chest pain, you know, like, difficulty breathing, definitely go get that checked, my friend. That's like, do get that checked. Okay, But. But also so good to know that a surprising number of these things when I was like, oh, my God, what's wrong with me? Or I'm dying, turn out to be hormonal perimenopause symptoms. Okay, now, I did mention earlier that we have some other episodes here about hormones, perimenopause, ADHD, all of this. Okay? Number 21, which is women with ADHD. Number 35, hormones and ADHD. And then number 54 is. Is hormones, perimenopause and ADHD with Dr. Samantha Newman. I will link to all of those in the show notes. Okay, now, I'm still navigating this. I have, like, to be completely transparent, I've cut back on my work. I've, like, reduced my. Like, I have no stress. The stress in my life right now is finding my puzzle pieces. To complete. My puzzle, which I'm fucking obsessed with, was jigs right now. But I've done so many things like this, and I'm navigating all of these different hormonal things, waiting for blood test results, trying the HRT and the testosterone and the progesterone and all of these things. And I'm gonna keep you posted on what I discover as I experiment with this. I'm still in the thick of it, but I hear from so many of my clients, so many of the women that I have the privilege of speaking to and connecting with regularly, that they, too, are feeling like this, and they feel like there's something wrong with them or they're the only one. Especially when their friends, their family, people around them seem to be functioning quite well. It's so frustrating. Or when it feels like it's getting worse or all of a sudden you thought you were getting better and then boom, you're tanking again. So I wanted to share this. I wanted to share where I'm at with you, what I'm experiencing so that you know you're not alone. Right? I'm right here with you and we are navigating this together, my friend. Okay? So there's going to be a follow up. There's going to be more updates I promise you as I learn more things. Okay? Huge, huge love to you. Take care. I can't wait to speak to you soon. Hey friend, if you want some more help navigating and thriving with ADHD and some help applying everything that you're learning here on the podcast, then head over to our website navigating adult adhd.com.