Navigating Adult ADHD with Xena Jones

Episode #155: 6 Things No One Told Us About ADHD & Perimenopause

Date: March 2, 2026

Episode Overview

In this insightful episode, Xena Jones dives into the intersection between ADHD and perimenopause—two experiences that often overlap and intensify each other, especially in women between the ages of 35-39. Through personal anecdotes, science-backed research, and practical coaching advice, Xena shines a light on the undertold realities of hormone shifts and their often confounding impact on energy, mood, cognitive function, and a host of unexpected physical symptoms. Xena’s goal is to validate her listeners’ struggles, provide knowledge as empowerment, and normalize the challenging journey of managing ADHD during perimenopause.

Key Points & Insights

1. Early and Severe Perimenopause Symptoms in Women with ADHD

• Research Highlights: New studies (including recent Cambridge University findings) confirm that women with ADHD experience perimenopause symptoms earlier and more severely than neurotypical women.
  • "Perimenopause symptoms may show up up to ten years earlier for women with ADHD." (13:30)
  • The hardest-hit age range is 35-39—many women are told they’re "too young," but research now proves otherwise.
• Double Dose: There’s significant overlap between ADHD and perimenopause symptoms, leading to amplification.
  • “Basically, a lot of ADHD symptoms are also perimenopause symptoms. So we’re getting a double dose.” (15:30)

2. The Estrogen–Neurotransmitter Connection

• Science Backed: Estrogen directly supports the production of dopamine and norepinephrine—two neurotransmitters already deficient in ADHD brains.
  • “Estrogen, which starts to decline when we’re in perimenopause, directly supports the production of both dopamine and norepinephrine, two chemicals ADHD brains already have lower levels of.” (17:40)
• Practical Impacts:
  • Lower estrogen = more brain fog, loss of motivation, worsened executive dysfunction, heightened emotional dysregulation, more anxiety, increased risk of burnout and sleep disruption.
  • Memorable analogy: “It’s kind of like somebody’s yanking the power cord in and out of the wall sporadically.” (21:35)

3. Hormone Testing—Timing Matters

• Testing Estradiol: The right hormone to test is estradiol, best measured on day 2 or 3 of your menstrual cycle for accurate, comparable results.
  • “When you’re testing your estrogen levels, you’re testing estradiol. And... the usual advice is to test early in the follicular phase ... day two or three of your cycle.” (25:24)
• Personal Story: Xena details her own quest for answers—comprehensive blood work, research, and the challenge of interpreting results for optimal (not just “normal”) ranges.
• Empowerment: Ask your provider why tests are ordered for particular days for better partnership and understanding.

4. Testosterone: The Overlooked Hormone for Women

• Testosterone Cream: While not commonly discussed in New Zealand, testosterone therapy may impact energy, mood, and libido—though research most robustly supports its use for sexual desire in post-menopausal women.
  • “Testosterone is only part of the puzzle, and it needs to be layered on top of a solid estrogen plan.” (30:10)
  • “I paid $180 for a tube of this stuff the other day. It’s not cheap!” (32:40)
• Clinical Wisdom: Adequate estrogen is necessary for testosterone therapy to be effective; always use under medical guidance and never as a DIY intervention.

5. Self-Advocacy is Essential

• You Deserve Support: Navigating this phase often requires multiple appointments, tests, and providers.
  • “You have to advocate for yourself, okay? When you’re going through this, you deserve support. And you’re gonna need ... multiple appointments, multiple tests to get answers.” (36:12)
• Tracking & Preparation: Xena suggests tracking symptoms daily (mood, sleep, focus, cycle days, strange symptoms) by keeping a calendar in an accessible spot.
  • “Bring notes to your appointment. Don’t rely on your ADHD brain to remember the things.” (38:20)
• Community Matters: Sharing experiences with partners, friends, or ADHD peers provides validation, emotional support, and practical insights.

6. The “Weird” Symptoms of Perimenopause

• Beyond Hot Flashes: Perimenopause can bring an array of unexpected symptoms, many not commonly discussed.
  • Lesser-Known Symptoms:
    • Changes in body odor (“I have got my stinky feet back.”) (43:05)
    • Migraines, restless legs, muscle spasms
    • Itchy skin, eczema, dermatitis flare-ups
    • Formication (sensation of bugs crawling on skin): “One night I woke up in the middle of the night and was like, there’s a fucking spider on me ... but this became a regular occurrence.” (44:20)
    • Tinnitus (ear ringing)
    • Air hunger (“If you feel like you can’t get a deep breath or enough oxygen ... that is also a symptom.”)
    • Chronic congestion, GI issues, reflux, phantom smells, heart palpitations, itchy ears
  • Key Message: Many such symptoms are hormonally driven and may not be serious, but if in doubt—especially with chest pain—always check with a professional.
  • “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.” (48:23)

Notable Quotes & Memorable Moments

• “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.” (09:18)
• “We are our own biggest experiment, our own greatest challenge, but also, we get to really learn so much from ourselves.” (21:12)
• “Bring notes to your appointment. 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.’” (38:20)
• “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.” (15:48)

Timestamps for Key Segments

• [03:00]–[13:30]: Xena's personal post-holiday energy crash, frustration despite lifestyle supports, intro to ADHD & perimenopause overlap
• [13:30]–[15:30]: Cambridge research—early onset, more severe perimenopause in women with ADHD
• [17:40]–[21:35]: Neurotransmitter impacts and estrogen’s critical role
• [25:24]–[28:00]: How and when to test estrogen (estradiol), personal hormone-testing journey
• [30:10]–[32:40]: Testosterone’s emerging role, availability, and cautions in therapy
• [36:12]–[39:00]: Advocacy, tracking, and information gathering advice
• [43:05]–[48:23]: Rundown of “weird” perimenopause symptoms, encouragement to normalize and seek help

Additional Resources

• Past Episodes on Related Topics:
  • #21: Women with ADHD
  • #35: Hormones and ADHD
  • #54: Hormones, Perimenopause & ADHD (with Dr. Samantha Newman)

Tone & Takeaway

Xena’s tone is honest, compassionate, and empowering—peppered with humor and no-holds-barred language that will resonate with women feeling both overwhelmed and unseen. Her message rings clear: “Knowledge is power,” and no, you’re not imagining things or failing. Advocating for yourself, tracking your symptoms, and finding supportive professionals and communities are key to staying afloat during this challenging hormonal passage.

“I wanted to share where I’m at with you, what I’m experiencing so that you know you’re not alone. I’m right here with you, and we are navigating this together, my friend.” (End of episode)

For more support and coaching tools, visit navigatingadultadhd.com.