Latest Research on Hormonal ADHD Women's Health from Dr Lotta Borg Skogland
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How many times have you walked into a doctor's appointment knowing something is wrong, and walked out feeling dismissed, unheard, or handed an explanation that just doesn't fit?
For women with ADHD, the intersection of hormones and neurodivergence has been one of medicine's most neglected areas. Not because it isn't important, but because for too long, women have been considered too complex, too variable, too messy to study properly. And the cost of that has been devastating.
This week on The ADHD Women's Wellbeing Podcast, I'm welcoming back Dr Lotta Borg Skoglund, a psychiatrist, researcher, and Associate Professor at Uppsala University in Sweden. Lotta has spent years investigating how hormonal fluctuations shape ADHD across women's entire reproductive lives — and her new book, Female Hormones and ADHD: The Impact on Brain and Body, is out in the UK on 4th June.
What Lotta shares in this episode is not just fascinating; it is information that women deserve to have, and that could genuinely change their long-term health.
In this episode, we explore:
- Why women have historically been excluded from research, and what that has cost us clinically
- Lotta's new research on ADHD medication during pregnancy, lactation, and across the menstrual cycle
- Why neurodivergent women may experience perimenopause symptoms earlier, and why this so often goes unrecognised
- The critical window of opportunity for hormone therapy
- Why a hormonal assessment should come before receiving ADHD medication
- The link between postmenopausal oestrogen loss and heart attacks in women
- The connections between ADHD and endometriosis, PCOS, burnout, pain and sick leave
- Why every doctor (regardless of specialism) needs to be asking about hormones
- How we can use the predictable hormonal risk windows across a woman's reproductive life to support her
- Testosterone, perimenopause, and what the research does and doesn't yet tell us
- How Lotta's new book can help you advocate for yourself in the doctor's office
This episode is for every woman who has ever felt that her hormonal health and her neurodivergence were being treated as two completely separate problems by two completely separate systems.
Lotta's work is quietly changing what is possible for us, and this conversation is essential listening.
You can also listen to our previous conversations with Lotta here:
E120 Connecting Hormones and Psychiatry to help more ADHD women
E174: Breaking down ADHD Neuroscience, Menstrual Cycles, Hormones and Anxiety
This week’s episode is sponsored by Understood.org, the leading nonprofit dedicated to empowering the millions of people with learning and thinking differences, like ADHD and dyslexia.
If you’re parenting a neurodivergent child, I’d recommend listening to their podcast, Everybody Gets a Juicebox, as it’s full of relatable stories and practical tools to help your family thrive while protecting your own wellbeing, too!
The ADHD Women's Wellbeing Live Event Recording is here!
My first-ever ADHD Women's Wellbeing Live event sold out, and now the full experience is available to you wherever you are, whenever it feels right.
Alongside three neuro-affirming experts, we spent four hours exploring the questions that matter most to late-diagnosed women. Get lifetime access here!
Inside the ADHD Women's Wellbeing Live Recording, you'll find:
- Kate Moryoussef on post-diagnosis growth and her gentle framework for what comes next
- Dr Hannah Cullen on the neuroscience of ADHD and why your brain works the way it does
- Hannah Miller on reconnecting with purpose through a neurodivergent lens
- Adele Wimsett myth-busting on hormones, HRT, progesterone and perimenopause
Understand yourself more deeply, feel less alone, and finally access the expert knowledge you deserve. Because every woman with ADHD deserves access to the knowledge, expertise and understanding that for too long simply hasn't been available to us.
To get lifetime access for £44, click here.
Links and Resources:
- Find my popular ADHD workshops and resources on my website [here].
- Follow the podcast on Instagram: @adhd_womenswellbeing_pod
- Visit Lotta's website (lottaborgskoglund.com) for more information
Kate Moryoussef is a women's ADHD lifestyle and wellbeing coach and EFT practitioner who helps overwhelmed and unfulfilled newly diagnosed ADHD women find more calm, balance, hope, health, compassion, creativity and clarity.
Transcript
Welcome to the ADHD Women's Wellbeing Podcast.
Speaker A:I'm Kate Moore Youssef, and I'm a wellbeing and lifestyle coach, EFT practitioner, mum to four kids and passionate about helping more women to understand and accept their amazing ADHD brains.
Speaker A:After speaking to many women just like me and probably you, I know there is a need for more health and lifestyle support for women newly diagnosed with adhd.
Speaker A:In these conversations, you'll learn from insightful guests, hear new findings, and discover powerful perspectives and lifestyle tools to enable you to live your most fulfilled, calm, and purposeful life wherever you are on your ADHD journey.
Speaker A:Here's today's episode.
Speaker B:Today, I'm welcoming back an incredible guest who I'm so excited to have back on the podcast.
Speaker B:She's a true, true expert on the topics of adhd, women's hormones, women's health, and her name is Lotta Borg Scogland.
Speaker B:Now, you may remember she was on the podcast a couple of years ago, but she is back.
Speaker B:She has a new book and we're gonna have lots of, lots of fun discussing what's been going on in this area over the past few years.
Speaker B:Now, if you don't know about Lotta, she is a Swedish MD, so she's a doctor.
Speaker B:She, she's a Ph.D. associate professor, author, keynote speaker, specialized in ADHD and hormonal health.
Speaker B:Hence the reason why I called her true expert.
Speaker B:So, welcome back to the podcast, Lotta.
Speaker B:It's so nice to have you here.
Speaker C:Thank you so much.
Speaker C:And it's so nice to be, to be back.
Speaker B:We were trying to work out how long ago it was, and time just flies and, you know, when we, when we spoke, and we'll make sure that we link our initial conversation in the show notes that people can really go back and listen.
Speaker B:But it felt like you were on the precipice of really making sure that people were understanding this, these connections.
Speaker B:And over the past few years, especially on this podcast, we talk about women's health or hormonal health.
Speaker B:So, so much.
Speaker B:It's really, for me, it's the foundations of my work.
Speaker B:Because if we don't understand that, we don't understand neurodivergence of women and we can't help them.
Speaker B:So I just want to thank you so much for all your help in driving the research, making sure that you're on the stages and doing those keynote speeches because it's so vital that doctors, you know, on the ground understand this.
Speaker B:So perhaps we can start a little bit on, I guess, what's been going on in this space over the past few years.
Speaker C:Yeah, I was trying to kind of recall and think back because there's so much going on and there is obviously so much more that needs to be done when it comes to ADHD and hormonal health.
Speaker C:But we are beginning to organize ourselves in our research group in Sweden, but also internationally.
Speaker C:And that is a joy because working on female issues with other females, it is so much easier than I've previously experienced, like my, my research collaborations.
Speaker C:So that is really something that is positive and gives you hope.
Speaker B:Yeah.
Speaker C:And then research, unfortunately, is what it is.
Speaker C:It takes a long time to do good research.
Speaker C:So we have been actually producing some literature and published some more papers since last time.
Speaker C:And I think we have been.
Speaker C:I've been collaborating with a lot of.
Speaker C:Of international researchers.
Speaker C:We have been looking at ADHD medication during pregnancy and lactation together with Ketchup Bank Madsen in, in Denmark.
Speaker C:And we have been together with Sandra Koi, who I know also have been on this show.
Speaker B:We love Sandra.
Speaker C:Yeah, yeah.
Speaker C:Published a really important overview, a paper where we review what is still missing, like the knowledge gap, pointing that out, also warranting for further research on these areas that we, I think is especially clinically relevant and urgent.
Speaker C:And we just last week actually published a beautiful interview study where we interview women with ADHD about their hormonal health and about how they experience these hormonal fluctuations across the entire, like, reproductive lifespan.
Speaker C:So there's a lot going on here and still a lot to do.
Speaker B:Yeah, yeah.
Speaker B:Well, thank you for that.
Speaker B:I mean, what would you consider, you said urgent.
Speaker B:What do you consider the most urgent research that is needed at the moment for neurodivergent women?
Speaker C:Oh, that's so hard to pick one kind of, of area.
Speaker C:And there.
Speaker C:Because women are struggling their entire reproductive lifespan with different forms of the different versions of their, like, hormonal health.
Speaker C:But I would say what we are focusing on right now, we're looking at ADHD medication and how the effect can change and vary over the menstrual cycle.
Speaker C:And we're also looking at menopause and perimenopause and how that affects women with adhd and.
Speaker C:And what we could do more for these women.
Speaker C:So.
Speaker C:So these are like two key areas where we are currently focusing on a lot.
Speaker C:And then we're also continuing with our research exploring different hormonal conditions or.
Speaker C:And conditions that are more prevalen.
Speaker C:So everything from endometriosis, pcos that is uniquely for women or unique in women and females, but Also these really, really burdensome conditions, like with burnout and different kinds of pain conditions, sick leave, that is so much more common in women than in men.
Speaker B:Yeah, absolutely.
Speaker B:And we brought out an episode with actually a doctor called Dr. Liz Murray, and she's written a book called, I think it's called Not Just Painful Periods.
Speaker B:And we talk about all the different connecting dots of like inflammatory health, hormonal health, whether it's endometriosis, she suffered with lupus.
Speaker B:And it's this sort of constellation of so many different symptoms and so many neurodivergent women just go, oh yeah, that tick, tick, tick, tick, tick.
Speaker B:Whether it's endometriosis, whether they've had postnatal depression, whether they've had pmdd, it, I, I say all the time, but I don't know one woman with ADHD or autism that hasn't suffered quite damagingly with their hormonal health, reproductive health.
Speaker B:And it kind of feels crazy that doctors are not understanding this.
Speaker B:And I know that the research you're doing and everything is helping, but I won't ever stop banging the drum on this and sharing the podcast because this is when we get the lay doctors seeing a woman come in and repeatedly saying, I've got, I'm suffering with this.
Speaker B:And then they can go, oh, okay, what are those sort of the separations that we're, we're getting the research, it's filtering through.
Speaker B:Why are we still seeing this?
Speaker B:Maybe this five year gap between knowledge on the streets, I guess.
Speaker C:Yeah, yeah.
Speaker C:I think there are a lot of, of factors contributing to that.
Speaker C:But when we started looking into, to this, me and Helena Kopkalner, who is my wingman in this research project, we kind of quickly realized that research wants really clear predictive patients.
Speaker C:We want to include patients that we know a lot about so we can correct and we can match them with other individuals who kind of function the same.
Speaker C:So historically that kind of has excluded women because we are not stable by default.
Speaker C:Right.
Speaker C:So I think researchers have found us as women, messy in that sense.
Speaker C:So it's easier to do the research on males.
Speaker C:And as an add on to that, it's also that people with psychiatric conditions are also messy in that sense.
Speaker C:Right.
Speaker C:So maybe they don't feel like showing up that day when you need to take that blood work and you need to do that assessment and they forget or they, they.
Speaker C:So I think we kind of have created research in a way that is not really ecologically relevant for very many people.
Speaker C:And that is just a shame.
Speaker C:But it's also something that can explain why so many women are struggling in searching.
Speaker C:Because this is complex, right?
Speaker C:So it's first of all you're a female, then you have ADHD or autism, then you have your periods and your hormones, then you have this increased risk for inflammation, all this kind of other functional disorders that we don't really know the cause of.
Speaker C:So it is really complex.
Speaker C:But that is how it is and that is what we need to stand in and start from.
Speaker C:And I think this is beginning to dawn on us and we're beginning in the research community to actually acknowledge this and to also sometimes question how we have done studies and how we have included individuals in scientific studies.
Speaker B:I mean, what I'm finding interesting is there is a shift I'm noticing in this conversation of in psychiatry.
Speaker B:But actually I wonder if we treated women with hormones first, what would happen?
Speaker B:And I wonder a little bit about what your studies are.
Speaker B:Women who are presenting with these, you know, I'm going to say inverted commas, psychiatric conditions, and we went hormone first.
Speaker C:Yeah.
Speaker B:What do you think?
Speaker C:I think that's an extremely relevant question.
Speaker C:The research is not there yet, obviously.
Speaker C:Again, I'm almost tired of hearing myself say that there is no research, but there's a clinical experience.
Speaker C:Right.
Speaker C:And there's testimonies.
Speaker C:And what we're seeing now in Sweden is a very rapid increase in ADHD diagnosis in women in their late or mid-40s and up to mid-50s.
Speaker C:And I would assume again that due to the lack of research and now the increased knowledge of ADHD and the cognitive challenges that you have with adhd, there might be a risk that we are actually treating women that should first of all be treated with hormones, hormones with ADHD medication, because we kind of take that route first.
Speaker C:That is also again a historical problem because hormonal therapy today we know that we have misinterpreted previous data where we saw the increased risk of breast cancer and other like adverse outcomes and due to menopausal hormone treatment.
Speaker C:But now when we look at the data in another way, we see that it's perfectly safe and it's also even protective of some forms of cancers, et cetera, et cetera.
Speaker C:And it increases a quality of life enormously for so many women.
Speaker C:We are now starting to realize that this is actually should be a first line treatment.
Speaker C:When our patients come in women in this period of life, there should be this kind of wide assessment where you assess psychiatric symptoms, life situation and the hormonal status.
Speaker C:Unfortunately, healthcare today are as research organized in these like silos.
Speaker C:Right.
Speaker C:So it is difficult still to find a GP or pain doctor or rheumatologist or whatever that is also or, and a psychologist, psychiatrist that is feels so comfortable in assessing the hormonal influence that they actually even ask the questions.
Speaker C:So today the normal thing is that you take up your anamnesis, you, you take the medical history but.
Speaker C:And you take the history about what medications you are using, but you don't ask if they're taking contraceptives or hormone replacements because that is considered something else.
Speaker C:So I think there are so many factors like tapping into this situation where women are actually not treated and when we are treated it's not always based on a complete like medical facts for the medical making.
Speaker B:Yeah, I mean what I can hear is that it's just the.
Speaker B:So many boxes and people are put into so many boxes and no one is seeing this like holistic view.
Speaker B:I would love to see all doctors being trained in being able to prescribe hormones.
Speaker B:You know, from what I know is progesterone body identical.
Speaker B:Progesterone can be very helpful with anti.
Speaker B:Inflammation, pain, sleep, mood.
Speaker B:We know that.
Speaker B:Unfortunately suicide risk goes up in perimenopausal years and then add on neurodivergence to that and it kind of compounds it even more.
Speaker B:And knowing how hormones can help with that, it feels like such a disservice to women that we are only just beginning to.
Speaker B:I mean I, I wonder.
Speaker B:We've almost gone back in time, haven't we?
Speaker B:Because exactly what you say the black box warning was on.
Speaker B:Fear was created.
Speaker B:There was a school of thought 20, 30 years ago that hormones were very helpful for women that got shut down.
Speaker B:Whole generation of women have suffered, missed that train.
Speaker B:Right, exactly.
Speaker C:So that is.
Speaker C:And there's also this window of opportunity that we know from research and that is also the explanation why the previous like studies was misinterpreted.
Speaker C:Because they initiated hormonal replacement therapy then in women that had passed menopause with over 10 years.
Speaker C:So they basically introduced estrogen to women in their 60s and 70s.
Speaker C:And that window of opportunity is very important as we now know that when we introduce hormonal therapy early on in and close to menopause, that is where we get these protective effects.
Speaker C:But if we miss that window of opportunity then we see these negative outcomes and negative effects and harmful effects even.
Speaker C:So it is really all about timing.
Speaker C:And so if you have, if you're unfortunate then enough to like pass these year of your life during, like when, when this was the golden standard.
Speaker C:And when this was the best we knew and the, the evidence that we based our clinical decision making on, then you missed that.
Speaker B:That is a really tough pill for a lot of women.
Speaker B:You know, the amount of women I hear from who are so sad and are grieving, you know, the decades that they lost to severe mental health problems, breakdowns of relationships, losing their careers, it's devastating.
Speaker B:It's a tragedy.
Speaker B:And my heart just goes out to the women in their 60s and 70s and just says, where was this when I, you know, when I was in my 40s?
Speaker B:I love what you're saying about the, the preventative care, because even me, I went on HRT, I think I was 41, and none of my friends were.
Speaker B:I felt embarrassed that I was grateful, so grateful to have had a doctor who understood this.
Speaker B:I was already working this space.
Speaker B:That was five years ago, nearly four or five years ago.
Speaker B:I'm so glad that I got there because my perimenopausal symptoms were there in full view.
Speaker B:But 41, I didn't think, I thought was too young.
Speaker C:We see that in research also.
Speaker C:And that is, it's beginning to come more and more publications.
Speaker C:And there was one last year that actually showed that women, neurodivergent women, experience perimenopausal symptoms earlier.
Speaker C:So, so that is.
Speaker C:You're not alone in that.
Speaker C:But our society is not only very sexist, but it's also very ageist.
Speaker C:Right.
Speaker C:So we are also.
Speaker C:Many women are ashamed about talking about perimenopause and menopause because you fear that you are, like, entering this, this part of your life where you're no longer, like, what, Useful, attractive.
Speaker C:And that is the fact that we, we have a tendency to kind of deviate to youth and.
Speaker B:Yeah, absolutely.
Speaker B:And it is, it's.
Speaker B:There's a stigma.
Speaker B:You know, you feel a bit like shriveled up and old and you're going to be discarded.
Speaker B:And, And I definitely felt like, oh, my goodness, I'm really young here and I've got menopausal symptoms now.
Speaker B:You know, I couldn't.
Speaker B:I'm so glad.
Speaker B:I'm so grateful.
Speaker B:But what I'm thinking is, like, women, it's almost, you know, first of all, if we've got a diagnosis earlier on in life, we're then aware that these hormonal shifts are, might come quicker, earlier, more extreme.
Speaker B:So would you say there's like a school of thought of women in their late 30s having a way of tracking?
Speaker B:I know we do cycle tracking, but these very subtle shifts and Getting on, on HRT before they become.
Speaker B:For example, when I.
Speaker B:My first shifts were quite extreme.
Speaker B:I was waking up in the middle of the night dripping in sweat and I wasn't sleeping and I would wake up at two, three o' clock in the morning and my heart would be racing.
Speaker B:And I live with that for six, eight months probably.
Speaker C:Me too.
Speaker C:Me too.
Speaker C:I thought I had like lymphoma or some, some like malignant because I was also younger then.
Speaker C:So it took me also too long to understand and appreciate period where I could have gotten treatment earlier on.
Speaker C:So, so I completely see that.
Speaker C:And the good thing with us women is that there are predictability in our reproductive life.
Speaker C:So we already know that during puberty we have an increased risk of experiencing different kind of, of mental challenges and, and have an increased risk also for actual like psychiatric disorders, anxiety, depression and so on.
Speaker C:And then we know that we have that in every menstrual cycle in the luteal phase.
Speaker C:And we know that we have a neurodivergent.
Speaker C:Women are at increased risk of postpartum depression.
Speaker C:Also predictable where we could actually work preventive.
Speaker C:We can talk about this, we can plan for this.
Speaker C:If it doesn't happen, good, everyone's happy.
Speaker C:But if, if it happens, then we're not caught off guard, we're prepared.
Speaker C:And then we have this perimenopause and menopause and PMS and PMDD that tends to get worse with age, also leading into perimenopause and menopause.
Speaker C:So there are a lot of things that we already know that we can do something about.
Speaker C:But I often think about.
Speaker C:I don't know what you think, but I'm a psychiatrist.
Speaker C:I'm a, I'm a GP by training from start.
Speaker C:And then I also trained to be a psychologist psychiatrist.
Speaker C:And I am now struggling to understand female hormones and the part that my colleagues were gynecologists kind of take granted.
Speaker C:And it's really complex and it's really messy and busy and it's.
Speaker C:There's so many like labels and forms of different hormones and there are the naturals and then there are identicals and they're on there synthetic.
Speaker C:And there's so much to, you know, keep in mind.
Speaker C:But I just think about the audacity that we as a medical profession have to say, well, you have to go to someone else because I don't know that much about hormones.
Speaker C:And that is completely okay to say if you're a GP or if you're orthopedic surgeon if.
Speaker C:Or if you Are like cardiologist, we get away with that.
Speaker C:How is that possible when 50% or even more, because women tend to seek more health care.
Speaker C:The majority of your patients are female, living with this every day.
Speaker C:I think, I think we need to kind of just redo this and demand that if you are in a medical profession, you need to factor in the hormones.
Speaker B:Yeah.
Speaker B:100% Unacceptable.
Speaker C:And still, I know it's really difficult, but it's also more difficult for me because I have to relearn it.
Speaker C:I read about it in med school and then I. I saw nothing of it until I started getting interested in this in research.
Speaker C:So I do realize that there's a resistance and that, that these, all these things seems very complicated, but it is a part of the clinical decision making and it should be.
Speaker C:So if you go to your orthopedic surgeon because you have this pain in your knee or this like starting to get pain in your tendons or muscles, because muscles and tendons, they are all like swamped with progestin and estrogen receptors.
Speaker C:They're all over the body.
Speaker C:So can't really escape this.
Speaker B:You can't.
Speaker B:I'm listening to you and I'm thinking it literally covers all aspects of women's health, you know, from cardiology, psychiatry.
Speaker B:Like you say, we've got it in.
Speaker B:You know, we see hypermobility and ehlers dad loss so prevalent in this community.
Speaker B:The guts, all of this.
Speaker B:And it's almost like health care needs to be completely rebuilt from the foundations that if you're wanting to help women, you know, 50% of the population, this is mandatory.
Speaker B:And we have to understand how it's so interconnected.
Speaker B:Yeah.
Speaker B:And it's crazy to think that, you know.
Speaker C:Right.
Speaker C:It is crazy.
Speaker C:And, and we just live with it.
Speaker C:It's just like, well, it's the male norm.
Speaker C:That is what we are working from.
Speaker C:That is our kind of baseline.
Speaker C:And then there are these difficult women who doesn't really follow the pattern.
Speaker C:And then the neurodivergent women, even more difficult because they don't even follow the traditional female pattern then.
Speaker C:So, so that is, that is what we are up against and, and what we need to address, I think.
Speaker A:So I want to speak to those of you who are currently parenting neurodivergent children while also navigating your own ADHD or neurodivergence and probably feeling pretty exhausted right now.
Speaker B:Maybe you've had moments of overwhelm, frustration,.
Speaker A:Or even what some of us call mum rage, and then that guilt follows.
Speaker A:I just want to say that you're.
Speaker B:Not alone in that.
Speaker A:That's why I want to share a new podcast that I've been listening to called Everyone Gets a Juice Box for parents of Neurodivergent kids.
Speaker A:It's from Understood.org and I've been listening to Everyone Gets a Juice Box.
Speaker A:And what I really appreciate about it is how it holds space for the real experience of parenting, not this polished online social media version.
Speaker A:The podcast has honest conversations about burnout, emotional overwhelm, meltdowns, but also so much compassion and understanding and even those moments.
Speaker B:Of humor and relief that we all need.
Speaker A:It reminds me that struggling doesn't make you a bad parent, it makes you a human one.
Speaker A:And doing something incredibly nuanced and demanding, like parenting neurodivergent children, especially after a late diagnosis, ourselves.
Speaker A:And alongside that validation, there are practical tools and insights that help you support your child while also taking care of yourself.
Speaker B:It's the kind of podcast that leaves.
Speaker A:You feeling a little lighter, a little more in stores, and a little bit more hopeful.
Speaker A:So to listen, search for Everyone Gets a Juice Box in your podcast app or go on the Understood.org website and.
Speaker B:You'll see it there.
Speaker A:That's Everyone Gets a Juice Box.
Speaker A:Now, back to today's episode.
Speaker B:Listening to this now.
Speaker B:And if anyone's listening and thinking, well, what do I do?
Speaker B:You know, what do I do with this?
Speaker B:Because there's a lot of very exhausted women advocating for themselves who are brilliant, clever women who are pulling the research, listening to the podcast, getting the books.
Speaker B:They've got all the information.
Speaker B:And it's like, but I need to then go to my doctor.
Speaker B:And I'm very worried that my potentially male doctor is going to be very dismissive and invalidate me.
Speaker B:And, you know, oh, here's another one coming through the door, another adhd.
Speaker B:And.
Speaker B:And it feels like we're having to arm ourselves, brace ourselves mentally and physically to be pushed back on.
Speaker B:And I mean, I guess what.
Speaker B:Tell me a little bit about the book that you've written.
Speaker B:And is that something that women can use to advocate for them themselves?
Speaker C:This is exactly why we.
Speaker C:We wrote the book.
Speaker C:Me and Helena Kopkelner is a professor in gynecology and a gynecologist.
Speaker C:We wrote this book to be almost like a handbook for not only the patients, but also for the clinicians.
Speaker C:So we have this early on feedback from one of my really dear colleagues, Larry Clason in Canada, and he said, you know what?
Speaker C:You need to be much more specific because I really, really want to learn this, but it is so difficult to understand.
Speaker C:So we really, really tried.
Speaker C:And, and what we did is during the book we.
Speaker C:We follow five women, girls and women from the age of puberty to post menopause.
Speaker C:And we have.
Speaker C:These are our like collapsed version of many our of our patients.
Speaker C:So we have kind of written about them so that they represent the, the typical difficult periods that women transition through.
Speaker C:So just before puberty and then to the post menopausal year.
Speaker C:And hopefully this book comes out, is published in the UK 4th of June and it's called Female Hormones and ADHD the impact on Brain and Body.
Speaker C:And at least we have tried to cover these kind of questions that you have and that you sit with and hopefully to educate women.
Speaker C:So there is one part what you can do for yourself like self care, and then there is one part with what you hopefully can discuss with your doctor, kind of introduce these topics if you recognize symptoms and if you feel that this is something that might be of interest for me.
Speaker C:And it's not always that this can work or will work because there might be so many different underlying causes that, that you don't know or that your doctor's also factoring in that that makes it hard or difficult or even impossible to get that particular treatment.
Speaker C:But to get the conversation starting because I think what we need to realize now is that good, like meeting should be a collaboration.
Speaker C:A good meeting between yourself and your doctor should be a collaboration and that responsibility on both parts.
Speaker C:So it is also a responsibility for the patient to do the best you can with what you got.
Speaker C:But it's a responsibility that the doctor sees like the holistic view of what this girl or woman is struggling with.
Speaker B:Yeah.
Speaker B:And I think to have something like that to give you that confidence to know that you're not going mad, you're not imagining it like you've got something very substantial in your hand that is just, you just can't be dismissed with.
Speaker B:I wanted to ask you a question about.
Speaker B:I know that Sandra Coy has done a lot of work on this about cardiology and heart issues with women and what that crossover is with regards to hormonal health.
Speaker B:And is there more research coming out there?
Speaker B:Because there's a lot of women talking from a lived experience and also generationally understanding.
Speaker B:There's been like heart health problems in my female side of the family.
Speaker B:And I can see the ADHD and or women saying, I had a heart attack at like 50.
Speaker B:Like what's that all about?
Speaker C:Yeah, that's so unfortunate.
Speaker C:And I.
Speaker C:One of my Close friends, who's also an associate professor.
Speaker C:So she's not like a lay person.
Speaker C:She had a breast cancer very early in her life, so she had to operate also to take out her ovaries.
Speaker C:So she lost, from one day to another, she lost all her, like, reproductive hormones.
Speaker C:And so she went into complete menopause from like one day to another when we, when she was, I think, in her early 30s.
Speaker C:And the problem there is that female heart health and vascular health starts deteriorating when the estrogen leaves your body.
Speaker C:So it is a very significant risk there, starting around menopause, for women to actually experience cardiac problems and even heart attacks.
Speaker C:And, and we have known for a long time that cardiac infarctions, for example, has different symptoms or is displayed differently in, in women than in, in men.
Speaker C:So if we're supposed to suppose we were to stand on, you know, in the ER room and dismiss everyone who did not experience a heart attack as the, the male norm, there would be a lot of women that would go home and then, you know, worst case, die from that.
Speaker C:So, so this is so important that we know that and we know that, that our heart health is intimately tied to our hormonal health and that what we, what we need to understand.
Speaker C:So, so.
Speaker C:And what happened to my friend then?
Speaker C:She got in heart attack, and she's not even 50 because she had had all these years without estrogen.
Speaker C:And when she came to her cardiologist and she said, do you think that this could have something to do with me being without hormones for so long?
Speaker C:And, and she, she was a female doctor, just looked at her and then she pointed at a model of the heart that she had on her desk and she said, well, you know, my focus is on this organ, just like for real.
Speaker C:And that is unfortunately.
Speaker C:So that is why Sandra Coy's work is so important to highlight this, because there are more like aspects to this when it comes to neurodivergent women because we live under a lot of stress in unfortunately a large part of our lives.
Speaker C:There is all these lifestyle factors that are so much more difficult to get healthy routines around.
Speaker C:There's like exercise and sleep and how we eat and if we smoke and if we drink alcohol or not and if it's in moderation and all these things, including also like everyday routines, remembering to take your medications, all these things, you know, pile on top of each other, putting neurodivergent individuals at risk for heart attacks.
Speaker C:So, and then you also have the ADHD medication, the stimulants that can, that can protect because typically it, it helps you with your routines and it gives you more healthy and balanced lifestyle but can also increase blood pressure and pulse and then be difficult to treat or even impossible.
Speaker C:There might be contraindication if you have already experienced like a heart attack.
Speaker C:So.
Speaker C:Yeah, so there's many factors that is again tied together for females, neurodivergent females and then hormones and then the, the heart.
Speaker B:Yeah.
Speaker B:And it's so important that you state, you know, that the lifestyle side because for me a while ago I would have just thought the reason, the connection why we have more heart problems is the stress and it is the lifestyle and you know, staying healthy.
Speaker B:But I would say it's also sort of this exacerbation of our nervous system just being also always heightened inflammatory.
Speaker B:But I never knew the connection between estrogen and heart and the heart.
Speaker B:And that's so powerful, isn't it?
Speaker B:Because I mean, I guess the EC estrogen is, you know, working with our different brain receptors, helping, you know, with our executive functioning.
Speaker B:Dopamine potentially that's helping us then you know, kickstart a healthier routine and you know, moving away from self medication and it's this compound effect, isn't it?
Speaker C:Yeah.
Speaker C:I didn't know that heart attacks is the number one cause of death in postmenopausal women.
Speaker C:I would thought it would be maybe breast cancer or something like that, but.
Speaker C:But it is.
Speaker C:So this is a huge, a huge deal and it's really important that, that we factor that in as well into our holistic health situation.
Speaker B:I mean, what are your thoughts on.
Speaker B:And this is like pipe dreams coming out here, almost like a screening at 35 for Women's Mental health and reproductive health where they can go in and at the age of 35 they can say, well actually now you're asking, my sleep has dropped off.
Speaker B:Or now that you're asking, I do feel this sort of like low level, you know, anxiety or irritation or my periods have got heavier and they're getting this sort of open dialog, this curiosity.
Speaker B:At 35, like you say it's like prevention, like can we get in there early?
Speaker B:So this group of women from 38 to 55 aren't suffering the way we have.
Speaker B:We have been.
Speaker C:I do, I do, I talk to all of my patients who are in that, in that kind of H span about this.
Speaker C:Not to, you know, that we have to start something here and now, but just to be aware and be attentive to it.
Speaker C:Because as you experienced also these hormonal symptoms can come while your Period is still really regular.
Speaker C:Right.
Speaker C:So we.
Speaker C:And it.
Speaker C:Often, it starts with sleeping problems and this slight feeling of discomfort.
Speaker C:And then maybe your, your period gets a little bit, you know, comes a little bit earlier or a little bit late.
Speaker C:There are a couple of days, but then it's, it's normal again.
Speaker C:So estrogen doesn't decline in like, this linear mode where you cross a line and then you're in menopause, but rather it goes up and down and you can have all these extreme vasomotor symptoms that causes this kind of flushes and sweats at night and still have regular period because.
Speaker C:And also because these kind of extreme fluctuations.
Speaker C:So suddenly your estrogen can drop down to below like, or menopausal.
Speaker C:Menopausal levels, and then it goes up again.
Speaker C:So you.
Speaker C:It is a really confusing time here for women with, with ADHD and, and with autism because maybe we have finally figured out how we feel and function in the different parts of the menstrual cycle.
Speaker C:And maybe we can even, you know, you know, deal with that and say, okay, so I have this week where everything is like a mayhem and a clusterfuck and I want to divorce my partner and I want to ask my boss to off, but I know that this is probably hormones, so I will just sit still in the boat and write this.
Speaker C:And then, you know, my regular life, you know, kicks in.
Speaker C:And I'm really happy that I didn't act on all these, you know, irrational feelings, but they felt so strong and they felt so true.
Speaker C:Right.
Speaker C:So maybe we have learned that.
Speaker C:And then things start to kind of be much more volatile again and you kind of, you can't count on that anymore.
Speaker C:And then you get so confused and again, you get gaslighted by all this.
Speaker C:But no, you're too young or this is not.
Speaker C:And, and you know, you're, you are still, you know, menstruating.
Speaker C:That can't be it.
Speaker C:And, and there's a lot of, like, misinformation out there as well.
Speaker B:Yeah, I mean, you've just described my situation like to a tea because I just, I, I had exactly that.
Speaker B:And I was sort of navigating the, the hormonal symptoms with hrt and I kind of still knew I could rely on my period.
Speaker B:And then this past two months has been awful because I've not had a period in two months.
Speaker B:So I felt like I'm in permanent pms.
Speaker B:That is horrendous.
Speaker B:And then it went to go and get a scan to check because I've got a Hormonal, you know, perimenopausal endometriosis and adenum meiosis.
Speaker B:I was told, like, my ovaries are shrinking.
Speaker B:I've got dry ovarian walls, whatever they use.
Speaker B:And I literally feel like I've been for two months, been in this PMS state.
Speaker B:And I like, am I going to get a period again?
Speaker C:There's no release.
Speaker B:And you don't know.
Speaker C:There's no.
Speaker C:When you have the period, you know that there's a release at the end of, like, dark tunnel.
Speaker C:But when you're in this state, you don't know.
Speaker C:This might go on for four months or it's tomorrow.
Speaker C:You don't know.
Speaker C:And that is not something that is easy to live with, right?
Speaker B:Yeah, it is.
Speaker B:And it's very hard.
Speaker B:And, you know, like, I thought I kind of got a grip, and then it's like, no, you're going through, like, let's.
Speaker B:Let's ramp it up, you know, to the next level.
Speaker B:And as I turn 46, and I think, oh, God, you know, part of me just wants a period, and the other part is just like, just get me through to the end.
Speaker B:Just, I'm gonna, like, right.
Speaker B:Knuckle it till, you know, I don't get my periods anymore.
Speaker B:But I'm just kind of diligently applying my, you know, estrogen and taking progesterone.
Speaker B:Before we close, I did want to ask about testosterone and if there has been any research with regards to testosterone in ADHD women.
Speaker C:I. I'm thought.
Speaker C:I'm sure there is something out there, but when I talk to my clinical colleagues, it's quite controversial still.
Speaker C:And I think the area is very much out on where testosterone might fit in to our kind of treatment arsenal here.
Speaker C:So.
Speaker C:So I'm not.
Speaker C:I am not sure.
Speaker C:And when that comes up on the table, I always refer to my gynecology colleagues.
Speaker C:And as far as I know, and I might be misinformed, but the only indication today for.
Speaker C:For testosterone treatments in menopausal or perimenopausal women are decreased sex drive.
Speaker C:If you've had a normal, like, libido or sex drive before.
Speaker C:So that is what I think, at least in.
Speaker C:In the Swedish context, that is where the indication lies.
Speaker C:But then I also know a lot of women who have tried testosterone and they.
Speaker C:They get their energy levels up and they feel really good about, you know, and stabilized by it.
Speaker C:So, I don't know.
Speaker C:I would love to hear if you have any kind of research or some clinician that uses this and how they use it because I'm a little bit behind on, on both the research and the clinical aspects of testosterone.
Speaker B:Yeah, I think there's definitely lots of mixed personal, you know, experiences and that.
Speaker B:And I think that's the thing, isn't it?
Speaker B:Some people go, yes, it's been incredible.
Speaker B:I didn't feel any difference.
Speaker B:Or actually, some women are saying it made me quite angry, you know, like, it made me, you know, a bit more aggressive than, than I want to be.
Speaker B:So, again, it just shows how personalized this treatment has to be for, for women.
Speaker B:And it's not just ADHD women or neurotypical women or autistic women.
Speaker B:It is.
Speaker B:The ADHD woman is still very personalized with how hormones show up because we know ADHD shows up so different currently.
Speaker B:So, yeah, we're very complex people and we are.
Speaker B:But, I mean, I can't begin to thank you for all the work that you're doing in this, you know, this, this, this field.
Speaker B:It's life changing and it's life saving and it's, you know, the beginning and we're going to look back and be like, oh, this is where it began, hopefully.
Speaker C:Yeah.
Speaker C:And it's a privilege and, and it's a pleasure and it's so rewarding because I, I, every day I get text and inbox messages from, from women who only buy, like hearing your podcast and hearing someone talking about what they're going through, it's not like it is.
Speaker C:They always have to do things differently or add a medication or do anything about it.
Speaker C:It's just hearing about it and not feeling so lonely and gaslighted.
Speaker C:I think that's extremely important.
Speaker C:So thank you for doing this, for your beautiful book as well.
Speaker B:Thank you and your, your contribution.
Speaker B:Listen, it's amazing that we can do this work together.
Speaker B:And I think, you know, I've realized over the years that the most important thing for me is to sort of highlight and create awareness and signpost people so they could, like you say, it's to.
Speaker B:It's hearing it.
Speaker B:It's validating.
Speaker B:It's like, I'm not alone.
Speaker B:I'm not imagining them this.
Speaker B:They can heal, they can learn, they can educate, they can feel empowered and.
Speaker B:Yeah, so tell people.
Speaker B:So your book is out on the 4th of June.
Speaker B:Just remind me what it's called again so we can spread the word.
Speaker C:Yeah, it's called Female Hormones and adhd the Impact on Brain and Body.
Speaker B:Wonderful.
Speaker B:I'll make sure the link is in the show notes.
Speaker B:And thank you Lotta, so much for all the work that you do.
Speaker B:And yeah, let's hope to catch up again very soon.
Speaker B:Nice.
Speaker C:Thank you.
Speaker A:Thank you for being here and listening to today's episode.
Speaker A:I just want to remind you that if you are looking for more support on your ADHD journey, there are so many resources waiting for you over@adhd womenswellbeing.co.uk so inside the ADHD Women's Wellbeing Workshop library you'll find find practical and compassionate guidance on topics such as nervous system regulation, rejection, sensitive dysphoria, perfectionism, emotional regulation, hormones, parenting and so much more.
Speaker A:All designed specifically for late diagnosed neurodivergent women.
Speaker A:You can also explore my new book, the ADHD Women's Wellbeing Toolkit, which was published by dk, which is also available in ebook and audiobook, which is packed full of tools to help you feel calmer, more regulated and more like yourself.
Speaker A:And if you do crave a bit more deeper connection and ongoing support, come and join us inside the More Yourself community.
Speaker A:It's a gentle space for learning, reflection and connection with other neurodivergent women.
Speaker A:And you'll also find the recordings from our first ever ADHD Women's Wellbeing Live event which brought the together incredible speakers and a room full of inspiring women for a truly special day.
Speaker A:We have recorded it all for you and it's there to buy.
Speaker A:So whether you're just starting your journey or looking to go deeper, there's something there for every stage.
Speaker A:Just head to ADHD womenswellbeing.co.uk to explore everything.
Speaker A:And as always, thank you so much for being here and for being part of this community.
Speaker C:SA.
