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I was recently reading a 2020 study, which found that 45% of the women studied who had ADHD also had PMDD. This is significantly higher than the 28.7% estimated prevalence of PMDD in the general population. It is also a pattern that I have noticed with many of my clients, who have severe PMS symptoms or PMDD, also have a diagnosis of ADHD or strongly suspect that they are neurodiverse.
ADHD is a cognitive disorder that affects the structure and functioning of the brain and nervous system. For a long time, it was thought that the symptoms of ADHD were behavioural, and a lot of my clients with this condition still feel that they could be ‘trying harder’ or that they are lazy or unorganised. We now know that this is not true. In people with ADHD, certain areas of the brain are affected that play a role in cognition, particularly in emotional regulation and memory.
This can affect executive functions such as planning, keeping track of time, sustaining attention on a task, and working memory. Researchers also found abnormalities in areas that involve emotional regulation and motivation.
Often, my clients with ADHD describe high sensitivity to touch, sounds, lights, and noises, especially in the week before their period is due.
Women are very likely to be underdiagnosed because the manual first used to diagnose ADHD in the 1980s was based on studies of boys, who are more likely to be hyperactive and disruptive with ADHD. Women and girls are likelier to have the inattentive subtype, to appear dreamy, forgetful or away with the fairies. Women with ADHD are also battling against society's expectations that they ‘should’ be good at organising the house, remembering children's birthdays, or taking on the majority of the household labour.
Changing hormonal levels throughout the menstrual cycle affects ADHD symptoms in women. Dopamine is a crucial neurotransmitter implicated in ADHD; it helps us to stay focused, tackle difficult tasks and sustain motivation, and this is the neurotransmitter that is low in women with ADHD. Oestrogen produced in the first half of the menstrual cycle boosts dopamine, so you may find life easier to manage in this phase of the cycle. However, progesterone, produced after ovulation, in the second half of the cycle, actually suppresses oestrogen and also dopamine, which can make ADHD symptoms much more complicated to manage.
Support and treatment for ADHD and PMDD require input from your medical team and therapists. Nutritional therapy can help to support the symptoms, but it is not a cure.
Recommendations I make in my one-to-one nutrition clinic for clients with ADHD and PMDD are highly personalised; I always like to suggest some blood tests to check that we are not missing a vitamin or mineral deficiency or underactive thyroid that could be making the symptoms worse. We can also do genetic testing to support the nervous system and neurotransmitter production such as serotonin, dopamine, and GABA and which foods you can add to your diet to support these pathways. I Use a company called Life Code Gx for this.
Some other general nutritional recommendations for brain health to support ADHD and PMDD include:
Eat foods rich in magnesium. Most (if not all!) of the clients I see are low in this mineral. Magnesium plays a vital role in the formation of neurotransmitters, particularly in serotonin production, which helps regulate mood. It is also converted to melatonin, which enables you to sleep. Magnesium-rich foods include nuts and seeds, leafy greens, beans, and dark chocolate. I commonly put clients on a magnesium supplement to help boost their levels. Book an appointment with me if you are interested in adding in a magnesium supplement. There are different forms of magnesium, so I need to choose the type that is most supportive of your symptoms, and it can also interact with medication in supplement form.
Eat more healthy fats! I still work with clients all of the time who are scared of fats in the fear that they will put on weight, but fat is essential for our brain health. Over 60% of the brain's weight is fat. Essential fatty acids such as omega-3 and omega-6 are necessary because we cannot make them in our bodies. Include more foods such as oily fish (salmon, mackerel, sardines), Chia seeds and flaxseeds, and cold-pressed oils such as olive oil in your food regularly.
Protein: Most of my clients need to eat more protein in levels sufficient to balance their blood sugar and make healthy neurotransmitters. Dysregulated blood sugar can exacerbate the symptoms of ADHD and PMDD, so it is essential to eat enough protein. I ask my clients to ensure they get a protein source with every meal and snack. Protein is found in meat, fish, eggs, nuts, seeds, and legumes.
If you suspect that you have ADHD and PMDD, then my best advice to you is to trust your intuition because it is always right. Women have historically been underdiagnosed based on outdated diagnostic criteria. Getting support and treatment for these conditions is life-changing and life-saving. Please see your GP with your suspicions, and go to another GP if the first one does not listen to you!
If you would like personalised support with managing your nutrition (and advocacy and support for your ADHD), please reach out to me. I offer a free initial call.
Catherine xx
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