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Upon immediately reading this, you might think these conditions are completely unrelated: One has to do with your brain, and the other has to do with your ovaries. They may seem like they affect completely separate systems in the body, but Attention-deficit/hyperactivity disorder (ADHD) and Polycystic Ovary Syndrome (PCOS) are more intertwined than you think. If you already have both conditions, you know exactly what we’re talking about.
Just ask Kristyn Hodgdon, co-founder and Chief Creative Officer of Rescripted, who has both PCOS and ADHD and discovered these diagnoses as an adult (a common experience for women in their twenties and thirties), after meeting with a fertility specialist while trying to get pregnant and later meeting with a psychiatrist. Once she knew she had both, so much made sense, including her creative, scattered nature, and her irregular periods.
Don’t have a diagnosis but are suspicious you might have ADHD and/or PCOS, or want to support a loved one who does? It’s important to understand how and why the two feed off of one another, the symptoms you should expect, and how you can best cope with both conditions.
The link between ADHD and PCOS
PCOS can involve polycystic ovaries, or tiny ovarian cysts that attach to the ovaries, but a hormonal imbalance is actually most characteristic of PCOS. People with PCOS have higher levels of androgens, or traditionally “male” sex hormones. Androgens can also affect how an area of the brain called the prefrontal cortex uses dopamine, a feel-good hormone that’s associated with motivation and reward, explains Misty Richards, MD, MS, a reproductive psychiatrist at UCLA Health and co-founder of the Maternal Outpatient Mental Health Services (MOMS) Clinic. Coincidentally (or not so coincidentally), ADHD involves that same area of the brain, which is responsible for executive functioning and organization, and may have lower levels of dopamine. “So, if PCOS is associated with higher androgen levels in the brain that ultimately compromise dopamine utilization in the prefrontal cortex, then this would translate into a presentation of ADHD symptoms,” Dr. Richards concludes.
There is some research that also suggests that there’s a genetic component, and people with PCOS might be predisposed to ADHD, explains Xenia Angevin, NB-HWC MSc(Psych), Principal Coaching Psychologist at Shimmer, an ADHD coaching platform. But there’s still so much to discover there. What’s important to note is that ADHD and PCOS can have some overlapping symptoms.
How do ADHD and PCOS symptoms exacerbate each other?
According to recent studies on PCOS, there’s an association with impulsivity and sensation-seeking and the condition. “Impulsivity shows up in many ways, including a tendency towards risky behavior whenever one feels extremely positive or negative or when seeking new, exciting experiences,” Angevin says. “The other ways in which impulsivity shows up is by getting distracted, or without pressing the ‘pause’ button: making up one’s mind too quickly or without thinking.” This impulsivity is also a key component of ADHD in many women.
ADHD and PCOS combined can greatly affect the brain and mental health. The changes in the brain from high levels of androgens can lead to difficult dopamine function, says Dr. Richards. Not only do these brain alterations make ADHD symptoms more severe, but the mental toll of living with both conditions plus having reduced dopamine can lead to mood disorders including depression, Dr. Richards adds.
It’s also possible that ADHD can interfere with PCOS management, which often involves setting goals, close monitoring of health markers, and problem solving, according to Angevin. “Weaknesses in executive functioning account for reduced ability to set goals, plans, break them down in parts, and allocate tasks to a timetable—coincidentally, a very much needed set of skills for those with PCOS,” she says. However, once you get a diagnosis for both conditions, there are some treatments and other ways you can work with your symptoms to make life with ADHD and PCOS more manageable.
The best ways to manage ADHD and PCOS together
Beware of information overload.
It’s easy to get lost in reading all the ADHD and PCOS hacks coming from every doctor, dietitian, or holistic health professional out there (and even non-professionals on the internet sharing their experiences). “There are so many different opinions on what you should be doing, which can lead to information overload for ADHD but also for PCOS,” Hodgdon says. “I tend to hyper-fixate on certain things, like trying to get my periods back as I deal with secondary infertility.” Instead of trying to treat your ADHD and PCOS using solely internet sources, make sure you see the right specialists that you can build a relationship of trust with. For ADHD, that might look like a health professional who specializes in neurodevelopmental conditions, says Angevin. And for PCOS, you can check out a directory by the PCOS Awareness Association to find the right gynecologist or reproductive endocrinologist in your area.
Get a formal diagnosis if you don’t have one already.
If you suspect you have ADHD, PCOS, or both, it’s not too late to get evaluated. Once you track down the right specialist, an evaluation for a neurodevelopmental condition and an official diagnosis can help you get health insurance coverage for treatment, Angevin says. You may even be able to access some support from your employer, such as executive assistant support or ADHD coaching, she adds.
Make sure you get the medication you need.
The next step for ADHD and PCOS management might mean medication. PCOS treatment is often multifaceted, to reduce symptoms of high androgen levels, such as insulin resistance, metabolic syndrome, and acne, and to regulate the menstrual cycle, explains Dr. Richards. Lifestyle changes like a more anti-inflammatory diet and regular exercise are part of the picture, but combined oral contraceptives can be an important medication for regulating hormones in people with PCOS. Specifically, birth control pills containing the medication drospirenone might help both hormonally and can improve mood for anyone who has mood changes or depression associated with PCOS and ADHD, Dr. Richards says. Another mental health piece of the treatment puzzle might be taking a stimulant (or another medication) to help manage ADHD symptoms, she adds.
Create streamlined self-care routines.
“Both ADHD and PCOS benefit from adherence to self-care routines designed to improve your quality of life,” says Angevin. Her suggestion is working with a digital calendar to create routines that will support your executive functioning. You can program in reminders to take medications or go on daily walks, schedule your workouts, track your menstrual cycle and any other reproductive or mental health symptoms, make lists for food shopping and meal planning for hearty, nutritious meals, and even set aside some blocks of leisure and self-care time. This can help you feel more in control of both your ADHD and PCOS.
Mara Santilli is a journalist reporting on health and wellness and how social and political systems influence the well-being of certain groups, including but not limited to Black and brown communities, women, and the LGBTQ+ community. Her editorial work has appeared in publications such as Shape, Marie Claire, Cosmopolitan, Women’s Health, InStyle, Glamour, and more. Outside of reading and writing, she enjoys traveling (especially to Italy), singing, dancing, musical theatre, and playing guitar and piano.