When Focus Slips: How Perimenopause Exposes Hidden ADHD Symptoms in Women

Introduction

If your focus has started slipping in your 40s or 50s, like forgetting why you walked into a room, losing track mid-sentence, or feeling like your brain tabs won’t stop multiplying, you’re far from alone. Many women describe this experience as something like this: “I used to be on top of everything… and now I can’t concentrate or keep up no matter how hard I try.”

Although many women are told that it’s “just aging” or “just stress”, they suspect there is something else going on. Perimenopause can unmask the ADHD-like symptoms that were previously manageable or simply unnoticed. A 2015 study in Neurobiology of Aging states clearly that estrogen influences the brain’s executive function systems. Attention, working memory, and emotional regulation. So, when these hormone levels start swirling as they do during the 7 to 10 year perimenopause transition, mental and emotional clarity can swirl too.

This article breaks down what’s really happening, why it feels so overwhelming, and what you can do (today, not someday) to start to feel more grounded again.

Why Focus Changes During Perimenopause

Estrogen and Dopamine: The Brain’s Focus Duo

Dopamine is the neurotransmitter that helps regulate motivation, task initiation, and focus. Think of it as your brain’s “get-started and keep-going” signal. Estrogen helps regulate dopamine pathways, and when estrogen dips, dopamine signaling can dip right along with it.

That’s one reason why previously mild attention issues suddenly feel like they’ve gone rogue.

Mini-aside: You’re not “lazy” or “forgetful.” Your brain chemistry is literally trying to recalibrate.

A 2009 paper in Nature Reviews Endocrinology described this hormonal shift as a stressor on the brain’s regulatory systems, affecting cognitive consistency and emotional control.

The Mental Load Meets Hormonal Turbulence

Women in midlife often juggle careers, aging parents, teens, partners, personal goals, and an inbox that multiplies like desert jackrabbits. This cognitive juggling act, often called the mental load, is exhausting all by itself.

Layer perimenopausal hormone fluctuations onto that? Suddenly, things that were doable feel unmanageable.

This is why some women say:
“I’ve felt busy before, but now I feel scattered.”
Or:
“It’s like my brain has 47 tabs open and half are frozen.”

ADHD… or Hormone-Driven Attention Changes?

Here’s where things get interesting:

Some women definitely have ADHD that went unnoticed for decades (since childhood). Others experience ADHD-like symptoms during perimenopause because of hormonal shifts impacting cognitive regulation.

Key things to think about:

Lifelong ADHD (previously masked or compensated for):

  • Chronic difficulty starting tasks

  • A history of being called “smart but scattered”

  • Emotional impulsivity or sensitivity (Rejection Sensitivity Dysphoria)

  • Periods of hyperfocus (the “in the zone for 3 hours” phenomenon)

  • Always felt “different’ or broken without explanation

A 2010 review in Neuroscience & Biobehavioral Reviews showed that chronic stress (allostatic load) combined with neuroendocrine changes amplifies cognitive “slip-ups”. Exactly what many women describe during midlife.

Signs Your Focus Issues Might Be Hormone-Related

Every woman experiences perimenopause differently, but some common patterns include:

  • Fatigue

  • Forgetting appointments you normally remember

  • Feeling easily irritated or overstimulated

  • Losing your train of thought mid-conversation

  • Trouble finishing tasks you start

  • Feeling mentally “foggy” at certain times of the month

  • Difficulty prioritizing or organizing

  • Feeling overwhelmed by small decisions

The key sign?
If symptoms fluctuate throughout your cycle or worsen during hormonal dips, there may be a hormonal component. Not all women will experience all these symptoms, and the impact of estrogen loss during menopause ranges widely.

Actionable Tip- Investigate and observe: keep a 3-month log tracking your cycles and symptoms. Record a number/score related to PMS; track your mood and irritability, attention, impulsivity, sleep quality, and energy.

Practical Strategies to Improve Focus During Perimenopause

These strategies aren’t meant to change who you are; they’re meant to give you tools so your brain stops feeling like it’s short-circuiting.

1. Reduce Cognitive Load (even a little)

A few small changes go a long way:

  • Use one calendar and one to-do list, not three.

  • Batch similar tasks (emails, calls, errands).

  • Keep predictable routines, especially for mornings and evenings (as much as possible).

Practice makes PROGRESS. It’s not about perfection.

2. Support Your Stress System

A review in the Annual Review of Psychology noted that chronic stress can impair executive function—aka the brain’s organizing center.

Try:

  • 5–10 minutes of slow breathing (e.g., box breathing or 4-7-8)

  • Short walks, especially outdoors

  • Light strength training or yoga for stress regulation (movement you enjoy or at least tolerate)

  • Saying “not today” more often

A 2018 study in Frontiers in Human Neuroscience, “How Breath-Control Can Change Your Life…” described that controlled breathing exercises help balance and regulate the nervous system. We all could use some emotional regulation strategies, but ADHD brains especially benefit from this kind of support to function well in daily life.

Be sure to read our new blog on stress coming soon: “Stress: Finding Your Sweet Spot”

3. Prioritize Sleep Like It’s a Job

Sleep is the real MVP. Poor sleep makes attention problems exponentially worse.

A few lived-in tips:

  • Stop scrolling in bed (I know, easier said than done). Set a “phones-down” time and honor that commitment to yourself.

  • Cool your room down. Fall and winter Scottsdale nights help.

  • Create a “wind-down window” that works for you. Even 20 minutes is a start.

For a deeper dive, read our post on "Sleep Support: Evidence-Based Supplements That Can Help You Rest Better."

4. Consider Nutrition for Focus Support

Stable blood sugar supports mental clarity. Try:

  • Eating protein earlier in the day

  • Pairing carbs with fat/fiber

  • Not skipping meals (especially breakfast!)

Magnesium may support relaxation and stress modulation, according to the NIH Office of Dietary Supplements, but always check with a clinician before starting new supplements.

Take our free Persona Nutrition health assessment for a customized supplement plan tailored to you. https://babyfacellc.personanutritionpro.com

If you need help with diet, fitness, or dietary supplements, ask about our in-house nutrition expert, Michael Colangelo, MS, CN.  Also, check out our “Evidence-Based Supplement Guide”

5. Talk to a Clinician If Symptoms Are Disruptive

This is not about self-diagnosis. It’s about clarity, reassurance, and support.

A clinician or mental health provider specializing in ADHD, endocrinology, or both can help you determine:

  • Whether symptoms reflect ADHD

  • Whether hormones are the main driver and starting transdermal hormones

  • Whether both are interacting

  • What treatment or behavioral strategies may help

No shame, no stigma, just support.

At BabyFace LLC in Scottsdale, we want to support you. From skincare to stress resilience, many clients appreciate having a place where their journey is taken seriously and their concerns are heard.

FAQs

Is this real, or am I just “losing it”?

It’s very real. Perimenopause affects hormones and neurotransmitters that regulate attention, emotion, energy, and mood.

Can midlife ADHD suddenly “appear”?

ADHD doesn’t appear suddenly, but perimenopause can make ADHD-like symptoms more noticeable.

How long do these focus changes last?

It varies. Some women improve after perimenopause; others need ongoing strategies.

Is medication or hormone therapy the only option?

These are consistently effective options; however,  lifestyle strategies, nutrition, therapy, and supportive routines can help significantly.

Should I see someone if I’m struggling?

Yes. Especially if symptoms significantly affect work, relationships, or daily life. A clinician can help clarify what’s going on and provide appropriate next steps.

Final Thoughts

If focus has started slipping during perimenopause, you’re not failing; you’re adapting. Your brain is recalibrating, your hormones are shifting, and your mental load is heavy. With the right tools, awareness, support, clarity and confidence are absolutely within reach.

And remember you're not supposed to do this alone. Don’t suffer in silence.

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Disclaimer: These statements have not been evaluated by the Food and Drug Administration. These supplements and treatments are not intended to diagnose, treat, cure, or prevent any disease. Always consult with your healthcare provider before starting a new supplement, especially when combining with medical spa treatments. Individual results may vary.

Babyface LLCADHD, Focus, Memory