PMDD and ADHD: Understanding the Connection and Managing Symptoms

Over 40% of women with attention-deficit/hyperactivity disorder (ADHD) also experience Premenstrual Dysphoric Disorder (PMDD). This highlights how closely these two conditions are connected and how often they overlap.^[1]

Despite this connection, many women struggle to receive a proper diagnosis or a treatment plan that covers both disorders.

If you have ADHD but feel like something else is impacting your mood, energy, or overall well-being, trust yourself—you know your body best. Don’t hesitate to reach out for an assessment of your symptoms. 

Knowing how PMDD affects women with ADHD can help you spot symptoms early, speak up for yourself, and get the right treatment.

What Is PMDD?

PMDD is a condition characterized by severe mood, behavioral, and physical symptoms. These symptoms typically begin 7-10 days before menstruation and resolve shortly after the period begins. 

Key symptoms of PMDD include:^[2]

• Strong feelings of depression and hopelessness
• Significant anxiety or tension, often accompanied by a sense of constantly being on edge
• Frequent mood swings
• Running out of energy quickly
• Persistent anger or irritability, often causing conflicts with other people

PMDD can sometimes be severe enough to disrupt your daily life—work, socializing, and relationships.

PMDD and ADHD Symptoms

PMDD and ADHD generally lead to different symptoms, though there are important areas where they overlap. The combined effect on both conditions may intensify the daily changes you face.

Here’s how PMDD and ADHD together can affect your mental, emotional, and physical health:

Emotional & Mood Symptoms

ADHD is often linked to emotional dysregulation—difficulty in regulating or controlling emotions. So, if you have ADHD, you may notice that you get irritated, excited, or angry quickly.^[3]

Similarly, PMDD can also bring about mood changes. Some of its symptoms include depression, anxiety, mood swings, and increased anger or irritability.^[2]

When combined, PMDD and ADHD overlap, emotional regulation becomes even more challenging.

Both brain and hormone changes have a real and powerful impact on the body. The effect of these changes makes it essential to acknowledge their seriousness and seek support.

Physical Symptoms

Apart from mood-related challenges, PMDD can also lead to physical symptoms. These include:^[2]

• Exhaustion/low energy levels
• Appetite changes
• Insomnia or sleep issues
• Breast tenderness or swelling
• Headaches
• Muscle or joint pain
• Bloating or weight gain 

Symptoms such as exhaustion and insomnia can lead to poorer focus and motivation. They can also increase feelings of depression, anxiety, or self-consciousness. 

Cognitive & Behavioral Symptoms

ADHD is often associated with poor focus, but PMDD can contribute to difficulty concentrating and mental fatigue as well.^[2]

Symptoms like low energy, poor sleep, and other physical discomforts make it even harder to stay engaged and motivated.

Thus, the added effects of ADHD and PMDD may impact the ADHDer’s productivity and performance at work or school. 

Additionally, forgetfulness and brain fog in ADHD can become even more pronounced due to PMDD. This can further affect a woman’s daily tasks and responsibilities.

The Impact of PMDD on ADHD Symptoms

PMDD can worsen many ADHD-related challenges. For example, it often brings about mood swings, irritability, and anger, making it harder for ADHDers to manage their emotions.^[2]

PMDD is also linked to sleep disturbances, fatigue, and low energy. ADHDers often struggle to get things done, and these symptoms may lower their motivation further.^[2]

Concentration issues can also worsen due to PMDD. This compounds the typical focus-related challenges ADHDers face. As a result, ADHDers with both conditions might struggle even more when trying to stay focused.^[2]

This can cause trouble organizing, planning, meeting deadlines, and following through on instructions.

That’s why it’s crucial to address both conditions. Proper treatment and support can go a long way toward preserving your mental, emotional, and physical well-being.

How Common Is PMDD in People with ADHD?

Researchers have found that PMDD tends to occur more often in people with ADHD than those without. 

One study estimates that over 45% of women with ADHD also report symptoms of PMDD. In contrast, only 28.7% of women who don’t have ADHD experience these symptoms.^[1]

Despite this greater prevalence, it’s common for PMDD to go undiagnosed and untreated in women with ADHD.

One reason is that PMDD was only recently recognized as a medical condition, so some doctors may not know how to identify it.^[4] Another is that when ADHD is also present, diagnosing PMDD can be even harder.

The best way to advocate for yourself is by learning to recognize both symptoms of ADHD and PMDD. This awareness allows you to seek further assessment if you suspect PMDD might be contributing to your symptoms.

Why Do PMDD and ADHD Co-Occur?

Researchers aren’t exactly sure why PMDD and ADHD tend to happen together. 

However, several factors likely contribute to this overlap.

The Role of Hormones & Neurotransmitters

Some research suggests that both PMDD and ADHD are linked to changes in the brain and hormones. 

For instance, ADHD is associated with lower dopamine levels in the brain.^[5]

Dopamine is a chemical messenger responsible for satisfaction and motivation. Because it also plays a role in controlling mood, it’s sometimes called the “feel-good hormone.”

The lower dopamine levels in ADHD might make women more vulnerable to hormonal fluctuations. So, when hormonal changes occur, they might have a more significant effect on mood. This could explain why they’re more likely to experience PMDD symptoms.^[5]

On the flip side, changing hormone levels are also thought to affect ADHD symptoms. Estrogen and progesterone levels change throughout the menstrual cycle. These fluctuating levels can affect specific pathways in the brain.^[5]

Because of this, you may notice that your ADHD symptoms feel worse in the days leading up to your period.^[5]

Differences Between PMDD and PMS

If you notice symptoms appearing cyclically, you could have either premenstrual syndrome (PMS) or PMDD. 

PMS shares some similarities with PMDD. It encompasses the physical, behavioral, and mood-related symptoms that usually occur in the days or weeks before your period.^[6]

Some of its symptoms include:^[6]

• Mood fluctuations
• Increased anxiety, irritability, or anger
• Increased fatigue
• Abdominal discomfort
• Back pain
• Feelings of nausea
• Sensitivity and swelling in the breast
• Constipation

While PMS can include mood changes and physical discomfort, PMDD is more severe, with symptoms that significantly affect daily life.

The mood swings in PMDD tend to be more intense. Plus, PMDD always includes at least one significant emotional symptom, such as depression, hopelessness, anxiety, or heightened anger.^[6]

Because of this, PMDD can have a more significant impact on daily life, affecting work, relationships, and overall mental well-being. 

The table below highlights the key differences between PMS and PMDD.^[6]

Category	PMS	PMDD
Severity	Research shows that women with PMS are more likely to miss work, have more significant healthcare expenses, and experience a lower health-related quality of life.	PMDD is the more severe form of PMS. It can disrupt daily functioning and strain social relationships.
Symptoms	Symptoms can be physical, such as nausea or abdominal discomfort. PMS may also involve emotional symptoms, such as mood swings, irritability, or anxiety.	PMDD is characterized by at least one significant emotional symptom. This may include depression, anxiety, or marked anger. Women with PMDD also have a risk of suicide that’s seven times higher than women who don’t have the condition.
Prevalence	Around 30-40% of women have PMS.	Around 3-8% of women have PMDD, making it less common than PMS.

Understanding these differences can help you distinguish between PMS and PMDD and determine which is the likelier cause of your symptoms. 

PMDD Causes and Risk Factors

Scientists don’t know the exact cause of PMDD yet, but it’s likely linked to hormone changes during the menstrual cycle. These changes can affect dopamine and serotonin—chemical messengers that help regulate mood. Any disruption in this balance can contribute to PMDD symptoms.^[2]

Research has also pinpointed factors that can put you at a higher risk of PMDD. These include: 

• Genetic factors: Studies suggest that genetics can contribute to the development of PMDD. If you have a close family member with PMDD, you may be more likely to experience it as well. However, scientists have yet to identify the exact gene responsible for PMDD.^[7]
• Lifestyle factors: Stress, poor sleep, and unhealthy eating could increase your likelihood of having premenstrual symptoms.^[8] Consumption of alcohol and smoking may also contribute to this risk.^[9]
• Background: Having a pre-existing anxiety disorder or experiencing traumatic events in the past can increase the possibility of developing PMDD.^[6]

Treatment Options for PMDD and ADHD

Proper management of PMDD and ADHD often requires a comprehensive approach. This usually includes a combination of medication, lifestyle adjustments, and therapy. 

Medications & Treatment

Your doctor can recommend medications to treat both conditions. 

• For PMDD: Treatments like birth control pills or serotonin reuptake inhibitors (SSRIs) can help regulate hormonal changes and improve mood. ^[2]
• For ADHD: Stimulant medications are commonly used and may be adjusted around your menstrual cycle to address hormone-related fluctuations.^[1]

It’s important to talk to your doctor about your options. Some medications may work well for certain people but not as well for others. 

Therapy

Research shows that Cognitive Behavioral Therapy (CBT) can benefit women managing both ADHD and PMDD. 

CBT helps you recognize and change negative thought patterns, replacing them with healthier mindsets and strategies. This can improve emotional regulation and help you feel better equipped to manage the challenges of both conditions.^[10]

Tracking and Planning

Period-tracking apps or symptom diaries can help identify patterns and prepare for challenging days. Some people find it helpful to:

• Schedule important tasks during less symptomatic times of the month
• Plan for extra support during difficult days
• Adjust medication timing with their doctor’s guidance
• Keep emergency supplies (like pain relievers or comfort items) readily available

Lifestyle Adjustments

Here are some lifestyle adjustments you can make to minimize your symptoms and improve your overall well-being: 

• Get regular exercise. Exercise helps stabilize hormones, increase endorphins (the “feel-good” chemicals), and reduce stress. It can also improve mood and self-esteem.^[6]
• Improve your sleep hygiene. A consistent sleep schedule, reducing screen time before bed, and creating a calming nighttime routine can promote better rest.
• Practice mindfulness. Mindfulness practices, such as meditation, journaling, or yoga, can also help support emotional regulation and improve focus.
• Create a stress management routine. Identify stress-relieving activities that work for you, such as deep breathing, physical movement, or creative hobbies like drawing or writing. 
• Eat balanced, regular meals. A nutrient-dense diet can support serotonin production and improve mood. Foods rich in calcium and vitamin B6 may also help relieve PMDD symptoms. If you’re considering supplements, consult a healthcare professional first.^[2]

What’s most important is having a personalized management plan. You can work together with your healthcare team to devise a plan that works best for you. 

ADHD and PMDD Are Treatable—You Don’t Have to Struggle Alone 

You may already have a diagnosis of either ADHD or PMDD. But that doesn’t mean you should stop seeking further assessment or support—especially if your symptoms continue interfering with daily life.

If you suspect PMDD might be contributing to your challenges, start tracking your symptoms for at least two months. A diary or mood chart can provide valuable insights for your doctor to help you achieve an accurate diagnosis.

The good news is that both ADHD and PMDD are treatable. You don’t have to just “live with it.” With the right support and treatment, you can better manage your symptoms and improve your quality of life.

To learn more about ADHD and other conditions that often co-occur with it, check out ADDA+. This resource center offers tips, tools, and courses to help adults with ADHD manage their symptoms and thrive.

References

[1] Prevalence of hormone-related mood disorder symptoms in women with ADHD. (2021). Journal of Psychiatric Research, 133, 10–15. https://doi.org/10.1016/j.jpsychires.2020.12.005

[2] Mishra S, Elliott H, Marwaha R. Premenstrual Dysphoric Disorder. [Updated 2023 Feb 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK532307/

[3] Soler-Gutiérrez, A. M., Pérez-González, J. C., & Mayas, J. (2023). Evidence of emotion dysregulation as a core symptom of adult ADHD: A systematic review. PloS one, 18(1), e0280131. https://doi.org/10.1371/journal.pone.0280131

[4] Schroll, J. B., & Lauritsen, M. P. (2022). Premenstrual dysphoric disorder: A controversial new diagnosis. Acta Obstetricia et Gynecologica Scandinavica, 101(5), 482–483. https://doi.org/10.1111/aogs.14360

[5] Lin, P.-C., Long, C.-Y., Ko, C.-H., & Yen, J.-Y. (2024). Comorbid Attention Deficit Hyperactivity Disorder in Women with Premenstrual Dysphoric Disorder. Journal of Women S Health, 33(9), 1267–1275. https://doi.org/10.1089/jwh.2023.0907

[6] Liguori, F., Saraiello, E., & Calella, P. (2023). Premenstrual Syndrome and Premenstrual Dysphoric Disorder’s Impact on Quality of Life, and the Role of Physical Activity. Medicina (Kaunas, Lithuania), 59(11), 2044. https://doi.org/10.3390/medicina59112044

[7] Hantsoo, L., & Payne, J. L. (2023). Towards understanding the biology of premenstrual dysphoric disorder: From genes to GABA. Neuroscience & Biobehavioral Reviews, 149, 105168. https://doi.org/10.1016/j.neubiorev.2023.105168

[8] Sei, J., Minai, J., Hara, H., & Matsuura, M. (2020). 138. Lifestyle Factors Associated with Premenstrual Distress Symptoms in High-School Girls with Premenstrual Syndrome. Journal of Adolescent Health, 66(2), S70–S71. https://doi.org/10.1016/j.jadohealth.2019.11.141

[9] Christian, D., & Shah, R. (2020). Association of socio-demographic, dietary and lifestyle factors with Premenstrual Syndrome (PMS) among undergraduate medical students of a tertiary care institute in Ahmedabad, Gujarat. Journal of Family Medicine and Primary Care, 9(11), 5719. https://doi.org/10.4103/jfmpc.jfmpc_1553_20

[10] Abdolmajid Bahrainian, S., & Derakhshanpour, Z. (2020). Original Research The Effectiveness Of Psychotherapy with Cognitive-Behavioral Approach On Emotion Cognitive Regulation Strategies Of Patients with Premenstrual Dysphoric Disorder. Int J Med Invest, 9(2), 75–89. http://intjmi.com/article-1-528-fa.pdf