http://www.bella-online.com/health_and_fitness/diseases_and_illnesses/attention_deficit_disorder/articles/art996193501791.htm

The Estrogen Connection: ADHD in Women

A search on PubMed turned up 11 articles about ADHD in women. A search on
the relationship between estrogen and dopamine, the main neurotransmitter
implicated in ADHD, revealed 1422 articles. Funny, but it seems to me that
we've done a heck of a lot of research on a specific area on Attention
Deficit Hyperactivy Disorder in women without realizing it.

From the time girls with ADHD hit puberty, they can be at the mercy of
estrogen fluctuations. Many women with ADHD report severe Prementrual
Syndrome symptoms. Many of them find that their ADD symptoms worsen during
that time. Although the cause for PMS is unknown, it has been established
that it's triggered by a drop in estrogen levels.

Declining estrogen levels also have an impact during perimenopause. Women
frequently experience cognitive symptoms during this period such as
difficulties with focus and memory. One site even referred to it as "brain
fog", a phrase many ADDers are familiar with. For women with ADHD, this
results in an increased severity in their ADD symptoms.

So why does fluctuating estrogen levels have such a large impact in ADHD
women? One of the reasons could be it's effect on neurotranmitters.
Estrogen affects the release and reuptake of both dopamine and
norepinephrine, both of which are associated with ADHD. It also increases
the concentration of these brain chemical at neuronal synapses.
Fluctuations in estrogen may result in fluctuations in brain systems which
we already experience difficulties with.

Estrogen also has a positive effect on the blood supply in the brain.
Although there are no corresponding studies in females, brain scans in boys
have suggested a decreased blood flow to the prefrontal cortex and
striatum. Although there is no definate evidence that the same is true in
females, recent brain scans in girls with ADHD have confirmed the same
structural differences as have been previously found in boys. If it is the
same, then what might typically be slight negative effects on the blood
supply in the brain during the prementrual period when estrogen levels
decline, may have a larger impact on areas which already experience a
reduced flow.

In spite of the large volume of research done on estrogen and the brain,
including areas that are affected in ADHD, we actually know very little
about how it affects ADHD in women. Estrogen researchers have only begun to
mention it in the past year. Their current speculation is that it may
provide a protective barrier against women developing ADHD as it does with
other conditions such as Parkinsons, thus accounting for ADHD occurring at
higher rates in males than it does in females. They obviously haven't been
talking to the ADHD experts who currently believe that females are
underdiagnosed and with better systems of identification we'll most likely
find that there is a 1:1 ratio.

A more promising theory is that sex hormones account for the fact that
males are more likely to have hyperactivity/impulsivity symptoms while
females are apt to have inattentive ones. Although a study on gender
difference in dopamine receptors seems to support that theory, it's
suspected that the changes that account for it may occur in early brain
development, which was beyond the scope of the study.

by Krista Jensen-Short ADD at BellaOnline
 

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