HOLISTIC, AFFIRMING THERAPY · CALIFORNIA
ADHD & PMDD or Peri-Menopause/Menopause Related Emotional Support
For adults in California, navigating the emotional weight of hormonal shifts, alongside ADHD
Is it your experience that hormonal fluctuations or changes significantly impact your mood, memory, and capacity? Especially if you have or suspect that you may have ADHD?
Some studies estimate that 30%-45% of adults who identify with ADHD and were assigned female at birth meet criteria for PMDD.
Across both PMDD and Peri-Menopause/Menopause, estrogen and dopamine levels can decrease. Since estrogen is associated with the production of dopamine (which is connected to motivation), there is a relationship between hormone and neurotransmitter-related decreases that are linked to significant distress in functioning, cognitively, emotionally, and physically.
Sources
Bendis, E. M., et al. (2024). "The Role of Estrogen Receptors in Menopausal Mental Health and Neurological Function." Journal of Neuroendocrinology.
Slopien, R., et al. (2018). "Menopausal transition and mood disorders: Interactions with neurotransmitter systems." Maturitas.
Gupta, S., et al. (2023). "The Role and Mechanism of Estrogen in Perimenopausal Depression." Frontiers in Endocrinology.
Sources
CYCLICAL, INTENSE, OFTEN MISUNDERSTOOD
PMDD (Premenstrual Dysphoric Disorder)
Folks who meet criteria for PMDD often report intense and impairing fatigue, low mood, intensified emotional sensitivity, difficulty regulating emotions, and brain fog. PMDD can be disorienting, exhausting, and deeply isolating, especially when your emotional world shifts in ways that feel intense, cyclical, and hard to explain.
Many people carry shame or self-doubt around these experiences, particularly if they have been dismissed or misunderstood.
Broughton, T., Lambert, E., Wertz, J., & Agnew-Blais, J. (2025). "Increased risk of provisional premenstrual dysphoric disorder (PMDD) among females with attention-deficit hyperactivity disorder (ADHD): cross-sectional survey study." The British Journal of Psychiatry, PMC7617793, PMID: 40528384.
Dorani, F., et al. (2021). "Prevalence of hormone-related mood disorder symptoms in women with ADHD." Journal of Psychiatric Research, PMID: 33302160.
Sources
A NEWER PIECE OF THE PICTURE
Peri-Menopause and ADHD
New studies as recent as 2025 have revealed that adults assigned female at birth (AFAB) who have ADHD can experience peri-menopausal symptoms up to 10 years earlier than their neurotypical peers. This is such new insight, that many neurodivergent women and AFAB folks have difficulty naming what could be contributing to what can be experienced as abrupt and disruptive changes in working memory, focus, distress tolerance, among other symptoms.
According to the National Institute of Mental Health, women and AFAB folks with ADHD score significantly higher on the Menopause Rating Scale (MRS), with cognitive, emotional, and physical distress experienced often at greater severity. In other words, you're not making this intensity up.
Nevriana, A., Larsson, H., Kooij, S. J. J. S., & Zoega, H. (2025). "Perimenopausal symptoms in women with and without ADHD: A population-based cohort study." European Psychiatry, 68(1), e75.
I consider it a vital part of my work to discuss self-advocacy with medical professionals and empower clients with empirically validated data when discussing things like HT (Hormone Therapy) with providers.
Amethyst Holistic Counseling offers therapy for adults in California seeking support around the emotional impact of PMDD, including mood changes, overwhelm, relationship stress, grief, and the strain of trying to function through repeated cycles of distress. Therapy can offer a steadier place to notice patterns, process what is happening, and respond with more care and understanding.
The focus is not on reducing your experience to one diagnosis or pretending that insight alone makes difficult symptoms disappear. Instead, the work can support emotional processing, self-understanding, boundary-setting, and a gentler relationship with the parts of life that feel hardest to carry.
HOW I CAN HELP
Support May Include
Processing cyclical emotional distress and shame.
Understanding relationship strain connected to PMDD symptoms.
Building self-compassion around capacity changes.
Exploring patterns, needs, and supportive coping strategies
PLEASE NOTE
A Grounded Scope of Support
This page is written as emotional support, not as a substitute for medical care. Therapy can be part of a broader support system while still offering meaningful help with the emotional and relational impact of PMDD and peri/menopausal-related symptoms.
FAQ
Frequently Asked Questions
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Yes. I enjoy helping clients identify patterns of increased distress that may be connected to hormonal fluctuations and changes. I aim to empower folks with information and language that helps them feel more confident when advocating with other healthcare professionals, e.g., gynecologists and primary care providers, for further evaluation.
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Therapy can be positively supportive for cyclical symptoms, especially when combined with awareness of cycles. Cycle tracking in a way that feels safe and protected can be massively beneficial for protecting against the experience of feeling blindsided by changes in mood, cognitive functioning, and capacity. Together, we can build a list of supportive tools and strategies to help you navigate hormonal shifts.
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Therapy is often beneficial in addition to medical care. We have different jobs, but we should work together. Since the medical system can often be experienced as lacking in relational compassion, therapy can serve as a supportive place to process your concerns and distress. I am also eager and happy to discuss your care with your other providers with your written consent. It is an honor to collaborate in client care, and to act as a well-informed advocate for you and your holistic health. I am passionate about being on your team.
ENDORSEMENTS
Endorsements
"Lea is so warm and caring, she's incredibly easy to talk to. Her relational approach and unique lived experience as a queer, neurodivergent therapist makes her especially qualified to help folks who want to be seen, heard, and understood."
Corina Bair, LCSW
"Having known Lea for over 10 years, I can firmly and confidently speak to her incredible depth of compassion, empathy and kindness. She truly embodies what it means to be a healer."
Micaela Krusemark, MS, LPC, YTT-500
Amethyst Holistic Counseling of California