Why Stimulants Aren’t the Solution—and What Functional Medicine Does Differently
By Dr. Christina Enzmann, Gynecologist | Menopause Specialist | Functional Medicine Practitioner
If you’re in your 40s or 50s and suddenly feeling more distracted, emotionally frazzled, forgetful, or overwhelmed—you’re not alone, and you’re certainly not broken. But before accepting a new diagnosis of ADHD and starting stimulant medication, it’s important to ask: Is this really ADHD—or are my hormones crying out for help?
A Surge in Midlife ADHD Diagnoses
In my clinical practice, I’m seeing more and more women in perimenopause or early postmenopause being diagnosed with ADHD and quickly prescribed medications like Ritalin or Adderall. While these drugs may offer temporary relief, they often obscure the deeper issue—your shifting hormonal landscape.
The Fast-Track Diagnosis That Misses the Root Cause
Conventional medicine is often quick to pathologize what may be normal, if uncomfortable, transitions in a woman’s body. A patient might say, “I think I have ADHD,” and leave that same visit with a prescription—without a true investigation into the why.
In truth, what looks like ADHD can often be traced back to hormonal fluctuations, particularly a drop in estrogen. Estrogen is essential for regulating neurotransmitters like dopamine and serotonin. When it drops, so does your brain’s ability to focus, regulate mood, and manage stress.
Common midlife symptoms that can mimic ADHD include:
- Difficulty concentrating
- Brain fog and forgetfulness
- Mood swings and irritability
- Insomnia and sleep issues
- Emotional overwhelm
Yet, stimulant prescriptions are often written without assessing hormone levels, adrenal function, nutrient status, or nervous system health.
The Hidden Risks of Stimulants During Perimenopause
Although stimulants can provide short-term mental clarity, they come with real risks—especially in the already delicate hormonal environment of midlife.
Cortisol Overload
Stimulants activate the HPA axis, causing a spike in cortisol levels. For many women already dealing with adrenal fatigue or chronic stress, this can worsen anxiety, sleep disturbances, and burnout.
Dopamine Depletion
Long-term use of stimulants can reduce dopamine receptor sensitivity. This means your brain may become less responsive to the very neurotransmitter responsible for joy and motivation—deepening emotional lows and identity challenges common in menopause.
Hormonal Disruption
By masking symptoms, medications can delay the discovery and treatment of underlying hormone imbalances—sometimes making them worse.
Bottom line? ADHD medications can be helpful in some cases, but for women in perimenopause or menopause, they should never be the first line of defense without a thorough root-cause evaluation.
The Functional Medicine Approach: Whole-Body Wisdom
In functional medicine, we don’t just chase symptoms—we decode them. Instead of labeling a distracted brain as disordered, we ask why it’s struggling and work to rebalance the entire system.
Key Areas We Evaluate:
- Estrogen and progesterone balance
- Cortisol and adrenal health
- Gut inflammation or microbiome imbalances
- Methylation issues (e.g., COMT, MTHFR)
- Nutrient deficiencies (especially B vitamins, magnesium, omega-3s)
- Mitochondrial dysfunction contributing to fatigue and brain fog
Targeted Nutritional and Supplement Support:
- L-Tyrosine for dopamine support
- 5-HTP or Tryptophan to boost serotonin
- Vitamin B1 (Thiamine) to support brain energy
- Magnesium glycinate for calming the nervous system
- Adaptogens like Rhodiola or Ashwagandha for adrenal support
- Omega-3s to reduce neuroinflammation and support cognition
- An anti-inflammatory, protein-rich diet to stabilize blood sugar and fuel the brain
Mind-Body Integration:
- Nervous system regulation techniques (e.g., breathwork, trauma-informed coaching)
- Sleep hygiene strategies
- Stress management tailored for neurodivergent women in midlife
The Empowered Alternative
You don’t need to be medicated into functioning.
You need support that honors your biology, your life stage, and your story.
Functional medicine offers a compassionate, evidence-informed path to help you reclaim clarity, energy, and joy—without masking the message your body is sending.
Curious If Your “ADHD” Symptoms Are Actually Hormonal?
Let’s get to the root of your midlife brain fog, overwhelm, and emotional fatigue. Book a discovery call and find out what’s really going on beneath the surface.
Book a Discovery Call
With clarity—not chaos,
Dr. Christina Enzmann
Gynecologist | Menopause Specialist | Functional Medicine Practitioner
