Brain Fog, Rage, Overwhelm: The ADHD and Menopause Overlap with Dr. Sasha Hamdani

In this episode of unPAUSED, Dr. Mary Claire Haver sits down with Dr. Sasha Hamdani, a board certified psychiatrist, ADHD clinical expert, and author of the forthcoming book Too Sensitive, for the first half of a two part conversation on why so many women are discovering ADHD for the first time during perimenopause and menopause.

Dr. Hamdani reframes ADHD as a regulation issue rather than a simple attention deficit, and explains why perimenopause does not create the condition but instead unmasks it, as the estrogen scaffolding that lets women mask and compensate for a lifetime starts to fall away. She and Dr. Haver walk through how ADHD tends to present differently in women, often as the inattentive, easily overlooked type rather than the hyperactive presentation the diagnostic criteria were built around, and why that gap has left generations of high achieving women undiagnosed.

The conversation moves into the biology behind the brain fog so many women describe in perimenopause, tracing the connection between declining estrogen and dopamine and what that does to memory, focus, and executive function. Dr. Hamdani and Dr. Haver also discuss where hormone therapy fits, including estradiol, progesterone, and testosterone, and how each one can help or complicate cognitive symptoms depending on the person. They also cover how a proper ADHD assessment works during perimenopause and how stimulant and nonstimulant medication options differ.

Guest links:

Sasha Hamdani, MD

Sasha Hamdani, MD (Facebook)

Sasha Hamdani, MD (YouTube)

Sasha Hamdani, MD (Instagram)

Sasha Hamdani, MD (TikTok)

Sasha Hamdani (LinkedIn)

Books

“The New Perimenopause,” by Dr. Mary Claire Haver

“The New Menopause"⁠ by Dr. Mary Claire Haver

“Too Sensitive: Rejection, Resilience, and the Science of Feeling Deeply,” by Dr. Sasha Hamdani

“Self Care For People With ADHD,” by Dr. Sasha Hamdani

For full show notes, please click here.