You may find that your symptoms are more pronounced during the first trimester or after childbirth, thanks to hormonal shifts.

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Attention deficit hyperactivity disorder (ADHD) symptoms can be sensitive to hormonal changes, including the ones that occur during and after pregnancy.

Though researchers aren’t sure why, spikes in estrogen tend to diminish ADHD symptoms, while drops in estrogen tend to increase them.

A steady rise in estrogen during the second and third trimesters tends to lessen many symptoms. But as estrogen levels drop after pregnancy, ADHD symptoms may surge again. Increased progesterone levels during the first trimester may also cause symptoms to be more pronounced.

Your physician may also advise you to stop taking certain ADHD medications while pregnant, which would also exacerbate symptoms.

Here’s what to know about living with ADHD during pregnancy and beyond.

So far, there’s no evidence that pregnancy can trigger the onset of ADHD.

However, some people who already have ADHD may be more likely to receive an official diagnosis during this time.

Since symptoms like inattentiveness, anxiety, or forgetfulness may be heightened during the first trimester or after pregnancy, people may be more likely to bring them up to a healthcare professional, resulting in a diagnosis.

If you haven’t received a diagnosis of ADHD but feel like you might be experiencing symptoms, there are a few things to keep an eye on.

Research suggests that attention-distraction symptoms may be more prominent during pregnancy. This might look like increased forgetfulness, trouble concentrating, or challenges with finishing tasks.

When estrogen levels drop again after birth, dopamine levels do, too, which can lead to increased depressive symptoms, such as low mood or poor self-esteem.

Keep in mind that pregnancy and childbirth can be stressful, even without any added complications. It’s not unusual for these periods to be accompanied by some changes to your mental functioning.

Regardless of whether your symptoms are related to ADHD, consider bringing them up with your care team. They can work with you to make a diagnosis or simply help you build new coping strategies.

Although ADHD typically onsets during childhood, more people are getting diagnoses in adulthood. This is particularly true for women, who are less likely to receive a diagnosis as children due to gender bias and other factors.

If you think you may be experiencing symptoms of ADHD, talk with your primary care physician. They can do an initial evaluation based on your symptoms and medical history. Depending on their assessment, they may refer you to a mental health professional for follow-up.

A mental health professional will likely evaluate your symptoms using various behavior rating scales, such as the Brown Attention-Deficit Disorder Symptom Assessment Scale (BADDS) for Adults or Adult ADHD Self-Report Scale (ASRS v1.1)

Read more about the process of getting an ADHD diagnosis as an adult.

ADHD is typically treated with medication, such as amphetamine sulfate (Adderall) or methylphenidate (Ritalin). Medication is often used alongside behavioral therapy.

However, taking these medications during early pregnancy is linked to an increased risk of certain birth defects, including:

  • gastroschisis (a rare birth defect that causes organs to protrude from the body)
  • omphalocele
  • transverse limb deficiency

The risk of birth defects from ADHD medications is still very low. Experts are also still trying to fully understand the risks of taking ADHD medication while pregnant or breastfeeding.

A 2021 review notes that doctors should not necessarily advise pregnant or breastfeeding patients with moderate to severe ADHD to stop their medication.

If you do receive an ADHD diagnosis, your care team can evaluate various treatment approaches to find a safe, effective plan.

Remember that your health — not only the health of your child — is important. If you currently take medication for ADHD, don’t stop taking it without talking with a healthcare professional first. They can help you weigh the risks of stopping or continuing medication treatment.

As hormone levels shift during and after pregnancy, you might experience a shift in ADHD symptoms too.

In the first trimester, you may notice more pronounced symptoms, or symptoms for the first time. During the second and third trimesters, you may find that symptoms decrease, only to spike again after birth.

As with many maternal mental health concerns, experts still have a lot to learn about the effects of pregnancy on ADHD. But don’t hesitate to bring up any new or worsening symptoms with your care team. Together, you can develop a plan to manage your symptoms safely.