ADHD at Work for Women in Perimenopause: Memory Slips, Overwhelm, and What Helps

If you’re noticing new “brain fog,” forgotten details, or workplace overwhelm, you’re not imagining it. For many ADHD at work women, perimenopause can intensify executive-function strain in a way that shows up first at work. It usually means your load and physiology changed at the same time. [1-4]

In this article, you’ll learn:

• Why work is often where changes become obvious first

• How ADHD and perimenopause can overlap (and intensify) at work

• Common patterns that look like “personal failure” but aren’t

• No-shame supports, communication tweaks, and accommodation ideas

• When an evaluation may help and what to ask for in a workplace-relevant report

🧠 Key takeaway: When cognitive load goes up and internal bandwidth goes down, work often becomes the “first place” the cracks show, even if you’ve coped for years. [1-4]

Why work can become the first place you notice changes for ADHD at work women

Work depends on working memory, task switching, prioritizing, and sustained attention. When those skills get taxed, missed follow-ups and dropped details show up fast. [2,5]

Perimenopause-related cognitive complaints are common and usually mild, but they can feel big in high-demand settings when ADHD is in the mix. [1,2]

Meetings, multitasking, interruptions

Meetings are a perfect storm: information comes fast, decisions happen live, and you’re expected to track action items while looking calm. If you’re also juggling email pings or interruptions, working memory overload is predictable. [2,5]

Practical example: Use a single-rule meeting system:

• One capture place that is always open during meetings

• One “next action” line at the bottom before you leave the call

• One 2-minute block right after to send the follow-up or set reminders

This is not “doing more.” It’s reducing the amount your brain has to hold. [5]

Performance anxiety and masking

Many women with ADHD have learned to mask by overpreparing, overcommitting, or working late to compensate. Perimenopause can shrink the “extra margin” that made masking possible. [3,4]

Misconception to drop: “If I’m capable, I shouldn’t need supports.” Supports are not special treatment, they are tools that reduce friction and protect performance. [5]

🌿 Key takeaway: Masking can look like success from the outside, while quietly draining sleep, recovery, and long-term sustainability. [4,5]

ADHD and perimenopause: how overlap shows up at work

Perimenopause involves fluctuating reproductive hormones, and many people report changes in concentration and mental clarity during this transition. [1,2] ADHD symptoms can also vary across hormonal life phases, though research is still emerging and individual patterns differ. [3,4]

Working memory and task switching strain

Working memory is the brain’s “scratch pad.” When it’s strained, you may reread an email three times, lose your place mid-task, or forget why you opened a tab. [2,5]

Task switching adds a real cost. Every interruption requires reorientation: what was I doing, what’s next, what did I miss? [2]

Practical example: Try a “two-lane” day:

• Lane 1 (deep work): 1–2 protected blocks for complex tasks

• Lane 2 (admin): a set time for email, messages, and quick requests

• A visible “parking lot” list for interruptions you can’t handle right now

Fatigue and emotional load

Perimenopause can affect sleep and mood, and fatigue can make ADHD symptoms louder: lower frustration tolerance, more overwhelm, and more difficulty starting tasks. [2,4]

Misconception to drop: “Brain fog means I’m getting dementia.” Brain fog is commonly reported in the menopause transition, and dementia in midlife is rare. [1]

🔥 Key takeaway: Fatigue changes attention, emotion regulation, and how hard it feels to start and finish tasks, it’s not a willpower issue. [2,4]

Common patterns (and why they’re not moral failures)

When executive function dips, shame-based labels show up fast: lazy, careless, undisciplined. Those labels miss the mechanism. Adult ADHD commonly includes disorganization, procrastination, time-management difficulty, and forgetfulness, especially under stress. [5]

Late starts, deadline sprints, avoidance

A common pattern is “can’t start” until the deadline creates urgency. That’s often a mismatch between task demands and your brain’s activation system, not a lack of caring. [5]

Try swapping moral language for a systems question:

• What is the smallest first step that reduces uncertainty?

• What earlier “preview deadline” can I set before the real one?

• What makes starting easier (template, example, timer, coworker check-in)?

Overcommitting and crashing

Overcommitting often comes from optimism, people-pleasing, or trying to prove you’re fine. Then the crash hits: missed meals, late nights, emotional shutdown, and a spiral of catch-up. [4,5]

A more sustainable habit is a capacity check:

• “If I take this on, what comes off?”

• “What does done look like, in one sentence?”

• “What’s the minimum viable version?”

🧭 Key takeaway: Deadline sprints and overcommitting are usually adaptations to executive-function strain, not evidence of low character. [5]

What helps without “productivity shame”

Supportive systems don’t require hustle culture. They reduce cognitive load and make tasks easier to begin and complete.

Environmental supports and realistic systems

Small environmental shifts can help:

• Reduce visual noise (one open tab, one active document)

• Add sensory supports if helpful (headphones, white noise)

• Put cues where you need them (checklist on the monitor, not buried)

If you want structured support, executive function coaching can help you build realistic systems for your role. Learn more about our executive function coaching services.

For therapy options, see our specialized therapy page.

🌱 Key takeaway: The best system is the one you’ll actually use on a hard day, not the one that looks perfect on a great day.

Communication tweaks that reduce friction

Many workplace stress loops are “unclear inputs” problems. Small clarity moves can prevent rework and rumination.

Try micro-scripts:

• “What’s the top priority and deadline you need?”

• “Do you want a draft, or the final version?”

• “Can we capture action items in writing before we end?”

Clarity helps teams. It’s not you being difficult. [8]

Accommodations: what they can look like

Some adults with ADHD may qualify for reasonable accommodations at work under the ADA. The process is typically an interactive conversation about barriers and supports that allow essential job functions to be performed. [8]

Scheduling, focus supports, clarity in expectations

Common accommodation ideas can include:

• A quieter workspace or reduced distractions

• Uninterrupted focus time

• Written instructions, agendas, or meeting notes

• Adjusted scheduling when feasible for the role [9]

You don’t need a perfect plan to start. Start with the barrier and the support: “Frequent interruptions make it hard to complete essential tasks; one protected block daily helps me deliver.” [8,9]

How documentation may support requests

When the need for accommodation isn’t obvious, an employer can request medical documentation. Documentation is usually sufficient when it supports both the disability and the need for the specific accommodation being requested. [10]

A workplace-relevant ADHD assessment report can focus on function: how attention, working memory, organization, and task completion show up on the job, plus specific recommendations. [6]

If you want a starting point, our Adult ADHD screening page can help you organize what you’ve been noticing before you talk with a clinician.

🧾 Key takeaway: Strong documentation connects symptoms to job impact and specific supports, so the request is clear and actionable. [10]

When to consider an evaluation

You don’t need to be in crisis to benefit from clarity, but certain patterns are good signals.

Impairment, burnout, repeated performance hits

Consider an evaluation if you’re seeing:

• Repeated performance issues despite effort

• Burnout or escalating anxiety about work

• A noticeable shift in memory, focus, or follow-through

• Long-standing patterns that are now less manageable [2,5]

ADHD diagnosis is a clinical process, not a single test, and it typically requires evidence of symptoms and impairment across settings with onset in childhood (even if it was missed then). [5,7]

What to ask for in a workplace-relevant assessment

If your goal includes accommodations or workplace planning, ask whether the evaluation/report will include:

• A clear description of functional impact in daily life and work

• Differential considerations (sleep issues, anxiety, depression, menopause-related factors)

• Specific, practical recommendations (systems, coaching, therapy, accommodations)

• Documentation that is written in workplace-relevant language [6]

High-quality adult ADHD evaluations rely on a detailed interview, careful attention to impairment, and multiple sources of information when possible. [6]

If you’re in Tennessee, you can learn more about our psychological assessments and request a free consult to talk through next steps.

Conclusion

If work has become the place where you notice changes first, you’re not alone. Perimenopause can bring cognitive shifts, and ADHD can make task switching, working memory, and overwhelm harder to manage. [1-4]

The goal isn’t to “optimize yourself.” It’s to reduce friction, protect recovery, and get supports that match your job and your brain.

About the Author

Dr. Kiesa Kelly, PhD, is the founder of ScienceWorks Behavioral Healthcare in Nashville, Tennessee, where we provide specialized therapy, psychological assessments, and executive function coaching. [11]

She earned a PhD in Clinical Psychology with a concentration in Neuropsychology and has extensive experience in psychological assessment, including work focused on ADHD. She is also available via telehealth in Tennessee and many other states. [11]

References

1. The Menopause Society. Perimenopause [Internet]. Available from: https://menopause.org/patient-education/menopause-topics/perimenopause (cited 2026 Feb 3).

2. Metcalf CA, Duffy KA, Page CE, Novick AM. Cognitive Problems in Perimenopause: A Review of Recent Evidence. Curr Psychiatry Rep. 2023;25(10):501-511. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC10842974/ doi: https://doi.org/10.1007/s11920-023-01447-3.

3. Osianlis E, Thomas EHX, Jenkins LM, Gurvich C. ADHD and Sex Hormones in Females: A Systematic Review. J Atten Disord. 2025;29(9):706-723. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC12145478/ doi: https://doi.org/10.1177/10870547251332319.

4. Kooij SJJ, de Jong M, Agnew-Blais J, et al. Research advances and future directions in female ADHD: the lifelong interplay of hormonal fluctuations with mood, cognition, and disease. Front Glob Womens Health. 2025 Jul 7;6:1613628. Available from: https://www.frontiersin.org/journals/global-womens-health/articles/10.3389/fgwh.2025.1613628/full doi: https://doi.org/10.3389/fgwh.2025.1613628.

5. National Institute of Mental Health. ADHD in Adults: 4 Things to Know [Internet]. Available from: https://www.nimh.nih.gov/health/publications/adhd-what-you-need-to-know (cited 2026 Feb 3).

6. Adamou M, Arif M, Asherson P, et al. The adult ADHD assessment quality assurance standard. Front Psychiatry. 2024;15:1380410. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC11327143/ doi: https://doi.org/10.3389/fpsyt.2024.1380410.

7. Centers for Disease Control and Prevention. Symptoms of ADHD [Internet]. 2024 May 16. Available from: https://www.cdc.gov/adhd/signs-symptoms/index.html (cited 2026 Feb 3).

8. U.S. Equal Employment Opportunity Commission. Enforcement Guidance on Reasonable Accommodation and Undue Hardship under the ADA [Internet]. Available from: https://www.eeoc.gov/laws/guidance/enforcement-guidance-reasonable-accommodation-and-undue-hardship-under-ada (cited 2026 Feb 3).

9. Job Accommodation Network. Attention-Deficit/Hyperactivity Disorder (AD/HD) [Internet]. Available from: https://askjan.org/disabilities/Attention-Deficit-Hyperactivity-Disorder-AD-HD.cfm (cited 2026 Feb 3).

10. Job Accommodation Network. Requests For Medical Documentation and the ADA [Internet]. Available from: https://askjan.org/articles/Requests-For-Medical-Documentation-and-the-ADA.cfm (cited 2026 Feb 3).

11. ScienceWorks Behavioral Healthcare. Kiesa Kelly, PhD [Internet]. Available from: https://www.scienceworkshealth.com/kiesakelly (cited 2026 Feb 3).

Disclaimer

This article is for informational purposes only and is not a substitute for medical, psychological, or legal advice. If you have urgent concerns, seek help from a qualified professional.