PMS, PMDD, Perimenopause & ADHD: Why Symptoms Overlap in Women with Dr. Alexandra Sisam, ND
49 min
PMS, PMDD, perimenopause and ADHD can produce overlapping symptoms, but similar symptoms do not always mean the same thing is happening. In this episode of Off the Charts, Dr. Bobby Parmar sits down with Dr. Alexandra Sisam, ND, to unpack the intersection of hormones, mood, ADHD, stress and the nervous system. They discuss PMS vs PMDD vs premenstrual exacerbation (PME), why perimenopause can complicate the picture, and why ADHD-like symptoms, hormonal changes and stress can sometimes be difficult to separate. They also explore progesterone and estrogen, ADHD assessment, stimulant medications, trauma, iron, blood sugar and other factors that may influence symptoms. The central idea: there may not be one thing going on. WHAT YOU’LL LEARN PMS vs PMDD vs premenstrual exacerbation (PME) Why PMDD, perimenopause and ADHD symptoms can overlap How hormonal changes may affect mood, focus and cognition Why ADHD can be difficult to assess during midlife How stress and trauma may complicate the clinical picture Why similar symptoms may require very different approaches TIMESTAMPS 00:00 — Hot open: “There isn’t one thing going on” 00:58 — Introducing Dr. Alexandra Sisam 01:12 — ADHD, perimenopause and PMDD 05:20 — Perimenopause, anger and mood changes 10:43 — What is PMDD? 11:06 — PMS vs PMDD vs PME 12:31 — Progesterone and PMDD 16:27 — Is perimenopause prolonged PMS? 18:48 — Trauma, stress and biological resilience 23:49 — ADHD and hormonal transitions 25:12 — Psychiatric or gynecologic? 30:05 — Why does ADHD seem to be everywhere? 32:03 — ADHD assessment and diagnostic uncertainty 37:45 — Stimulants and ADHD 41:03 — Iron, nutrition and blood sugar 43:04 — Estrogen, ADHD and perimenopause 46:14 — Neuroinflammation 47:46 — Why this needs a Part Two 48:44 — Closing REFERENCES & RESOURCES ACOG — Management of Premenstrual Disorders https://www.acog.org/clinical/clinical-guidance/clinical-practice-guideline/articles/2023/12/management-of-premenstrual...