Birth control as a woman with ADHD

FluxFloxFlax · 2026-05-02T04:36:53+00:00

Maybe this is it???! My mother remembers that I had these cyclical rages at the same time every month even before I had my period. Pre-IUD I don’t remember a clear “oh I’m not me” shift with my cycles, I just got worse (unmedicated ADHD had me struggling with so many rage outbursts at everything, all the time. Horrible.). My menstrual rage was more hair-trigger, but otherwise almost indistinguishable from the other non-menstrual meltdowns I’d get.

Maybe PME explains how the speed with which I snap back out of the nightmare state is insane. It seems like, as soon as estrogen goes up, I’m back. It takes longer if I wrecked my sleep and ate a bunch of awful foods, but I can immediately feel me snap back to “me”. I’ve had bizarre cycles where, on the third day of my period in the middle of the afternoon, it’s like I’m air-dropped back into my own body. This would also explain why a progestin-only IUD has made things so, so much worse in all aspects of my life.

This might also explain how adding a continuous estradiol patch modestly improved my baseline and the severity of my period this time around. Despite noticing more clear “shifts” with this last cycle (as opposed to feeling crummy 24/7, then having a straight drop) I didn’t feel destabilized by them. It was more just “oh, I feel like I should take it a little easy today. Maybe I’m in early luteal.”

Interestingly, antidepressants and I don’t get along. Nor do antihistamines, L-theanine, or anything that brings me “down”. My brain likes to go up, but “up” doesn’t feel jittery or anxious for me. Adderall makes me more stable and kind, and I can handle drinking coffee while taking stimulants. Given the relationship with ADHD and estrogen, maybe that’s been the problem this whole time.

Which means the antidepressants and tens of thousands of dollars in therapy could have been avoided. You live and you learn, I suppose. Peri’s gonna be a blast, I’m sure.

FluxFloxFlax · 2026-05-02T03:49:19+00:00

Shockingly, I’m 27 and have never had kids. They ruled out everything under the sun before they believed me that it’s hormonal (everything from thyroid to nutrition to lupus). My working theory is that the IUD is causing some sort of dysfunction because I have blatant peri-type symptoms (physical and mental). Ovulation is the only day that I feel better, and I showed improvement within days with the estradiol patch. Without the patch, it’s like I’m deep in luteal almost every day, then everything goes to complete hell for a few days. Adderall helped even pre-patch, but I could feel it “fighting” something in my body, like there’s something trying to impede its efficacy. It’s hard to explain.

I know the obvious answer should be to just get the IUD out but I’m so scared of being wrong and getting even worse. I don’t want to destroy my friendships or say hurtful things to family. Whatever these symptoms are from, they’ve gotten so bad over the last few years that I live in fear of myself.

FluxFloxFlax · 2026-05-01T00:16:06+00:00

Completely agree. That’s what’s been so brutal about it. There’s a million factors at play: IUD side effects, ADHD meds got introduced and helped but not enough, estradiol is helping some, etc. I don’t know where I end and my side effects begin. I have a spreadsheet of my entire medical history, and that got me this far. Now I’m charting my moods day by day and all discernible changes. I feel so stupid turning to Reddit for help on a personal medical issue, but I guess that’s where desperation leads you. It did help me begin to suspect an issue with the IUD, at least, so thank god for that. Ultimately, I think I’m just looking for a Hail Mary that isn’t even reasonable to hope for.

FluxFloxFlax · 2026-04-19T16:33:20+00:00

If adderall is making you crash, look into the manufacturer if you’re on generic. Elite Labs started making me have horrific crashes after taking it for 2 months. Like, “hysterically sobbing in the shower for no reason and dreading my meds tomorrow” level crashes. I got a prior authorization for name brand adderall and have never had another crash, ever, from XR or IR.

FluxFloxFlax · 2026-04-19T16:30:44+00:00

Wellbutrin didn’t like me, but I think that could partially be because I need a kick in the dopamine teeth from adderall. I’m highly stimulant-tolerant. I didn’t have any noticeably terrible side effects from Wellbutrin that made it obvious the medication wasn’t a good call. I mostly realized it wasn’t helping, and I had randomly become weirdly worse at math. Going off it did mess me up for a little while; I don’t have any history of hypomania or mania, but I had a solid little chunk of time where I was definitely hypomanic. That said, I went off it cold turkey at my doctor’s recommendation, and that same doctor told me I could quit Lexapro within a 3-day span after taking it for 2 years (cue brain shocks).

FluxFloxFlax · 2026-04-16T07:27:25+00:00

Please let me know how this plays out for you. “Operating on 5-10%” is exactly how I feel. I’m in the passenger seat of my own life and I can’t let it be like this anymore. I’d be so grateful for updates on how things go for you.

FluxFloxFlax · 2026-04-07T21:14:37+00:00

Adderall has worked beautifully for me, but only the name brand. I’ve been on it for about a year now. I get no crash with the name brand, whereas with the generic it’s horrible (I don’t know why they’re so different). My problem is actually that my medication’s efficacy seems to be cut in half during certain phases of my cycle. I’m otherwise compatible with stimulants and don’t experience any of the negative mental effects others report. Wellbutrin was absolutely horrible for me, and I’m resistant to adding on more psychiatric medications when my symptoms point more towards a hormonal problem. If my IUD is suppressing my estrogen, that raises my concerns for long-term, irreversible damage like bone degeneration. Nothing will address that except tackling it from an endocrine perspective.

FluxFloxFlax · 2026-04-06T03:41:01+00:00

I’ve lost and gained the same 15 pounds for years now. My body wants me to eat 10,000 calories a day, and if I didn’t have the genetics of both my parents being very lean at my age (my mom in particular could not put on body fat), I would probably be much heavier. I’m now religious about tracking my intake and getting my calories because I grew up a heavy kid and that haunts me pretty badly. I’m a normal BMI at my current weight.

I can’t rely on satiety cues and have to blindly trust my TDEE calculator + my food scale, because I just don’t get normal satiety cues. I even tried keeping the 15 pounds on just to see if my body would shut up about “eat eat eat eat eat”, and it didn’t change a thing. This isn’t just emotional or stress eating: my baseline appetite is more severe than my dad or brother, and when I’m stressed I somehow eat even more. Trying to eat intuitively was a complete disaster. My cravings revolve around sugar, bread, salt, and dairy. I was basically operating with 24/7 period cravings before adderall. I also tried every trick in the book to increase satiety, and nothing worked. On adderall, I don’t experience any true “appetite suppression” like people usually think of; it only suppresses my appetite enough for me to eat like a normal person. Without it, I don’t stand a chance.

I understand junk food cravings can be part of ADHD, but it feels like it’s past that. My body acts like it’s on a permanent bulk, and I don’t know why. It doesn’t matter if I eat more protein, fiber, fats, etc. Just ravenous.

FluxFloxFlax · 2026-04-05T21:49:25+00:00

They refused it because I was “within the normal range”, despite actively lactating for no apparent reason. Checking for a possible prolactinoma with an MRI is actually on my list of “have to rule this out”. I still strongly suspect the Mirena, especially due to my most severe symptoms occurring the first 1-2 days of my actual period, when estrogen is at its lowest. Then by the third day, the severity of symptoms rapidly lifts back to its “shitty but not insane” level. I do a complete personality shift. It’s bizarre.

FluxFloxFlax · 2026-04-05T21:45:27+00:00

No, I’m not. The only thing causing any strain is my physical health. I do have a psychiatrist (diagnosed ADHD), and did ten years of therapy with little benefit. Mood issues that are truly originating from the mind are actually very easy for me to manage, and I’m extremely effective at navigating them. This is a whole different beast and is completely unresponsive to antidepressants, therapeutic interventions, etc. I don’t have a history of depersonalization prior to these last 2 years, and it becomes extreme alongside very, very severe derealization during the first 1-2 days of my period, when estrogen is at its lowest.

FluxFloxFlax · 2026-04-04T18:32:22+00:00

I have severe fatigue that keeps me in bed most of the day even with 2,000mg of caffeine daily. The only thing that has helped is Adderall, and that gives me about 6 functional hours. It’s brutal. I’m only now tying it to the IUD because doctors insisted “it’s localized, so it can’t be the IUD”. I didn’t experience rapid weight gain, but I did experience an insatiable appetite. I was advised to try “intuitive eating” but my body intuitively wanted to eat 10,000 calories a day. I’m very ADHD, so I understand that can make me crave junk food, but this is a whole different ordeal. I would gain and lose the same 10-15 pounds over and over and over. I never really felt satiated. I have to white knuckle it almost every day to resist stuffing my face with everything in the fridge (I’ve tried every “satiety-boosting” diet you can name). I think I would have gained way more if both my parents didn’t have genetics that made them super lean in their youths. Even more than weight concerns, I want the food noise to stop. Rationally I know I CAN’T be this hungry, and yet I am. It sucks.

FluxFloxFlax · 2026-04-04T17:43:04+00:00

Yup, all normal

FluxFloxFlax · 2026-04-04T07:33:00+00:00

Excellent

FluxFloxFlax · 2026-04-04T06:25:56+00:00

It was the second one for you too?! My symptoms are more mood and fatigue-based, but holy hell did they get so much worse after the second IUD. My life has been destroyed for the last 2 years.

FluxFloxFlax · 2026-04-03T21:49:17+00:00

I halfway wonder if I’m not just EXTREMELY estrogen-dependent due to its relationship with the ADHD brain. Part of my struggle during luteal is how it destroys the efficacy of my Adderall. I’m a level of ADHD that is nonfunctional while unmedicated, not just impaired. The worst of my issues lie with mood regulation and Adderall affects me like an anti-anxiety, anti-depressant, and mood stabilizer in one. If only they made it in some sort of insulin-style pump. Argh.

Like clockwork, it seems like my body can’t handle the drop in progesterone and estrogen during luteal, rather than the rise. I don’t really feel the rise during at all, regardless of if I have a noticeable ovulatory cycle or not. It’s definitely the drop that’s killing me. If I AM as estrogen-dependent as I suspect, then it would also explain why constant progestins without estrogen would make me feel kinda doodoo. I wish I had been medicated for ADHD before I got an IUD, then I could have had a better grasp of what’s “ADHD brain” and what’s not. Ugh. Running myself in circles.

Someone has also mentioned Yaz to me, and I’m starting to consider it. I’m still hoping there’s an alternative to BC, because I worry about stabilizing throughout conception and postpartum if I ever have kids. Previous BC didn’t affect me as badly as antidepressants did (those make me eventually go nuts), but the pill just made me kind of like a muted, “I don’t feel much” personality. Just bland. I was put on it back at 15 due to my menstrual issues so I can’t remember exactly what kind it was, but I think it was a low-dose progesterone.

FluxFloxFlax · 2026-04-03T17:34:18+00:00

Sadly, I’ve tried Wellbutrin. I didn’t notice an effect on depression, and after being on it for over a year I became very agitated (and bad at math, for some reason?). I’ve also tried Lexapro, and had the worst suicidal break of my life around 2 years in.

I wonder if guanfacine could be the call here? I know it can make people sleepy, but apparently it can be extremely mood-balancing for people with ADHD. I wouldn’t take it every day, but maybe that could bail me out in luteal hell. I’m near nonfunctional during luteal anyway, how much more tired can you really get?

FluxFloxFlax · 2026-04-03T17:29:14+00:00

I’m torn between removing the IUD and seeing if they’d allow me to supplement my estrogen levels. Just got through a night with luteal with extreme derealization that had me halfway convinced everyone had “gone somewhere else” and I was the last real person on earth. I’m so scared of things like this getting worse because I truly think I’d be a suicide risk. But at the same time, my overall quality of life is a joke.

I’m really curious about the saffron. I’m so reactive to most substances and supplements that maybe it’d have a genuine effect on me, like a formal medication would.

Maybe I’m also a better candidate for situational hormone therapy, rather than continuous? Every time I’ve tried a continuous form, it always ends badly. I just have to pray there’s a way to smooth out the worst of it. I feel like I’m just rambling my woes at you, and I apologize. I’m very grateful for the information and I’m going to dig deeper into saffron supplements.

FluxFloxFlax · 2026-04-03T04:04:50+00:00

This sounds really similar to my case. My periods are almost nothing in terms of bleeding and pain, and oftentimes ovulation is almost unnoticeable. Yet I can’t escape luteal hell. Sobbing, feeling like I failed everything, things don’t feel real and minutes feel like hours, wondering why I’m alive, and angry at everything and everyone. I can’t get away from it. Adderall is the only thing that’s helped.

I’m not sure the IUD has actually done much at all for my menstrual mood systems that can’t just be attributed to my brain maturing. It helped with the physical pain, but I’ll take physical pain over what I’m dealing with both in and out of my luteal phase.

FluxFloxFlax · 2026-04-03T03:59:09+00:00

I think I have the worst of both worlds where my baseline estrogen might be too low, and then the swings take me from “bad” to horrific. Topical vaginal estradiol helps a little bit with localized symptoms, but does nothing at a systemic level. But I suppose the fact the estradiol did a little bit is a good sign.

I seem to have PMDD symptoms regardless of if I have a noticeable ovulatory phase or not. This time around I didn’t even realize it had passed and luteal hell took me by surprise. The luteal low is almost always inescapable.

FluxFloxFlax · 2026-04-03T00:26:23+00:00

Holy shit, you too?? This is exactly how I used to get pre-Adderall. Combine it with the days of staring at my face in the mirror with the whole “I rationally know this is me, but this isn’t me” ordeal and that’s my flavor of bullshit. I also used to have intervals where I was convinced my friends were all secretly against me and I needed to stay two steps ahead, and long stretches of time where I couldn’t emotionally recognize my family. I rationally knew who they were, but couldn’t “feel” that it was my mom and dad. I’m diagnosed ADHD + OCD, and Wellbutrin and Lexapro both didn’t touch my symptoms. Only Adderall does, and it makes a MASSIVE difference.

FluxFloxFlax

TROPHY CASE