Perimenopause ADHD has a clear mechanism: falling estrogen disrupts dopamine, collapsing executive function. Task paralysis, emotional dysregulation, working memory failure — it's neurochemical, not personal. A 2025 study found severe symptoms were nearly twice as common in women with ADHD during perimenopause. Many get their first diagnosis in their 40s. Here's the estrogen-dopamine link and what actually helps.