ADHD and Fertility: Is There a Link?

Attention deficit hyperactivity disorder (ADHD) is a complex neurodevelopmental disorder affecting adults and children, both male and female. Although ADHD is often diagnosed in childhood, it affects more boys than girls and therefore women with PCOS or other fertility conditions may have been 'missed' in childhood, leading to undiagnosed ADHD as adults.

Characteristics of ADHD are divided into two categories:

1. Hyperactivity

2. Inattention

In Traditional Chinese Medicine (TCM) ADHD is seen as an imbalance between feminine and masculine energies or Yin and Yang. In a healthy constitution, Yin and Yang should remain in equilibrium, in the body and in the fertility organs.

Let's look at the two types of ADHD and how they can relate to fertility conditions such as:

• PCOS

• Low AMH

• Thin uterine lining

• Implantation issues

We are also going to determine which type of ADHD has a Yang component, which type of ADHD has a Yin component and what each means for specific fertility conditions.

Hyperactive ADHD

Women who fall under the 'hyperactivity' category of ADHD often exhibit symptoms of the following:

• Restlessness

• Impulsivity

• Difficulty staying still

• Difficulty concentrating during meditation

• Difficulty remaining focused

• Increased talking

• Increased motor or physical activity

  
  

  Hyperactivity ADHD is diagnosed as excess Yang in TCM. The nature of Yang energy is associated with the masculine, physical exertion, day time and heat. If you have symptoms of Yang excess, you might feel restless, need to exercise frequently and often feel hot all throughout the day.

  
  

  When there is excess Yang, there is too much energy and too much heat in the body. This can damage the eggs.

Inattention ADHD

Women who fall under the 'attention deficit' category of ADHD often exhibit symptoms of the following:

• lapses of concentration

• overthinking

• easily distracted

• forgetful

• slower processing speed

• shy or withdrawn

• procrastination

  
  

  Attention Deficit ADHD is diagnosed as deficient Yin in TCM. The nature of Yin energy is associated with the feminine, rest, relaxation and cooling the body. If you have symptoms of Yin Deficiency you might feel tired, restless (irritable), hot in the evening or night, have difficulty sleeping or wake frequently and suffer from anxiety.

When there is deficient Yin, there is not enough feminine energy in the body (think follicular stage and oestrogen) and the cooling mechanism in the body is deficient, which indirectly leads to heat symptoms, at certain times of the day or of the cycle.

So How Does ADHD Relate to Fertility?

Attention Deficit ADHD and PCOS

As ADHD is a neurodevelopmental disorder, its main essence is of deficiency. So let’s explore the attention deficit type of ADHD first as this is often seen in women and there has been a proven link with PCOS.

With Yin Deficiency (attention deficit) ADHD other deficiencies develop including:

• Blood Deficiency

• Spleen Qi Deficiency

• Kidney Deficiency

Kidney, Spleen and Blood deficiency are all TCM diagnoses of PCOS, so it follows that women who have been diagnosed with or show symptoms of ADHD may also have PCOS or ovulation issues, or vice versa.

For example, when the Kidney Yin is weak, it fails to nourish the Spleen, leading to Spleen Qi deficiency. The Spleen is responsible for making the Blood in TCM and so a weak Spleen contributes to Blood deficiency.

The Spleen when strong, it flows the fluids around the body and in the fertility organs. When the Spleen is weak, fluids accumulate causing cysts characteristic of PCOS. They then disrupt the hormonal balance, leading to ovulation problems.

The Blood needs to be nourished in order to supply the follicles with energy to develop and produce eggs and nourish the lining of the uterus for implantation.

Attention Deficit ADHD and Potential PCOS

Let’s Put it all Together:

Spleen:

• Overthinking and anxiety

• Pcos or imbalanced hormones

• Ovulation problems

• Difficulty losing weight

• Slower processing speed

Kidney Yin:

• Eggs not mature in IVF

• Poor embryo quality (from egg quality)

• IVF implantation failure

• Low AmH or AFC

• Miscarriage

• Frequent waking, hot at night

• Restless

• Distracted, forgetful

  
  

Blood:

• Thin uterine lining

• Dizziness

• Dull headaches

• Short or long follicular phase

• Light periods

• Anxiety

• Difficulty getting to sleep

You don’t have to have all of the symptoms, a majority would be enough. In acupuncture, we would nourish the Blood, tonify the Spleen and nourish Kidney Yin. We would also calm the spirit and work on emotional blocks with meditation.

Hyperactivity ADHD and Fertility

With hyperactivity ADHD, this is often seen and diagnosed in boys in childhood. It makes sense as this has a large Yang excess component, with Yang being masculine energy.

Remember that both males and females have both Yin and Yang energies, so having an excess of Yang is seen in women too.

But can you also see that excess Yang may lead to an imbalance in the feminine and masculine equilibrium therefore disrupting the hormonal balance for fertility.

Whilst attention deficit ADHD has a clear link with PCOS, which according to TCM would be largely due to the Yin and Spleen deficiency, hyperactivity ADHD relates more to the Liver and Heart.

When Yang is in excess, it can lead to the following TCM diagnoses:

Liver Qi Stagnation

Heart Fire

Kidney Yin Deficiency (here there is an overlap with attention deficit pattern)

This happens because when Yang is in excess, Liver Qi (energy) also rises and can become blocked, leading to Liver Qi Stagnation. Stagnation causes Heat which rises and disrupts the Heart energy, causing Heart Fire. As the heart is the master of the emotions in TCM, this means that the emotional expresssion can become heightebed. ADHD symptoms of impulse control, hyperactive behaviour and difficulty regulating emotions would surface, especially in childhood.

The best thing to do to move the blocked Qi and clear heat is to have acupuncture and to exercise, which is why women with fertility issues and hyperactive ADHD may feel quite hot, need to exercise to burn off energy and to release emotions and might find the lack of movement required during IVF unbearable!

Lets Put it all Together:

Liver Qi Stagnation

• Bloating

• PMT

• Mood changes

• Feeing better when exercising

• Headaches/ migraines

• Feeling hot before or during your period

• Vivid dreams

Heart Fire

• Hyperactive

• Heart palpitations

• May have childhood trauma/ chaotic upbringing

• Tongue ulcers

• Red tongue tip

Kidney Yin

• Low Amh

• Poor egg quality

• IVF failure

• Restless

• Thirsty at night

  
  

So hopefully we can see that each individual has their own level and degree of severity of symptoms in each bracket of TCM diagnosis.

As a fertility specialist, my job is to classify the severity of each of your diagnoses and focus my treatment upon that until everything is back in balance.

I hope this helps!

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