ADHD and Fertility: Is There a Link?

Attention deficit hyperactivity disorder (ADHD) is a complex neurodevelopmental disorder which affects both adults and children, male and female. It’s been in the spotlight over the past few years, with more of us having a knowledge of the condition and the impact it has on someone’s life. 

ADHD is usually diagnosed in childhood and affects more boys than girls. This means women with PCOS (Polycystic Ovary Syndrome) or other fertility conditions have often been 'missed' in childhood, leading to undiagnosed adults with ADHD.

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 conditions affecting fertility such as:

• PCOS. Polycystic Ovary Syndrome is a common hormonal condition affecting women of reproductive age, characterised by symptoms such as irregular or absent periods, excess androgen levels (leading to acne or hair growth), and polycystic ovaries.

• Low AMH (Anti-Müllerian Hormone.) This hormone that serves as a key indicator of a woman's ovarian reserve (egg count) and is used in fertility testing to assess potential response to fertility treatments

• A 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 the following symptoms:

• Restlessness

• Impulsivity

• Difficulty staying still

• Difficulty concentrating during meditation

• Difficulty staying 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 the following symptoms:

• lapses in 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 of 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 your cycle.

So How Does ADHD Relate to Fertility?

Attention Deficit ADHD and PCOS

As ADHD is a neurodevelopmental disorder, its main essence being a 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, causes fluids to flow 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.

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

ADHD and Potential PCOS

So, is there a link between ADHD and Polycystic Ovary Syndrome (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

• Restlessness

• 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, our treatments involve nourishing the Blood and Kidney Yin and tonifying the Spleen. We also look to calm the spirit and work on emotional blocks with meditation. If you want to know more, I’m always happy to offer information on the treatments at my acupuncture clinic in Wolverhampton. 

Hyperactivity ADHD and Fertility

When it comes to 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 traditional Chinese medicine, this means one’s emotional expression can become heightened. The symptoms of ADHD like 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

• Feeling 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 a TCM diagnosis.

As a highly trained fertility specialist based in Wolverhampton, my job is to classify the severity of each of your diagnoses and tailor treatments to bring you back into a state of balance. 

I hope this helps!