Why PCOS is So Hard to Manage with ADHD
About a 7 minute read time
There is SUCH an overlap between PCOS (Polycystic Ovary Syndrome) and ADHD (Attention Deficit Hyperactivity Disorder).
Let’s talk about it!
Both of these conditions are directly impacted by underlying factors that involve an imbalance of signalling chemicals like hormones and neurotransmitters.
In PCOS, several hormonal and metabolic factors contribute to raised levels of androgen hormones, especially testosterone.
Higher androgen levels can cause or significantly contribute to many of the major symptoms experienced in PCOS like irregular or missed ovulation and periods, acne or oily skin, weight gain, infertility and an excess of body hair.
In ADHD, key neurotransmitters like dopamine are deficient, which results in ADHD symptoms like difficulty paying attention, difficulty starting and completing tasks, dysregulated energy levels and mood, impulsivity, heightened sensitivity, hyperactivity and many more.
Both PCOS and ADHD are also directly impacted by multiple metabolic factors and symptoms of each are made way worse by blood sugar dysregulation that can over time contribute to insulin resistance. (Marcelli et al. 2025; Lewis et al. 2025).
Both PCOS and ADHD are associated with low-grade chronic inflammation is that very often sourced to an imbalance in the bacteria in our guts (Lewis et al. 2025; Sun et al. 2023)
Various psychiatric disorders can be observed more often in women with PCOS, including depression, anxiety, OCD, eating disorders and ADHD (Stanczak et al. 2024).
Diet and physical activity are among the most effective and cost-efficient ways to manage PCOS (Stanczak et al.2024) - but managing PCOS with ADHD requires a more nuanced approach than just following a healthy hormone meal plan.
Why PCOS is so hard to manage with ADHD
This isn’t exactly unique to PCOS - having ADHD can make a lot of things that are often seen as not a big deal through a neurotypical lens - like eating, really challenging.
We have to eat everyday, multiple times a day. Eating nutritiously in ways that make us feel good and give our brains and hormones the nutrients they need also requires more effort and planning than eating foods that are less nutritious.
Executive function is something that most folks with ADHD struggle with - this refers to our ability to plan, organize, initiate, see through and complete a task.
Eating (especially foods that are nutritious) can become SO overwhelming SO fast because there are actually SO many steps involved in feeding and nourishing yourself - aka in many ways traditional healthy eating that supports both PCOS and ADHD is not executive dysfunction friendly.
Tasks involved in traditional healthy eating through a neurotypical point of view include deciding what to eat (hello decision-fatigue and information overwhelm leading to confusion), buying groceries (time consuming, often overstimulating, usually not the most motivating task), storing groceries, food preparation, cooking, actually eating, storing any left-overs, are all things that people with ADHD often have a hard time with.
Again - we have to do this (eat) every day, multiple times a day. There are few things that we have to do daily or we die, so without the right support and tools this can get old fast and make following any PCOS meal plans that don’t take our neurodivergence into consideration unlikely to work.
Nutrition for PCOS should be aimed at regulating blood sugar levels to either prevent or begin to reverse insulin resistance, reduce any overactive inflammation in the body and support the trillions of bacteria living in our gut.
That’s all great but is easier said than done, especially with ADHD.
A challenging relationship with executive function, irregular eating patterns, binge eating foods high in sugar and carbohydrates, difficulty recognizing hunger and fullness cues, specific texture needs around food, and the energy and time it takes to prepare food are just a few of the factors that many people with ADHD often experience that act as major barriers to eating in ways that support PCOS.
How I work with people with PCOS and ADHD
Improving access to foods that you like, make you feel good and have the nutrients that support your hormones, brain and gut health is essential and almost always the first place I start when working with clients with ADHD and PCOS to improve their nutrition so it supports their brains and hormones.
Although there’s lots of overlap between barriers to healthy eating that supports hormones, PCOS and ADHD, everyone is going to be different and experience challenges differently and have very different preferences around what they like to eat and actually will eat.
So we begin by identifying these barriers and seeing where we can introduce small changes that don’t feel overwhelming. This is the beginning of building a solid foundation to your nutrition so you can improve your access to the right foods that contain adequate protein, fibre, fats and carbohydrates. This way you can start to eat these foods more regularly without experiencing so much overwhelm and frustration.
When we eat more regularly (ideally every 3-4 hours) and include the essential macronutrients mentioned above (protein, fibre, fats and carbohydrates) as well as minerals, vitamins and antioxidants - this stabilizes our blood sugar levels.
Both ADHD and PCOS symptoms get so much worse when our blood sugar levels are dysregulated from not eating regularly enough and not eating the right types and amounts of nutrients.
Dysregulated blood sugar levels also contribute to the chronic low-grade inflammation that is another major factor contributing to both PCOS and ADHD. Eating the right balance of nutrients and especially incorporating sources of foods with antioxidants is the best way to reduce this systemic inflammation, so another reason to prioritize finding the right ways to be able to nourish your body, brain and hormones regularly. (Marcelli et al. 2025; Sun et al. 2023).
Much of this chronic low-grade inflammation is directly impacted by the bacteria in our guts, so including the right foods that support gut health is another essential for managing both ADHD and PCOS that we build on over-time (Sun et al.2023; Lewis et al. 2025).
Another key that I find works so well that’s central to intuitive eating is improving interoceptive awareness - this refers to your ability to recognize the signals your body sends to your brain about what it needs.
Many people with ADHD have lower interoceptive awareness than neurotypical people, so the benefits to improving interoceptive awareness with ADHD don’t just stop with nutrition but can also really support emotional regulation, other forms of self-care and executive functions as well.
But circling back to nutrition for ADHD and PCOS, when applied through a neurodivergent-lens, over time improving your interoceptive awareness can help you better recognize hunger and fullness (often experienced differently by people with ADHD) so you can respond to both hunger and fullness better and keep blood sugar levels stable.
Intuitive eating and improving interoceptive awareness also both prioritize satisfaction - so again over time being able to recognize what your body needs and responding in ways that make you feel better and support your hormones and brain but doing so with foods you actually enjoy and find satisfying.
It’s not you it’s the system
As a neurodivergent nutritionist and intuitive eating counsellor with ADHD who works with mostly women with ADHD and hormonal conditions, I’ve noticed that there can be so much shame and guilt around food.
As much as I wish we didn’t, the reality is that we do live in a neurotypical patriarchal society that for the most part doesn’t acknowledge neurodivergent adults or the severity of how hormonal conditions like PCOS impact people’s quality of life.
Hormonal conditions like PCOS that impact women, many trans and non-binary people are significantly less funded and researched than conditions that impact men, and the majority of studies on ADHD are only done on children.
These conditions impact so many people - PCOS is the most commonly diagnosed hormonal condition in women of reproductive age (Rodriguez-Paris et al. 2019).
So many women, trans and non-binary people with ADHD are missed and under-diagnosed because there is still a giant assumption in the medical community that ADHD is a condition that mainly impacts young boys (Attoe et al. 2023).
Since the research, funding, acknowledgement and support for women, many trans and non-binary people have been so absent around both of these conditions, it makes sense why so many people have such a hard time managing these conditions.
If you experience shame and guilt around feeling like you’re not doing enough to nourish yourself with PCOS and ADHD, please remember the context of the neurotypical heteropatriarchal society we live in.
It’s not your fault - it's the system and the lack of support, acknowledgement and information it’s failed to provide you with.
There are always alternative ADHD-friendly ways to better support yourself, your PCOS and ADHD with nutrition - it's just about finding the right tools that work for you, your lifestyle and neurodivergent brain.
Sources:
Attoe et. al (2023). Miss. Diagnosis: A Systematic Review of ADHD in Adult Women. J Atten Disord
Lewis et. al (2025). Gut dysbiosis as a driver of neuroinflammation in attention-deficit/hyperactivity disorder: A review of current evidence. Neuroscience
Marcelli et. al (2025). Bridging ADHD and Metabolic Disorders: Insights into Shared Mechanisms and Clinical Implications. Diabetology.
Rodriguez-Paris et. al (2019) Psychiatric disorders in women with polycystic ovary syndrome. Psychiatr.Pol
Stanczak et. al (2024). The latest reports and treatment methods on polycystic ovary syndrome. Ann Med.
Sun et. al (2023). Gut microbiota dysbiosis in polycystic ovary syndrome: Mechanisms of progression and clinical applications. Frontiers in Cellular Infection Microbiology
