How PCOS and ADHD Intersect: Bailey’s Story

“I was really struggling with my mental health, and I couldn’t figure out why,” says Bailey Pilant, a licensed mental health counselor and certified ADHD therapist in New York. Bailey’s work with neurodivergent women is deeply personal.

For years, she lived with ADHD and PCOS without answers, and her symptoms were often overlooked or dismissed. “I felt like such an outsider in my own life,” she recalls, a sentiment that would later fuel her passion to help others.

Bailey's story mirrors what many women with PCOS face: unanswered questions and a range of confusing symptoms.

Her ADHD and PCOS Diagnoses

“It’s been a journey. Actually, it has been a journey,” Bailey reflects. For her, ADHD came first—diagnosed at 17 after years of struggling with mental health and feeling like “such an outsider” in her own life. It wasn’t until a late night of crying in her room that she stumbled upon an article about ADHD in women.

 “The chaos and noise in my head… finally, for the first time in my life, went away.”

“I was like, ‘Oh my God, this is me. This is exactly how I experience life.’” Determined to advocate for herself, Bailey took the article—printed out and highlighted—to her doctor. Her persistence paid off.

“Thankfully, I had a really awesome doctor who had known me my entire life and was like, ‘Let’s try stimulant medication.’” The impact was immediate. “The chaos and noise in my head… finally, for the first time in my life, went away.”

Bailey’s PCOS diagnosis came later, but in hindsight, the symptoms were there all along, especially around puberty. “I started experiencing symptoms of PCOS almost immediately,” she recalls, citing painful and irregular periods, extreme fatigue, weight gain, and severe hormonal acne. Despite obvious signs, Bailey faced dismissive medical responses like, “It’s just your period” or “Try birth control.”

After enduring years of ineffective treatments and worsening symptoms—including losing hair and enduring 45-day periods—Bailey finally found answers through a dermatologist who suspected PCOS. An ultrasound confirmed it. “The tech looked at me and said, ‘I’m sorry, I was wrong. You do have PCOS.’ And I was like, ‘I know. Thank you.’”

The Connection Between ADHD, PCOS, and Hormones

Bailey’s experience highlights an underexplored intersection: the link between PCOS and ADHD. According to research published in Nature Reviews Endocrinology, PCOS is a hormonal disorder characterized by elevated androgens, which can influence brain function, including dopamine pathways.

Similarly, ADHD is associated with dysregulation of dopamine in the prefrontal cortex, as noted in findings from the Journal of Psychiatry and Neuroscience. This shared impact on brain regulation may explain why women with PCOS often report more pronounced ADHD symptoms.

“There’s not a lot of research, but once you understand it, it kind of makes sense,” Bailey explains. “PCOS impacts the brain’s use of dopamine, just like ADHD does. Higher androgen levels can affect brain development, and studies show women with PCOS are more likely to have children with ADHD.”

For women living with both conditions, this hormonal dysregulation can exacerbate ADHD symptoms, particularly during certain phases of the menstrual cycle. Bailey notes: “ADHD is not just an attention deficit disorder; it’s an attention regulation disorder. PCOS is similar—it’s a hormone regulation disorder. Both impact how the brain operates, processes signals, and regulates itself.”

Understanding Hormonal Fluctuations and Executive Functioning

Bailey emphasizes the importance of understanding how hormones impact ADHD symptoms throughout the menstrual cycle. A recent study on the “multiple hormone sensitivity theory” supports this connection, showing that executive functioning deficits change during different phases of a woman’s cycle.

“When my hormones surge, I get insomnia. Now, I can better plan, ask for help, and clear my schedule, knowing that phase is coming.”

“I know that I’m going to have more brain fog and lower energy in my luteal phase—about 10 days before menstruation,” Bailey shares. For her, tracking these changes with tools like Mira, a hormone-tracking device, helps predict fluctuations and manage her needs.

“When my hormones surge, I get insomnia. Now, I can better plan, ask for help, and clear my schedule, knowing that phase is coming.”

Managing PCOS and ADHD: A Personalized Approach

One of Bailey’s biggest realizations was that her body has unique needs that require personalized care. After trying various types of hormonal birth control, she discovered it worsened her PCOS symptoms rather than improving them. “I’ve never felt better since going off hormonal birth control,” she admits. “For some women, it’s a phenomenal treatment. For me, it wasn’t. Everyone’s body is different.”

Bailey’s management strategy focuses on accommodations and self-compassion:

• Tracking hormonal cycles to predict executive functioning challenges.

• Prioritizing sleep and maintaining a consistent schedule.

• Joyful movement: “I focus on exercising in ways that bring me joy, not punishment.”

• Diet flexibility: Bailey avoids rigid food rules. “It’s about making it easier for myself, not shaming myself for eating mac and cheese when I need comfort.”

  
  

Advocating for Care and Building a Support Team

Bailey stresses the importance of working with a trusted care team knowledgeable about PCOS, ADHD, and the interplay between the two. For her, small accommodations—like paying copays immediately and scheduling follow-ups in person—help her manage her executive functioning challenges.

She also encourages others to educate their support systems: “It’s about understanding that some of this is out of our control and asking for support to work with it, not against it.”

The Importance of Self-Compassion

“Having PCOS and ADHD can make it feel like your energy and abilities fluctuate week to week,” Bailey says. “But understanding the relationship between our hormones and our ADHD helps us plan better and be more patient with ourselves. We don’t have to beat ourselves up for not showing up the same way every day.”

“Our bodies react differently. That doesn’t make us any less valuable. It just means we have different needs. And that’s okay.”

Through strategies like cycle syncing—adapting lifestyle habits to align with hormonal fluctuations—Bailey has found more balance. “Since implementing cycle syncing, I’ve gone from two good weeks a month to three and a half. That’s a huge difference.”

Words of Advice

Bailey’s story underscores the need for more awareness and research on the link between ADHD and PCOS. Her advice for women navigating both conditions is clear: be compassionate, track your symptoms, and find a care team that supports you.

“Our bodies react differently. That doesn’t make us any less valuable. It just means we have different needs. And that’s okay.”