There is a sentence women say quietly, usually near the end of an appointment, usually while reaching for a coat: I think there is something wrong with my brain. The measured answer is more reassuring and more precise than either the fear or the dismissal. Women in late perimenopause stopped improving on repeated cognitive testing while every other group carried on, and then the curve came back. But underneath that sits a second question, about ADHD in this window, where a systematic review went looking for studies and found none.

There is a specific week of the month where everything becomes harder. Not harder the way Monday is harder than Friday. A different kind of harder — where tasks that were manageable seven days ago now require effort that feels unreasonable, where you lose your keys three times before 10am. If you have ADHD, that week is not a coincidence. It is your dopamine system responding to a hormonal signal nobody told you about.