What should I track before an ADHD assessment if I think hormones affect my symptoms?

Track patterns, not just bad days

The most useful record shows a pattern across time, not a list of a few rough days. Canadian guidance, including CADDRA-informed practice, generally looks at symptoms across settings and over time, alongside other possible explanations. That is why a brief tracker can help if you think symptoms change with hormones.

Bring several weeks of notes if you can. If your cycle is irregular, or you think perimenopause is involved, a longer record is even better. The point is not to prove anything yourself. The point is to give the assessor a clearer timeline of when symptoms rise, when they ease, and what else was happening then.

• Use one page, a notes app, or a spreadsheet. Keep it simple enough that you will actually finish it.
• Record the same few items every day, even on good days.
• Add one or two examples each week of how symptoms affected work, school, home, driving, appointments, or relationships.
• If this is for a teen, a parent can track observations too, but it helps if the teen adds their own description in plain words.

Bring these five kinds of information

The core items to bring are menstrual timing, sleep, mood, focus variability, and treatment change data. This gives the assessor something concrete to compare against your symptom history.

If you are not menstruating, the same idea still applies. Track symptom changes around perimenopause, menopause, postpartum changes, gender-affirming hormone changes, or any other hormone-related shift you and your clinician are already monitoring.

If depression, anxiety, substance use, or thoughts of self-harm are part of the picture, include that in the timeline because it matters to assessment. If you need help now, call or text 9-8-8 in Canada, or call 911 in an emergency.

Keep your notes short and specific

Short notes are easier for a clinician to use than long journal entries. Aim for quick, repeatable data plus a few real examples.

1. Give each day a simple rating for attention, sleep quality, and mood, such as 0 to 3 or low, medium, high.
2. Mark the cycle day or the hormone-related phase if known.
3. Note one functional example when relevant: missed deadline, forgot pickup time, lost track in a meeting, could not start homework, impulsive spending, or unusually good focus.
4. Write down treatment changes on the exact date they happened, including dose changes only if you already know them and can state them accurately from the label.
5. Bring your tracker plus any calendar screenshots or health app summaries you already use.

That kind of note is more useful than saying, “I think my hormones make everything worse.” It gives the assessor timing, severity, and impact.

Include treatment and health context

A symptom tracker is stronger when it sits beside a clean health history. Hormones may affect symptoms, but they are rarely the only thing an assessor needs to review.

• Bring a full medication list, including hormone therapy, birth control, sleep treatments, supplements, and mental health medications. If you need help organizing that, see Should I take my current mental health medications before an ADHD assessment?.
• Note major health events such as pregnancy, postpartum changes, thyroid issues, anemia, surgery, concussion, or major stress periods.
• If sleep is a concern, write down snoring, observed pauses in breathing, CPAP use, or severe daytime sleepiness.
• For teens, include school reports about inconsistency, timing of symptoms around periods, and whether attention changes are new or longstanding.

The Society of Obstetricians and Gynaecologists of Canada and the Menopause Foundation of Canada both provide public education showing that hormone changes can affect sleep, mood, concentration, and daily functioning. That does not mean hormones explain everything, but it is a valid reason to bring a timeline to an ADHD assessment.

If you are booking private care, it can also help to tell your usual clinician what you are investigating, especially if hormone therapy, mood treatment, or menstrual concerns are already being managed. See Should I tell my family doctor before booking a private ADHD assessment?.

What the assessor does with it

Your notes help the assessor ask better questions, but they do not decide the diagnosis on their own. The clinician still needs to look at childhood history, symptom persistence, impairment, and whether another condition fits better, as described in Canadian ADHD guidance.

A hormonal pattern can point to several possibilities: ADHD with symptom fluctuation, another condition that mimics ADHD at certain times, or more than one condition at once. This is exactly why detailed timing matters.

• If symptoms were present long before puberty or hormone shifts, that supports looking closely at ADHD.
• If symptoms mainly appeared with major hormonal change, the assessor may consider a broader differential.
• If attention worsens only when sleep collapses or mood symptoms spike, those links matter too.
• If treatment changes clearly altered focus or irritability, the clinician may factor that into next steps or follow-up questions.