Many challenges and discomforts women experience can be blamed on hormones, from the monthly menstrual cycles that can leave you feeling exhausted, achy, and irritable to the hot flashes and mood swings brought on by menopause.

Hormonal changes can present difficulties for all women, but for those with ADHD, it can be even more challenging.

Language matters

The terms “women/girls” and “men/boys” are used in this article to reflect the terms that have historically been used to identify a person\’s sex or gender. Your identity may not match how your body responds to this condition. Your doctor can help you understand how your circumstances will affect your diagnosis and treatment.

There is a neurological disorder called attention deficit hyperactivity disorder.

There are three different types of attention deficit disorder.

  • Predominantly inattentive: This type is characterized by difficulty with organization, paying attention, and staying on task.
  • Predominantly hyperactive-impulsive: This type is characterized by high levels of energy, fidgeting, and impulsivity.
  • Combined: This type is characterized by both inattentiveness and hyperactivity.

“Sex will be the main symptom, but it will vary depending on a person’s age, personality, and more.”

Boys who are diagnosed with ADHD are more likely to have the combined or hyperactive-impulsive subtype. So they tend to have more overt symptoms, such as hyperactivity, aggression, and impulsivity.

“It is often subtle for girls with attention deficit Hyperactivity Disorder. Girls show more symptoms of attention deficit disorder. Many girls go years without proper diagnosis or treatment. It may be easier to overlook a child who is daydreaming than a child who can’t sit still.”

Estrogen, the primary sex hormone in those assigned female at birth, is a key component in the reproductive system. But there’s also a link between estrogen and various cognitive functions. Specifically, estrogen can affect dopamine, serotonin, and norepinephrine. These neurotransmitters play a role in ADHD as they have a strong impact on memory, focus, and mood.

Of course, estrogen doesn’t cause or cure ADHD, but it can certainly have an impact on symptoms. Research from 2017 suggested attention and executive thinking skills can improve when estrogen levels are higher. On the other hand, ADHD symptoms can worsen when estrogen levels are lower.

Estradiol levels are constantly changing. Estradiol levels rise and fall monthly during the reproductive years. Women with attention deficit disorder can experience hormonal changes that can affect how symptoms are experienced.

Puberty is a time of change and emotional upheaval as hormones take over.

puberty hits between the ages of 9 and 13 for girls, and it comes with physical and emotional changes. There is an increase in hormones.

It might be easy to assume that, with higher levels of estrogen, girls with ADHD would have an easier time during puberty. However, the opposite tends to be true. That’s because, while estrogen can improve ADHD symptoms, progesterone does not.

There is also the issue of medication. Stimulant medications can be less effective during puberty, so they are the most commonly used treatment for ADHD.

It is possible to keep a symptom diary and discuss changes with your doctor.

Women menstruate from puberty until perimenopause. Estradiol and progesterone levels change during the menstrual cycle. The fluctuations are not as dramatic as they are during puberty, but they still affect the symptoms of the disorder.

According to an article by Marcy Caldwell, a licensed clinical psychologist specializing in ADHD, women often experience more or worsening symptoms during the last 2 weeks of their cycle as progesterone levels rise.

And, as if that weren’t bad enough, it’s also been suggested that premenstrual syndrome (PMS) is more common in women with ADHD.

Just like with puberty and periods, pregnancy brings a substantial shift in hormone levels. For many women, Caldwell explains, ADHD symptoms get worse during the first trimester.

Increased progesterone could be the reason, but medication could also be involved. The first trimester can be a big adjustment for women who stop taking their medication during their pregnancies.

There’s limited research regarding medication use and ADHD during pregnancy. A small 2022 study found that, among those who discontinued, maintained, or adjusted their ADHD medication during pregnancy, there were no significant changes in symptoms.

There was a difference between those who discontinued medication and those who continued or adjusted their medication. There is more research that needs to be done.

Perimenopause is when women start to experience menstruation. Estradiol levels begin to decline and menstruation becomes more irregular during this time. This stage can last up to 10 years until the woman stops menstruation.

Along with hot flashes, menopause often brings memory fog and difficulty focusing. Unsurprisingly, this can be even more difficult for women with ADHD, who already face challenges in the area of focus and attention.

Women with attention deficit Hyperactivity Disorder can experience additional challenges. Understanding how hormonal changes can impact your symptoms can help you manage them over time.