ADHD in females: Survey findings on symptoms across hormonal life stages

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental condition associated with excessive levels of inattention and/or hyperactivity/impulsivity. Symptoms usually persist into adulthood and negatively influence functioning and quality of life. Although sex differences in ADHD are commonly reported, ADHD remains under-recognised in females (including women and people assigned female at birth), and there is limited knowledge about experiences of females with ADHD across hormonal life phases. This study aimed to investigate self-reported ADHD and related traits in females across hormonal life phases and menstrual cycle phases.

A cross-sectional sample of 600 female participants, who reported having an ADHD diagnosis and ADHD symptoms, completed an online survey between June and November 2023. Self-reported ADHD, depression, anxiety and stress traits were assessed using validated scales. Participants were also asked about perceived symptom changes at different hormonal life stages.

Self-report data suggested most participants perceived a worsening of ADHD symptoms during the postpartum period (70.4 %) and menopause (97.5 %). Cross-sectional analysis of Adult ADHD Self Report Scale scores indicated similar symptom severity in all hormonal life phases. A large proportion (88.6 %) of premenopausal participants not taking hormonal therapy reported changes in their ADHD symptoms across the menstrual cycle, with most reporting a worsening during the luteal phase.

Findings provide novel evidence of ADHD symptom profiles in hormonal contexts unique to females, supporting anecdotal clinical experiences and reflecting a need for further research. Understanding how hormonal phases experienced by females may interact with ADHD symptoms is integral to effective management and care.