Menstrual Cycle-Related Hormonal Fluctuations in ADHD: Effect on Cognitive Functioning-A Narrative Review.

Area of Science:

• Neuroscience
• Psychiatry
• Endocrinology

Background:

• Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder impacting cognition and dopamine.
• Women with ADHD report hormone-related difficulties, with menstrual cycle changes affecting mood, cognition, and treatment efficacy.

Purpose of the Study:

• To review the influence of menstrual cycle hormonal fluctuations on cognitive functioning and ADHD symptoms in women.
• To synthesize current evidence on how hormonal changes impact attention, executive function, and impulsivity across the menstrual cycle.

Main Methods:

• A comprehensive literature search was conducted on Ovid EmBase for studies published between 2015 and 2025.
• Included studies examined cognitive performance in women with or without ADHD across menstrual cycle phases, utilizing neurobiological measurements.

Main Results:

• Non-clinical populations showed enhanced attention in the mid-luteal phase, potentially linked to progesterone.
• Women with ADHD and/or mood disorders exhibited impaired attention, executive function, and impulsivity during the mid-luteal and pre-menstrual phases.
• These objective findings align with subjective reports of worsened cognition and diminished medication efficacy.

Conclusions:

• ADHD-related cognitive functioning varies with the menstrual cycle, with impairments most pronounced in women with ADHD and comorbid mood disorders.
• Potential mechanisms include heightened sensitivity to allopregnanolone and estrogen withdrawal.
• Further research is crucial for clinical applications, including female-specific diagnostics and treatments.