ADHD, or Attention-Deficit/Hyperactivity Disorder, can affect women differently than men, often causing unique symptoms that fluctuate throughout the month as women's hormones do.
While each case of ADHD is unique, studies1 show that compared to men, many women with ADHD present with more:
- Inattention
- Emotional dysregulation
- Trouble managing stress
- Social challenges
They also tend to exhibit less hyperactivity, which is the predominant symptom most people think of when they hear ADHD.
This can lead to underdiagnosis and delayed treatment for women with ADHD.
In this article, you'll learn about the distinct symptoms of ADHD in women, its underlying causes, including hormonal influences, and reasons for rising prevalence. We'll also explore the different options for managing ADHD, which can include:
- Balanced diet
- Regular exercise
- Consistent sleep schedule
- Medications, if needed, including stimulants
- Supplements including omega-3s and vitamin D
Symptoms of ADHD in Women
ADHD is a neurodevelopmental condition characterized by difficulties sustaining attention, controlling impulses, and regulating activity levels. Everyone deals with some degree of these symptoms, but among people with ADHD, they're present often enough to impact daily functioning and behavior.
Many women with ADHD experience unique hormonal influences and societal expectations that contribute to and affect their ADHD symptoms. And, as mentioned above, ADHD symptoms in women can vary significantly2 from those typically seen in men and boys.
Common ADHD symptoms in women can include:
- Talking Excessively: This can look like interrupting or answering people’s questions before they are finished. There is often difficulty waiting for your turn to speak and feeling anxious about what you have to say.
- Inattention: Women with ADHD can struggle with maintaining focus on tasks and organizing activities, including their schedules and priorities. This can be especially difficult when the task is boring or not something you’re interested in.
- Emotional Dysregulation: Emotional sensitivity, mood swings, and intense emotional responses are common symptoms among women. Women with ADHD can also experience difficulties in managing stress and regulating their emotions. These symptoms can be most pronounced in those with PMDD or prior to starting your period.
- Hyperactivity: Unlike the more obvious physical hyperactivity often seen in men, women can exhibit more of an inner sense of unease and restlessness, which can mimic symptoms of anxiety. Sometimes this feels like internal restlessness and can manifest in over exercising or engaging in many activities.
- Social Challenges: Some experience difficulty maintaining friendships and relationships due to impulsivity, interrupting others, or having trouble waiting their turn in conversations and listening well. Additionally, it may also be difficult to remember to check in with someone, make scheduled dates to meet, or not skip important dates, like birthdays.
- Misplacing items: Regardless of gender, people with ADHD might misplace items frequently and experience forgetfulness.
- Comorbidities: ADHD often occurs along with other psychiatric conditions3, including behavioral issues, anxiety, depression, and autism. Many women with ADHD report feeling4 “different,” “stupid,” or “lazy” and blaming themselves for their underachievements, which can contribute to low5 self-esteem and poor sense of self-worth that can increase the risk for smoking, drug use, alcohol abuse, and teen pregnancy. In addition, there are a high number of women diagnosed with ADHD who are also autistic, something the community has termed AuDHD.
ADHD Symptoms In Girls
It's estimated that about 9% of children living in the U.S. have ADHD and that up to 90% will continue to experience symptoms6 into adulthood.
In childhood, ADHD affects about three boys for every girl7, but in adulthood, this ratio evens out to about one boy for every girl. This suggests that girls and women are often not diagnosed with ADHD during childhood.
ADHD symptoms in girls are frequently less apparent than in boys, which is one reason why girls are thought to be underdiagnosed and commonly receive delayed treatment.
Girls with ADHD often display more internalized symptoms such as:
- Daydreaming
- Talking excessively
- Being seen as “spacey” or disorganized
- Heightened emotions
- Difficulty staying seated
- Fidgeting
- Difficulty playing quietly
These behaviors can be mistaken for shyness or anxiety8, leading to inaccurate diagnoses or lack of intervention in many cases.
Options for Managing ADHD in Women: Natural Solutions and Medications
Living with ADHD can be challenging, but there are both natural solutions and medications available that can help mitigate symptoms and improve functioning in day-to-day life. Below are strategies that women can use to help manage ADHD.
| Evidence Based Options for ADHD | How to Implement |
| Nutrient Dense Diet | Use the free recipe guide here to help you get started. |
| Quality Sleep | Practice the sleep hygiene tips found here Leverage supplements that support sleep |
| Exercise | Aim for 150 minutes of moderate physical activity weekly or as advised by your medical provider. |
| Cognitive Behavioral Therapy | Meet with a trained mental health professional who has trained in the unique needs of ADHD |
| Stress Reduction | Tai chi, yoga, meditation, acupuncture, journaling |
| Mindfulness or Meditation | YogaTai chiMindfulness or meditation apps |
| Vitamin D | Sunlight exposure Foods: fatty fish, fortified foods, mushrooms Vitamin D3/K2 supplement |
| Omega-3 Fatty Acids | Eat cold water fish, walnuts, and other omega-3 food sources Omega Plus |
| Hormone Support Nutrients | Vitamin B6, C, folate, calcium d-glucarate, Vitex, selenium Balance Women’s Hormone Support |
| Rhodiola rosacea | Adrenal Support Note: avoid in cases of bipolar disorder diagnosis |
| Pharmaceutical Therapy | Stimulants vs. Non-stimulants: Treatment options should be discussed with a qualified, licensed healthcare professional |
Healthy, Balanced Diet
A balanced diet rich in omega-3 fatty acids (found in fish like salmon), antioxidants (in fruits and vegetables), and protein (like lean meats, yogurt, eggs, and legumes) support brain health and cognitive function.
Adequate Sleep
Adults with ADHD tend to experience poor sleep, including delayed sleep phase disorder, where sleep onset and wake times are significantly delayed compared to standard patterns. Late-night activities, screen use, and sleep deprivation can all worsen ADHD symptoms, which is why sleep hygiene is important.
Quality sleep is crucial for cognitive function and managing ADHD symptoms, especially during periods of exacerbation and stress. Prioritizing sleep can also help decrease symptoms associated with hormonal changes, such as those that occur with PMS or PMDD.
Tips for better sleep include:
- Setting a consistent bedtime
- Reducing screen time before bed
- Ensuring a comfortable sleep environment that's quiet, cool, and dark
- Practicing relaxation techniques like bathing or meditation
- Trying melatonin and L-theanine supplements at night to support sleep quality
Regular Exercise
Physical activity supports mental health in many ways, including helping to regulate dopamine and serotonin levels, improving focus and mood stability, and reducing symptoms of hyperactivity.
Exercise can naturally lift your mood, boost creativity, expend excess energy, and support overall hormone balance. Aerobic/cardio activities, in particular, can reduce impulsivity, improve attention, and enhance cognitive performance by promoting structural changes in the central nervous system and boosting dopamine levels.
Behavioral Therapies and Support
Cognitive Behavioral Therapy, or CBT, is one therapeutic approach that can help teach women coping strategies to manage ADHD symptoms, such as by improving time management skills and emotional regulation.
Along with therapy and mindfulness exercises, journaling can help to pinpoint patterns and spot triggers of symptoms. If you'd like help understanding your body, triggers, and cycle and how to create more balance, check out my free Hormone Balancing Starter Kit.
Mindfulness and Meditation
Practices that promote mindfulness, including meditation and yoga, are useful for reducing stress levels, increasing self-awareness, and improving attention span and impulse control.
Omega-3s and Vitamin D
Studies suggest that omega-3 fatty acids, found in fish oil from sources like salmon and sardines, are beneficial for managing ADHD symptoms. DHA and EPA, two types of omega-3s, support cell membranes and neurotransmitters while reducing inflammation. This can enhance mood, overall brain function, and potentially improve behavior in children with ADHD.
For a high-quality, tested omega-3 supplement, consider my Omega Plus formula, which provides 1,600 milligrams of EPA/DHA per serving and includes lipase, a digestive aid to help with absorption.
Vitamin D supplementation is another option that can help alleviate ADHD symptoms, particularly inattention. Exposure to sunlight triggers vitamin D production in the skin; however, indoor lifestyles or lack of sun exposure can necessitate supplementation, which is recommended for many adults. I recommend combining vitamin D3 with vitamin K2 for the greatest hormone-balancing effects.
Hormone Supportive Supplements
Supplements aimed at improving hormonal balance can indirectly support ADHD since ADHD is influenced by a number of reproductive and stress hormones. Supplements to consider taking for help with hormone balance and ADHD include:
- Vitamin B6
- Folate
- DIM
- Sulforaphane (from broccoli seeds)
- Calcium D-glucarate
- Vitex
- Selenium
These nutrients and herbs are all found in my Balance Women's Hormone Support supplement and can help support healthy estrogen, progesterone, and testosterone levels.
One other supplement to mention that can be very helpful for ADHD is Rhodiola, an adaptogenic herb that influences neurotransmitters like dopamine and serotonin, which are crucial for regulating mood, attention, and cognitive function. By modulating these neurotransmitter levels9, Rhodiola can potentially enhance focus, attention span, and mental clarity, making it easier for individuals with ADHD to manage tasks and maintain productivity.
Additionally, its adaptogenic properties help the body cope with stress more effectively, potentially reducing the emotional dysregulation often associated with ADHD.
Supplement needs during perimenopause and menopause can differ and should be tailored with guidance from your provider. If you're in these life stages, discuss specific treatment options with your provider to determine which combination will be most helpful.
Medication Options for ADHD
While natural approaches are usually helpful for those with ADHD, medications can also play a role in coping with symptoms. Medications used to treat ADHD often target neurotransmitters to help increase dopamine and norepinephrine levels in the brain, helping to improve attention, focus, and impulse control.
Other non-stimulant medications also work by affecting neurotransmitter levels or how they are processed in the brain, providing alternative treatment options for managing ADHD symptoms.
- Stimulant Medications: These include methylphenidate (like Ritalin) and amphetamines (like Adderall), which are commonly prescribed to improve concentration and executive function.
- Non-Stimulant Medications: These include atomoxetine (Strattera) and guanfacine (Intuniv), which target different neurotransmitters to alleviate symptoms while minimizing potential side effects associated with stimulant use.
Why Are Rates of ADHD Among Women Increasing?
The recognition and diagnosis of ADHD in women have increased in recent years. For example, from 2020 to 2022, the number of women in their 20s through 40s who received an ADHD diagnosis nearly doubled10.
The rise of ADHD among women reflects a better understanding of different ADHD presentations beyond the stereotypical male profile, which includes hyperactivity and impulsivity.
Experts believe that factors contributing to rising ADHD rates among women include:
- Improved testing and diagnostic criteria
- Increased awareness among healthcare providers
- Societal shifts in recognizing ADHD symptoms in girls and women
The rising diagnosis of ADHD among women highlights the importance for providers to grasp its unique impact on women so they can get the support they need to improve their coping skills and quality of life.
How is ADHD Diagnosed in Women
To receive the diagnosis of ADHD you must meet five or more of the nine major criteria for inattentive and/or hyperactive ADHD as defined by the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). These issues are present the majority of the time and have been present for at least 6 months. They include:
| Symptoms of Inattention | Symptoms of Hyperactivity/Impulsivity |
| Makes careless mistakes with work, school, or other activities. Lacks attention to detail. | Fidgets, taps foot, shakes leg, and otherwise unable to sit still. |
| Often finds it difficult to maintain attention on tasks or activities. | Gets up from seated position often, even when the expectation is to remain seated. |
| Appears not to listen when spoken to. | Feels internally restless. As a child, may have run or began climbing during inappropriate times. |
| Difficulty organizing tasks, projects, or activities. | Difficulty playing or relaxing quietly. |
| Often avoids activities they dislike or find boring, especially those that require long periods of focus. | Talks excessively. |
| Difficulty following through and completing tasks. | Constantly on the move, more active than others. |
| Often losing items, including those needed to complete a task. | Often interrupts or answers questions before they are finished being asked. |
| Easily distracted. | Finds it difficult to wait their turn. |
| Difficulty remembering or appearing forgetful. | Interrupts or inserts oneself into conversations or activities. |
A psychologist or psychiatrist can diagnose ADHD in both children and adults. A diagnosis usually involves a questionnaire, discussion of symptoms, and evaluation of risk factors like family history. They will also evaluate if:
- Symptoms are present in multiple settings
- Whether the symptoms interfere with or reduce the quality of someone’s social, academic, or work life.
- If symptoms were present before age 12.
Meeting with a qualified mental health provider is important as they can help rule out additional conditions that could explain symptoms.
There aren’t any lab or medical tests that are used to diagnose ADHD, although if you suspect you have ADHD, telling your provider about all of your symptoms and existing health issues can be useful for them to know.
Underlying Causes of ADHD in Women
ADHD is believed to be influenced by a number of factors, including genetics, upbringing, environmental factors, and hormonal fluctuations. Causes of ADHD in women can include:
Genetics
Research indicates a strong hereditary component in ADHD, with women often inheriting the condition from parents or relatives. Genetics are thought to play as much as 60% to 70%11 of a role in causing ADHD, according to some research.
Hormonal Influences
Estrogen and progesterone fluctuations throughout the menstrual cycle can impact ADHD symptoms. This explains why there's a connection between PMDD12 (premenstrual dysphoric disorder, which causes intense symptoms before the start of a woman's period) and ADHD.
Research has found that women with ADHD tend to experience more severe symptoms13 of hormone-related mood disorders than women without ADHD.
Changes in hormone levels during puberty, pregnancy, and menopause can also exacerbate ADHD symptoms14, particularly affecting executive function (such as focus, learning, and memory) and emotional regulation.
Neurotransmitter Dysregulation
Dopamine and norepinephrine are two key neurotransmitters involved in ADHD.
Dopamine, known as the “feel-good” neurotransmitter, regulates reward and pleasure centers in the brain, influencing attention, motivation, and movement control. Norepinephrine, a stress hormone and neurotransmitter, helps maintain alertness and focus.
In people with ADHD, there is often dysregulation or imbalance in these neurotransmitter systems. Lower levels of dopamine can lead to difficulties in sustaining attention, impaired impulse control, and reduced motivation, while low norepinephrine can contribute to problems with executive functions such as planning, organization, and emotional regulation.
Key Takeaways on ADHD Symptoms, Causes, and Treatments in Women
- ADHD manifests differently in women compared to men, often presenting with less hyperactivity and more internalized symptoms such as inattention, emotional dysregulation, and social challenges.
- Hormonal influences, including fluctuations in estrogen and progesterone throughout the menstrual cycle, can exacerbate ADHD symptoms in women. ADHD is often connected to PMS and PMDD due to these hormonal effects.
- Treatment options for ADHD in women include lifestyle changes like diet, sleep, and exercise, supplements such as omega-3s and vitamin D, behavioral therapies, and medications tailored to individual needs.
- Understanding the unique impact of ADHD on women helps healthcare providers offer targeted support and improve quality of life with help from strategies like supplements, therapy, diet, sleep, and medications.
References
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8385721/ ↩︎
- https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-020-02707-9#Sec3 ↩︎
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9616454/ ↩︎
- https://journals.sagepub.com/doi/10.1177/10870547231161533 ↩︎
- https://www.apa.org/monitor/feb03/adhd ↩︎
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9616454/ ↩︎
- https://journals.sagepub.com/doi/10.1177/10870547231161533 ↩︎
- https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-020-02707-9#Sec3 ↩︎
- https://www.mdpi.com/2076-3921/12/8/1603 ↩︎
- https://www.nationalgeographic.com/premium/article/women-diagnosed-adhd-historic-rates ↩︎
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9616454/ ↩︎
- https://www.additudemag.com/pmdd-pms-adhd-women/ ↩︎
- https://www.sciencedirect.com/science/article/abs/pii/S0022395620311134? ↩︎
- https://www.additudemag.com/add-and-menopause-how-hormones-affect-adhd-symptoms/ ↩︎
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