ADHD in women is often misunderstood and underdiagnosed, with many not receiving a diagnosis until adulthood, sometimes during menopause. In the U.S., around 4.2% of women are diagnosed with ADHD, yet the true prevalence may be higher. ADHD symptoms in women often present as inattentive, forgetful, and emotionally unregulated, leading to a condition known as "subclinical ADHD," where symptoms are present but don’t meet full diagnostic criteria. These traits are frequently mistaken for anxiety, depression, or hormonal imbalances, particularly during significant life stages like puberty, pregnancy, and menopause.
Historically, ADHD has been viewed through a predominantly male lens, with boys diagnosed more frequently due to visible hyperactive behaviors. For women, however, this disparity in diagnosis means they often go untreated for years, with symptoms worsening in response to hormonal changes. As a board member of the Endometriosis Foundation of America, I heard countless women share stories about the physical effects of hormonal shifts, yet few discussed the cognitive and mental challenges that often accompany these changes.
Dr. Michael Lewis, MD FACOG FRCSC, a director in the Department of Obstetrics and Gynecology at New York Presbyterian Brooklyn Methodist Hospital (and an investor in Comigo), highlights this issue: “Our challenge as women’s health providers is our lack of awareness of ADHD and its intersection with menopause. Their cognitive issues are being dismissed as a typical part of aging instead of the compounded effects on someone with ADHD. We have ignored the mental health changes that we assumed happened only during pregnancy and the postpartum period.” He adds, “In order to address the gaps in education, healthcare providers need the development of an interdisciplinary approach including both gynecologists and ADHD specialists.”
The Role of Estrogen in ADHD Symptoms
Estrogen plays a critical role in regulating dopamine levels in the brain, a neurotransmitter closely linked to ADHD. As Dr. Daniel R. Leopold, PhD, co-developer of Comigo, explains: “Part of my motivation to co-develop Comigo comes from the executive functioning difficulties I’ve seen the closest women in my life experience around their reproductive and hormonal journeys.” When estrogen levels drop, particularly during menopause, ADHD symptoms such as memory issues, focus difficulties, and a sense of overwhelm can intensify.
How hormone shifts impact ADHD symptoms during key life stages:
- Puberty: Estrogen surges can increase symptoms like emotional volatility.
- Menstrual Cycle: Estrogen drops during the premenstrual phase may worsen symptoms.
- Pregnancy: Rising estrogen in the second trimester may temporarily reduce symptoms.
- Perimenopause/Menopause: As estrogen declines, ADHD symptoms, including memory issues and inattention, often intensify. Many women seek help for brain fog, memory lapses, and inattention for the first time at this stage, but they are frequently misdiagnosed with depression or anxiety instead of ADHD.
What You Can Do:
- Track Symptoms – Monitoring symptom fluctuations can help differentiate between ADHD and hormone-driven changes.
- Advocate for Yourself – If you suspect ADHD or experience new symptoms, pursue a thorough evaluation.
- Consider Hormonal Support – Treatments like HRT may relieve some symptoms, especially during menopause.
- Seek Tools for Support – Apps like Comigo, which offer ADHD-focused productivity and self-regulation tools, can provide valuable support for daily challenges.
Awareness of the interplay between ADHD and hormonal changes is crucial. If you’re experiencing mental health struggles, track changes, seek professional guidance, and advocate for the support you need.
Products I use and find useful:
- Alloy – Delivers medication and care for your menopause journey.
- Perry – A supportive, compassionate perimenopause platform.
- Juna – Natural wellness products designed to help with stress and focus.
- Semaine – Premium Science-Backed Supplements for Women.
- August – Period care for all stages of menstruation.
- Boss Ovary Podcast – Expert insights to empower your best health and longest life.
- Comigo – Productivity & emotional support companion for ADHD.
