In recent years, there has been growing awareness of how ADHD uniquely affects women across their lifespan, particularly due to hormonal fluctuations and related health conditions – but much more research is needed.
Our latest webinar, broadcasted Wednesday 30th October, was hosted by our expert clinical advisors Jess Brunet (UK), Penny Lazell (UK), and Corina Weir (US). Exploring these complexities, our team members with clinical experience and education, shed light on how ADHD manifests differently in women and the urgent need for tailored approaches to diagnosis and management.
Hormonal changes and medication management
"I can distinctly remember having a cohort of young women who really struggled with their premenstrual period," Jess explained. During this phase, the effectiveness of medication appeared to diminish, leading to increased risk behaviors such as self-harm and suicidal thoughts.
To manage this, Jess found herself needing to adjust medication dosages based on her patient’s menstrual cycles. Some young people ended up in much more risk during that period or experienced extreme emotional lability. This aligns with emerging research suggesting that women with ADHD are more likely to suffer from hormone related mood disorders.
Addressing gaps in research
Corina noted that there are a couple of studies, though small in scale, showing that women with ADHD are more likely to experience premenstrual dysphoric disorder (PMDD), depression, and anxiety as hormonal changes through a woman’s cycle can alter her ADHD symptoms.
In a study led by the Jong et al (2023) which was shared from their clinical experience that some women reported self-managing these changes by increasing their own medication dosages, often without professional guidance because they felt they needed more stimulant medication at certain times.
Corina also pointed out that large elements of the current diagnostic criteria and rating scales are based on research that is carried out primarily on children and boys, which can lead to missed or misdiagnosed cases in women.
Using data from the Swedish birth register, a study found that for women diagnosed with ADHD before pregnancy, at one year postpartum, approximately 17% were diagnosed with depression disorders and 25% with anxiety disorders, compared to just 3-5% respectively in women without ADHD.
Perimenopause and late diagnosis
Penny highlighted how hormonal shifts during perimenopause can trigger ADHD symptoms that have long been masked or misunderstood, often resulting in a late diagnosis. This is because a reduction in estrogen after giving birth or during menopause can worsen symptoms.
For example, many women in their late 40s or early 50s suddenly find themselves grappling with brain fog, memory issues, and an overwhelming sense of executive dysfunction.