Adderall is a controlled stimulant used to treat attention-deficit/hyperactivity disorder (ADHD). As it has misuse/abuse potential, it should be used with caution. While research on the effects of stimulants on menstruation, fertility issues, and breastfeeding is limited, there are general recommendations females taking stimulants should be aware of.
*The use of females or males in this article refers to the sex assigned at birth of the individual
What Is Adderall & What Is It Used For?
Adderall is a stimulant controlled by the DEA due to its abuse/misuse potential. It can be prescribed by your primary care physician for the treatment of ADHD symptoms. It increases the release of neurotransmitters and decreases their reuptake in the brain.1 Adderall comes in immediate release (lasts 3-4 hours) and extended release (lasts up to 12 hours.)1
Adderall Misuse
Roughly 20% of college students abuse stimulant medications to boost their academic performance.1 76% of college students who use stimulants without a prescription believe it positively affects their grades, although studies show negative effects with non-prescription use. Males are more likely to use non-prescription stimulants vs. females.2
Abuse/misuse of stimulant medication is also a growing concern in patients with eating disorders and users who want to lose weight.3
Severe Side Effects
Stimulant medications come with many potential side effects, including risk of abuse/misuse as well as addiction. They can put a significant burden on cardiac tissues and result in heart attacks, arrhythmias, and palpitations.1 They can also cause nausea, vomiting, and decreased appetite resulting in weight loss.1 While stimulant use for patients that have ADHD is FDA-approved, patients should be aware.
Why Does Adderall Affect Females Differently?
Adderall’s effects on females have been poorly studied; however, there are studies that show the possible effects of stimulants on menstruation. During the estrogen predominant phase of the menstrual cycle, the follicular phase, the effects of stimulants may be more pronounced.4 Females report feeling more euphoric, energetic, and intellectually efficient.4
Females do not report this feeling during the combined progesterone and estrogen phase, the luteal phase. This suggests that estrogen may have an enhancing effect while progesterone may have a masking effect on stimulants. It’s important to note that there are no guidelines suggesting that females increase or decrease their dose of stimulants due to this effect.
More research is needed to understand if Adderall does affect females differently.
Adderall Side Effects in Females
It’s important to know that patients react differently to medications from person to person. One study found that females report more side effects of decreased appetite and anxiety. Female patients also had more incidence of headaches, nausea, and dizziness.3 Similarly, studies found that females have more adverse reactions in general compared to males. This may be due to differences in metabolism, weight, or body fat percentage. However, more research is needed to know if Adderall does cause different side effects in females.
It is important that all patients carefully monitor their adverse effects and report them to their doctor.
Adderall side effects include:
- Nausea
- Headaches
- Dizziness
- Decreased appetite
- Anxiety
Other common side effects of Adderall include:
- Weight loss
- Abuse/misuse
- Addiction
- Sexual dysfunction
- Palpitations
Severe side effects of Adderall that require immediate attention include:
- Palpitations or chest pain
- Very high blood pressure
- Serotonin syndrome (seizures, tremors, sweating)
Can Adderall Affect Your Period?
Stimulant medications may affect parts of the menstrual cycle differently. Menstrual cycles are broken down into follicular (estrogen) phase and a luteal (estrogen + progesterone) phase. Studies have suggested that amphetamine medication such as stimulants may have a greater effect during the follicular phase vs. the luteal phase. Patients have reported having a more energetic and euphoric response to stimulant medications during this phase.4
However, there are no guidelines suggesting that patients decrease or increase their dosage of stimulants in different parts of their menstrual cycle and more research is needed to understand if Adderall does affect the menstrual cycle. If Adderall is affecting your menstrual cycle, speak to your doctor about different treatment options.
Impacts of Adderall on Sex Life
Although there is little research on female libido and stimulant use, there is an established connection between ADHD and sex. Studies show that stimulants can decrease libido in both males and females; however, the exact cause is unknown. Stimulants can affect libido even in smaller doses.7,8 In males, Adderall has been linked to erectile dysfunction, the inability to orgasm, or even premature ejaculation.9
As a decrease in libido can impact a relationship, it is important to talk to your partner(s). It should also be brought up to your prescribing doctor. If it affects your quality of life, it may be worth it to switch to a different ADHD medication. Sex counseling and sex hygiene are also recommended during this time.
Adderall & Pregnancy
The effects of Adderall on fertility issues and pregnancy are poorly understood. There are currently no recommendations stating that patients who want to become pregnant should stop taking stimulant medications. Some studies show a small increased risk of preeclampsia and preterm delivery.5 There was also a small increase in placental abruption for females taking stimulants in the second trimester, but the clinical significance is unknown and more research is needed.5
For patients that have moderate to severe ADHD, it is unknown if not taking stimulant medication during pregnancy could cause more harm than good. Every patient with ADHD is different and it is important to talk to your doctor about any specific concerns you have.
Adderall & Breastfeeding
Adderall during breastfeeding is generally considered safe. While patients that abuse/misuse their Adderall should stop breastfeeding, patients that take it as prescribed should not be concerned. While Adderall can be passed into breast milk, studies don’t show any adverse neonatal effects.5 If there’s still concern, patients should speak to their primary care provider and see if other medical options would be better for them.
Abusing Adderall for Weight Loss
Adderall misuse has increased over the years, especially in young adults. This can be due to a multitude of reasons, one being weight control. One study looked at patients that did and did not use stimulants for weight control in order to find key similarities. In this study, females were more likely to try stimulants for weight loss.6
The study also showed that patients who used stimulants to lose weight were more likely to have a history of dieting, poor self-esteem, stress related eating tendencies, and unhealthy eating habits.6
Another study showed that patients who misused stimulants for weight loss were at risk for using other medications for weight loss as well (diuretics/laxatives).7 While Adderall can be used for the treatment of ADHD, misuse is a growing concern that comes with significant and dangerous side effects.
Questions to Ask Your Health Team About Side Effects of Adderall in Females
It is important that all patients taking any prescription medications feel comfortable with their treatment plan. Similarly, patients should understand why they are taking the medication, how the medication works, and side effects they should look out for.
Questions a female should ask their care team about side effects of Adderall include:
- What are the symptoms that the medication should improve?
- What are the common side effects to look out for?
- Should I expect this medication to alter my menstrual cycle?
- Should I expect this medication to have any effect on my fertility?
- Is this medication safe to use while pregnant? Does the benefit outweigh the risks?
- Will this medication have any effect on my breastfeeding?
- What steps should I take if this medication affects my libido?
Final Thoughts
Adderall side effects in females can be different from side effects in males. It is important that patients understand how the medicine affects their ovulation, pregnancy, breastfeeding, and libido. Always consult with your doctor to determine the best medication for you.
For Further Reading
- The Centers for Disease Control (CDC): Use of ADHD Medicine is Increasing Among Pregnant Women
- CDC: Attention-Deficit/Hyperactivity Disorder (ADHD)
- National Institute of Mental Health (NAMI): Attention-Deficit/Hyperactivity Disorder
- Adderall Side Effects in Men: Erectile Dysfunction & Other Sexual Side Effects
