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ADHD in Women: Signs, Symptoms, & Treatments

Published: December 14, 2022 Updated: January 5, 2023
Published: 12/14/2022 Updated: 01/05/2023
Headshot of Erica Laub, LGSW
Written by:

Erica Laub

MS, LICSW
Headshot of Benjamin Troy, MD
Reviewed by:

Benjamin Troy

MD
  • What Is ADHD?Definition
  • Causes of ADHDCauses
  • ADHD Symptoms In WomenSymptoms
  • ADHD In Women vs. MenDifference
  • Treatment for ADHD in Adult WomenTreatment
  • Final Thoughts on ADHD in Women Conclusion
  • Additional ResourcesResources
  • ADHD in Women InfographicsInfographics
Headshot of Erica Laub, LGSW
Written by:

Erica Laub

MS, LICSW
Headshot of Benjamin Troy, MD
Reviewed by:

Benjamin Troy

MD

Men and women can have any and/or all symptoms of attention-deficit/hyperactivity disorder (ADHD), but current research, based on self-reports, suggests that women may perceive they struggle more with certain symptoms or areas in life, including inattention, organization, time management, emotional regulation, dating, shame, and more.

Evidence has shown that online therapy can be effective in the treatment of ADHD symptoms. BetterHelp can connect you with a licensed, experienced therapist to help you manage your ADHD symptoms and reduce any negative impact on your life and relationships. Online therapy with BetterHelp starts at $60 per week. Complete a brief questionnaire and get matched with the right therapist for you.

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What Is ADHD?

ADHD is a neurological, mental health disorder in which individuals experience chronic issues with inattention, hyperactivity, and/or impulsivity.1 The onset of attention deficit-hyperactivity disorder (ADHD) is in childhood and symptoms typically persist into adulthood. Those with adult ADHD can experience an impact in their ability to perform in school or at work as well as have difficulty managing social relationships.

For adults struggling with ADHD, the stakes can have a massive impact in all areas in life, including academic, occupational, and social. ADHD is often misdiagnosed or overlooked in childhood. For adults who have never been accurately diagnosed or properly treated for their symptoms, it may feel highly distressing to consistently struggle, all the while thinking their symptoms are “normal.”

Causes of ADHD

ADHD runs in families and is attributed to genetic and environmental factors, but it is typically a result of the combination of the two.2 The newest version of the Diagnostic and Statistical Manual of Mental Health Disorders (DSM-5), the guide to mental health diagnoses, notes that ADHD may or may not include symptoms of hyperactivity and impulsivity and may present as more inattention in some individuals.1

ADHD Symptoms In Women

Men and women can have any and/or all symptoms and signs of adult ADHD, but self-reports suggest that women may perceive they struggle more with certain symptoms or areas in life, including inattention, organization, time management, procrastination, dating, and shame.3

It is important to keep in mind the role that gender bias plays in diagnosing ADHD. The level of impact a mental health condition may have on someone is based on the perception of suffering, either by individuals with such conditions or the professionals diagnosing them, as many women may have found ways to have high functioning ADHD.

Common ADHD symptoms in women include:

  • Inattention: many studies suggest that women struggle with inattentive symptoms of ADHD more often. People who struggle with inattention may feel like they are daydreaming a lot and have difficulty retaining information. Inattention is subtle and easily goes unnoticed in childhood, leading biological females to be diagnosed later in life.3
  • Being overly talkative: ADHD women may present as being “overly talkative” or blurting out responses quickly. This may be a reflection of the mind moving quickly and impulsively before choosing to speak.
  • Difficulty listening: ADHD women who report more difficulty listening may find they struggle in higher education settings and feel they cannot focus or retain information as they want to. They may zone out or feel like they are in a different world.
  • Trouble staying organized: some women report that they have a difficult time managing concrete things, such as finances, or more subjective experiences such as a work life balance. When someone’s bucket feels like it is overflowing, it can feel really distressing and disorienting.
  • Time management issues: with difficulty focusing comes a sense of time blindness or losing track of time. This symptom of ADHD in women may look like being chronically late, likely due to lack of focus and ability to ground and difficulty finishing tasks and managing appointments.
  • Poorer emotional regulation: poor emotional regulation may be due to shifts in hormones and fluctuating moods that appear to be more drastic than men with ADHD. Poor self-esteem also plays a role here, with women getting the sense that they are on display and being judged more critically.
  • Chronic procrastination: due to the symptoms mentioned above, chronic procrastination can be an additional concern. Women struggle to manage their time and emotions, as well as stay organized. This can contribute to feelings of frustration and inadequacy.
  • Difficulty dating: rejection sensitive dysphoria (RSD) is a highly debatable symptom of people with ADHD, and for women in particular. Anyone with ADHD can experience difficulty managing emotions or struggle with the pain of rejection. This is not a diagnosis on its own, but rejection sensitivity in ADHD may look like a more extreme reaction to being teased or feeling like you are a disappointment to your partner, family, or friends.
  • Shame: the cultural expectations prescribed to women can make neuro-typical and atypical women feel like they are failing, not meeting standards, or the opposite of perfect. Since many women report they feel they have to work hard to prove themselves, it can feel defeating to have to battle a neurological disorder on top of managing high expectations of performance.

ADHD In Women vs. Men

When we discuss differences between ADHD in men and women, it’s important to note that there is the biological sex assigned at birth (i.e., boy or girl) and then the gender that an individual chooses to express (female or male, among others). Biologically-born males are diagnosed with ADHD more often than females, with some research suggesting the ratio is as high as 10 to 1.3, 4

With research supporting that women with ADHD typically display more inattention than hyperactivity or impulsivity, their needs are easily missed. It’s common for many adults to be diagnosed with ADHD in adulthood, feeling like they’ve always struggled and didn’t know why. Over time, adults who haven’t received proper treatment may innately normalize their experience (i.e., ADHD masking) and assume by default “it must just be me” or that they can’t keep up.

There is a lot of research that supports the idea that there is gender bias involved in the diagnostic criteria for ADHD, with younger boys being labeled hyperactive for big behaviors and ADHD in girls who are assumed to be emotional, shy or not confident.3, 4, 5, 6, 7

Why Does ADHD Go Unnoticed In Women?

With children and youth, ADHD is more commonly diagnosed in biological males than females.4
Gender bias and expectations certainly play a role in the diagnostic process. For example, it’s believed in the mental health community that women with ADHD tend to demonstrate more inattentive symptoms rather than the impulse/conduct symptoms that are prevalent in males diagnosed with the condition.4, 5

Stephen V. Faraone PhD Headshot“Many people don’t realize that difficulties with inattention and impulse control are often due to disorders that can be treated, says Professor Stephen Faraone. “Those with undiagnosed ADHD will blame themselves for not doing better or not trying hard enough. Indeed, many had been told in childhood that they were ‘lazy.’ This type of stigmatizing communication makes it difficult to get treated. If we add to that the misinformation about ADHD on the Internet, it is no surprise that many women are undiagnosed.”

When looking at comorbidities or the presence of more than one mental health concern, women with ADHD are more likely to be diagnosed with major depression. Depressive symptoms are often treated before considering ADHD.5
With procrastination symptoms in ADHD like distractibility, disorganization, and poor concept of time, one might assume someone is depressed or “lazy,” (i.e., ADHD paralysis)  when in fact, that’s an assumption based on incomplete information.

It’s important to keep in mind that men and women are expected to display behaviors differently, based on culturally created norms.

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Treatment for ADHD in Adult Women

For decades, the first line of treatment or adult ADHD medication has been prescription use of stimulants like ritalin or adderall. There are also other medications, such as non-stimulants or third line antidepressants.

Research supports that women don’t display as many overt, behavioral symptoms that men do and therefore, they don’t have as many referrals for medication treatment.7 Instead, women who internalize may try to overcompensate, want to adapt or meet expectations, and be diagnosed with a mood or personality disorder in return.

Medication for ADHD

Prior to taking ADHD medication, discuss symptoms and medical history with your prescribing doctor to determine whether stimulants vs. non-stimulants are the best choice for you, and discuss any potential medication side effects in females.

Therapy for ADHD

There are many types of therapy that support the treatment of adult ADHD. Cognitive behavioral therapy (CBT) for ADHD is an approach that therapists use to examine the connection between unhelpful thoughts and unwanted behaviors. With CBT, a therapist works with a client with ADHD to examine how much their personal thought patterns impact functioning or ability to complete certain tasks.

Other therapies that may provide skill development include DBT skills work, acceptance and commitment therapy (ACT) values work and general psychoeducation on ADHD. A good therapist will take a validating, understanding approach to your unique symptoms and your desire to make changes.

Finding the Right Therapist

Some therapists do not treat neurodiverse populations, so it is important to consult with a provider and confirm that they’re skilled and experienced in working with someone who has ADHD. You can also see a therapist if you question that you may have ADHD and your symptoms have been overlooked since childhood. A neurodiverse affirming therapist will have special knowledge of different neurotypes and nuances associated with your diagnosis.

How Sex Affects ADHD Treatment

There are many schools of thought on the use of stimulant medication during pregnancy, but many doctors feel stimulant use is relatively safe, especially if the mother has already been on medication. Going off medication can be extremely distressing for expectant mothers, causing stress that may lead to other complications during pregnancy.

There are many studies out there that provide mixed information and no real answer on whether or not medication is actually safe; some providers will advise against use due to fear of birth defects, premature birth, and cardiac issues in newborns, among other concerns. Conversely, some research suggests that overall risk of fetal malformation is extremely low.9

Just like other mental health disorders, hormones play a role in the timing of symptoms and impact medication. During the 3rd or 4th week of the menstrual cycle, some women experience a decrease in medication effectiveness due to hormone fluctuation.9 With some women experiencing more severe premenstrual symptoms, it’s been said that contraceptive use may help regulate or decrease severity of ADHD symptoms in women.9

Final Thoughts on ADHD in Women 

ADHD is difficult to deal with but there are effective treatments. It’s important to have an honest conversation with your therapist and doctor when discussing your personal symptoms and where in life you feel the most impact. It may be worthwhile to ask whether they have experience treating ADHD in women and are aware of diagnostic gender bias.

Additional Resources

Education is just the first step on our path to improved mental health and emotional wellness. To help our readers take the next step in their journey, Choosing Therapy has partnered with leaders in mental health and wellness. Choosing Therapy may be compensated for marketing by the companies mentioned below.

ADHD Management Tools

Inflow App Inflow is the #1 science-based app to help you manage your ADHD. Their support system helps you understand your neurodiverse brain, and build lifelong skills. Free Trial

Virtual Psychiatry

Talkiatry Get help from a real doctor that takes your insurance. Talkiatry offers medication management and online visits with top-rated psychiatrists. Take the online assessment and have your first appointment within a week. Free Assessment

Online Therapy 

BetterHelp Get support and guidance from a licensed therapist. BetterHelp has over 20,000 therapists who provide convenient and affordable online therapy.  Complete a brief questionnaire and get matched with the right therapist for you. Get Started

Choosing Therapy  Directory 

You can search for therapists by specialty, experience, insurance, or price, and location. Find a therapist today

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For Further Reading

  • Attention Deficit Disorder Association (ADDA)
  • American Psychological Association (APA)
  • ADD.Org: ADHD Questionnaire
  • Children and Adults with ADHD (CHADD)
  • Postpartum Support International (PSI)
  • Best ADHD Books

ADHD in Women Infographics

ADHD Symptoms in Women ADHD in Women vs. Men Why Does ADHD Go Unnoticed in Women?Treatment For ADHD in Adult Women

9 sources

Choosing Therapy strives to provide our readers with mental health content that is accurate and actionable. We have high standards for what can be cited within our articles. Acceptable sources include government agencies, universities and colleges, scholarly journals, industry and professional associations, and other high-integrity sources of mental health journalism. Learn more by reviewing our full editorial policy.

  • Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA: American Psychiatric Association, 2013.

  • Cortese, S., & Coghill, D. (2018). Twenty years of research on attention-deficit/hyperactivity disorder (ADHD): looking back, looking forward. Evidence-based mental health, 21(4), 173-176. https://pubmed.ncbi.nlm.nih.gov/30301823/

  • Fedele, D. A., Lefler, E. K., Hartung, C. M., & Canu, W. H. (2012). Sex differences in the manifestation of ADHD in emerging adults. Journal of Attention Disorders, 16(2), 109-117. https://psycnet.apa.org/record/2012-01850-003

  • Mowlem, F. D., Rosenqvist, M. A., Martin, J., Lichtenstein, P., Asherson, P., & Larsson, H. (2019). Sex differences in predicting ADHD clinical diagnosis and pharmacological treatment. European child & adolescent psychiatry, 28(4), 481-489. https://pubmed.ncbi.nlm.nih.gov/30097723/

  • Quinn, P.O. Attention-deficit/hyperactivity disorder and its comorbidities in women and girls: An evolving picture. Curr Psychiatry Rep 10, 419–423 (2008). https://pubmed.ncbi.nlm.nih.gov/18803916/

  • Rucklidge, J. J. (2008). Gender differences in ADHD: implications for psychosocial treatments. Expert Review of Neurotherapeutics, 8(4), 643-655. https://pubmed.ncbi.nlm.nih.gov/18416665/

  • Young et al. (2020). Females with ADHD: An expert consensus statement taking a lifespan approach providing guidance for the identification and treatment of attention-deficit/hyperactivity disorder in girls and women. BMC psychiatry, 20(1), 1-27. https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-020-02707-9

  • Kolding et al (2021). Associations Between ADHD Medication Use in Pregnancy and Severe Malformations Based on Prenatal and Postnatal Diagnoses: A Danish Registry-Based Study. The Journal of clinical psychiatry, 82(1), 20m13458. https://pubmed.ncbi.nlm.nih.gov/33406323/

  • Antoniou et al. (2021). ADHD Symptoms in Females of Childhood, Adolescent, Reproductive and Menopause Period.Materia Socio-Medica, 33(2), 114. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8385721/

     

update history

We regularly update the articles on ChoosingTherapy.com to ensure we continue to reflect scientific consensus on the topics we cover, to incorporate new research into our articles, and to better answer our audience’s questions. When our content undergoes a significant revision, we summarize the changes that were made and the date on which they occurred. We also record the authors and medical reviewers who contributed to previous versions of the article. Read more about our editorial policies here.

  • Originally Published: May 13, 2022
    Original Author: Erica Laub, MSW, LICSW
    Original Reviewer: Benjamin Troy, MD

  • Updated: December 14, 2022
    Author: No Change
    Reviewer: No Change
    Primary Changes: Updated for readability and clarity. Reviewed and added relevant resources.

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Headshot of Erica Laub, LGSW
Written by:

Erica Laub

MS, LICSW
Headshot of Benjamin Troy, MD
Reviewed by:

Benjamin Troy

MD
  • What Is ADHD?Definition
  • Causes of ADHDCauses
  • ADHD Symptoms In WomenSymptoms
  • ADHD In Women vs. MenDifference
  • Treatment for ADHD in Adult WomenTreatment
  • Final Thoughts on ADHD in Women Conclusion
  • Additional ResourcesResources
  • ADHD in Women InfographicsInfographics
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