Sex Hormones in Women Impact ADHD Symptoms, Medication Efficacy: Study

May 27, 2025ADHD symptoms are impacted by changes in sex hormone levels in females across the lifespan, finds a new systematic review published in the Journal of Attention Disorders.1 The review included 11 studies that investigated puberty, pregnancy, postpartum, and the menstrual cycle and tracked changes in symptomology and in the efficacy of ADHD medication during these times.“There is an ADHD experience that is unique to females,” the study’s authors concluded. “Recognizing potential influences of sex hormones on ADHD symptoms in females may have key implications to clinical management and treatment of ADHD.”The study included several key findings.The research reviewed four studies that explored the fluctuation of ADHD symptoms during the menstrual cycle.

The following associations were identified:Linking these symptom trends to increase and decrease of specific female hormones, the authors wrote: “Inattention symptoms may be related to decreasing estrogen and moderated by progesterone, whereas hyperactive/impulsivity symptoms may similarly be driven by reducing estrogen levels, though without effect of progesterone.” 5These significant shifts in symptom severity were vividly described by Chloe, an ADDitude reader, in an article titled “Menstrual Cycle Phases and ADHD.” “The entire week leading up to my period is where my ADHD symptoms get even more intrusive than usual,” she wrote. “My executive functioning dips even lower, distractibility and difficulty focusing is increased, and my mood/energy level is much lower, causing me to feel badly about all the things I’m not being successful at that week.”The review found that increasing stimulant dosage premenstrually resulted in improvement of ADHD and mood symptoms,.