ADHD in Women

What is ADHD in women?

Attention-deficit/hyperactivity disorder (ADHD) is a condition that affects how different brain areas develop and work together. ADHD starts in childhood, but many people don’t get this diagnosis until they’re teenagers or adults.

The condition is more likely to affect people differently depending on sex. Research shows ADHD rates are higher in men and people assigned male at birth (AMAB). However, there’s evidence that there are more women and people assigned female at birth (AFAB) with ADHD than previously thought.

Which ADHD symptoms are women most likely to experience?

The symptoms of ADHD revolve around an issue called executive dysfunction. Executive functions help you manage focus, concentration, emotional regulation, impulse control and self-motivation.

There are three subtypes of ADHD: inattentive, hyperactive/impulsive and mixed. The subtype depends on which symptoms you have. The inattentive and hyperactive/impulsive subtypes each have nine possible symptoms. To have a subtype, you must have at least six of its symptoms for at least six months. The mixed subtype requires six symptoms from each subtype (meaning a minimum of 12 total symptoms) lasting more than six months.

Women aren’t as likely to have hyperactive/impulsive symptoms. That means they’re less likely to have the hyperactive/impulsive or mixed subtypes.

Inattentive-type symptoms

Inattentive-type symptoms can disrupt work or schoolwork and social relationships. To have the inattention subtype of ADHD, you must meet at least six of the following criteria for at least six months.

• You’re prone to making errors because of inattention.
• You have trouble staying focused and on-task.
• You often seem like you’re not paying attention when others talk (you “zone out” or have what’s known as a “thousand-yard stare”).
• You can start projects easily but have trouble following through and completing them.
• You have difficulty organizing and setting priorities (especially with projects or tasks that involve multiple steps).
• You dislike or avoid boring or tedious tasks, such as busy work, chores or paperwork.
• You’re prone to losing, misplacing or forgetting things.
• You’re easily distracted by what’s happening around you or by your own thoughts.
• You’re forgetful or absentminded in your daily routine and may forget appointments, to pay your bills, etc.

Hyperactive/impulsive-type symptoms

Hyperactive/impulsive-type symptoms can disrupt your relationships, work, schoolwork habits and more. Women are less likely to have these symptoms, but they’re still possible.

To have hyperactive/impulsive subtype of ADHD, you must have at least six of the following, lasting over six months.

• You fidget often.
• You frequently need to stand up and walk around.
• You often feel restless.
• You have trouble staying quiet, and you talk to yourself or say nonsensical phrases or sounds (sometimes, without thinking about or intending to).
• You are unusually active, and people have trouble keeping up with you.
• You find yourself talking excessively (this can look like over-explaining yourself or “info-dumping,” an informal term for talking at length about something you enjoy).
• You have conversational self-restraint problems (you frequently interrupt people or finish their sentences).
• You have trouble being patient and waiting your turn.
• You don’t always understand social boundaries (you may interrupt or intrude on others without realizing that others may find this behavior rude).

How common is ADHD in women?

The estimates for how ADHD affects people based on their sex vary. According to most estimates, the male-to-female* ratio is 2 to1 during childhood. However, some studies estimate that the ratio is as high as 17 to 1. In adulthood, the rates become much more similar because women are more likely to receive this diagnosis as adults.

While research confirms that the condition is more common in boys and men, there’s also evidence that it commonly goes undiagnosed in women. Researchers suspect multiple factors contribute to this disparity.

ADHD in women may be underdiagnosed for a few reasons:

• Symptom types: Hyperactive/impulsive-type symptoms, which are more common in boys and men, are usually easier to notice. That makes it more likely that boys and men will draw attention that leads to a diagnosis.
• Bias: Because ADHD is more common in men and boys, healthcare providers and educators may not look for the symptoms in women. That can make it harder for women to receive a correct diagnosis and treatment.
• Less available ADHD research in women: Early ADHD research mainly focused on the condition’s effects in boys and men/people AMAB. That’s why ADHD research specific to women is years behind.
• Criteria flaws: Some experts argue that the writing of the current criteria is less helpful or accurate for diagnosing women.
• Stereotypes about sex, gender and behavior: ADHD-linked behaviors — especially hyperactive/impulsive symptoms — are often considered more socially acceptable for boys and men. As a result, women may suppress or hide ADHD behaviors to fit in better.

*Note: Research studies don’t all use the terminology the same way. Some use male/female to refer to sex, while others use those same terms to refer to gender. To reduce confusion, “male” here refers to boys and men/people AMAB, and “female” here refers to women/people AFAB. These terms are all meant the same way, explained above, throughout this article.

What causes ADHD in women?

Experts don’t fully understand why or how ADHD happens to anyone. However, they do know ADHD has a strong genetic link. That means your chance of having ADHD is higher if at least one of your parents has it. If you have ADHD, your children are also more likely to develop it.

People who have ADHD are neurodivergent. That means their brains develop and work differently than people who are neurotypical (which means their brains developed and work as expected).

Researchers are continuing to look for an explanation of why and how brain development differences cause ADHD. There’s evidence that it may involve differences in brain structure, chemistry or both. Researchers also suspect that sex-based hormones or characteristics may affect ADHD and its symptoms. That might be why certain symptoms are more likely in boys and men.

How is ADHD diagnosed?

A healthcare provider — usually a psychologist or psychiatrist — can diagnose ADHD in you or your child. This process typically involves asking questions about current and past symptoms. Providers also use special questionnaires designed to help diagnose ADHD. There aren’t any lab or medical tests that can help with diagnosing ADHD.

How is ADHD treated, and is there a cure?

ADHD isn’t curable, but it is treatable. Medications are a key form of treatment. Different types of psychotherapy are also very common. Therapy approaches can help children and adults with ADHD learn how to adapt to or cope with the effects of this condition. Therapy can also help with other mental health conditions, such as anxiety or depression, which happen commonly along with ADHD.

What medications or treatments are used?

There are a few different types of medications that can treat ADHD. These tend to be medications that affect the levels of certain neurotransmitters, which are chemicals your brain uses for communication.

• Stimulants. Examples include methylphenidate (Ritalin®), dextroamphetamine/amphetamine salts (Adderall®) and lisdexamfetamine (Vyvanse®). Many of these come in multiple forms, allowing for shorter or longer times when the medication is active.
• Non-stimulants. Examples include atomoxetine (Strattera®), viloxazine (Qelbree®), clonidine (Kapvay®) and guanfacine (Intuniv®).
• Antidepressants. Examples include bupropion (Wellbutrin®), desipramine (Norpramin®), imipramine (Tofranil®) and nortriptyline (Pamelor™).

What are the possible complications or side effects of the treatment?

The possible complications and side effects from ADHD medications depend on many factors, especially which medication(s) you take. Your healthcare provider is the best person to tell you more about the side effects or complications you may experience and what you can do about them.

One side effect you may want to watch for with stimulant medications is reduced appetite. It’s common for these medications to make you feel less hungry, which can be a concern when a person also has an eating disorder. Eating disorders are also more common in women than they are in boys and men. If you notice or have concerns about this side effect, you should talk to your child’s pediatrician or your healthcare provider.

Is it possible to reduce the risk of developing ADHD or prevent it altogether?

ADHD happens unpredictably and for reasons that experts still don’t fully understand. Because of that, it’s impossible to prevent it or reduce your risk of developing it.

What can I expect if I have this condition?

ADHD isn’t a dangerous condition, but it can affect many parts of your life, including school and work, relationships and more.

Women with ADHD have higher risks of:

• Being a target of bullying (both in-person and cyberbullying).
• Emotional control issues, especially rejection sensitive dysphoria.
• Learning-related difficulties, such as dyslexia and dyscalculia.
• Physical symptoms related to mental health, such as headaches, stomachaches, fatigue, trouble sleeping, etc.
• Related mental health conditions like anxiety and depression.
• Self-injury behaviors, such as cutting, nail-biting, skin-picking, etc.
• Trouble forming and maintaining friendships and relationships (women commonly “mask” the symptoms of ADHD to better fit in).

How long does ADHD last?

ADHD is a condition you develop during childhood, almost always before age 12. ADHD is technically a lifelong condition. People who “outgrow” it usually still have some symptoms, but the symptoms eventually aren’t severe enough to meet the criteria for diagnosis.

Women are less likely to outgrow ADHD. About 60% of women have ADHD that continues into adulthood, compared with about 30% of men.

What’s the outlook for this condition?

With treatment and practice, it’s also possible to harness the effects of this condition and turn them into advantages. The links between ADHD and creativity, problem-solving and stronger memory abilities are well-recognized by experts and researchers. Many major corporations specifically seek to hire neurodiverse individuals, including those with ADHD, because the effects of the conditions are advantages for certain types of careers.

Each person's ADHD is as unique as they are. Many people live with ADHD without a diagnosis or treatment for most of their lives. While it's possible to adapt to it — and even to harness it and turn many of its symptoms into strengths — this condition often makes life more difficult for people who have it.

How do I take care of myself?

If you suspect you or your child have ADHD, a good place to begin asking for help is your primary care provider or your child’s pediatrician. They can refer you to a specialist with training and experience in diagnosing and treating ADHD.

If a specialist provider diagnoses you with ADHD, they can also give you guidance and recommendations on treatment options. Some of the best things you can do to help yourself along the way include:

• Take medications as recommended. You should always take medications that treat ADHD exactly as prescribed. Doing so helps prevent unpleasant or unwanted side effects from the various types of medications.
• See your provider(s) as recommended. Depending on the laws where you live, a healthcare provider may only be able to prescribe certain medications to you if you see them regularly. You should also regularly see your provider(s) for therapy sessions or other visits as recommended.
• Find what works for you. In addition to finding treatment strategies that work for you, there are also ways you can adapt your life to manage your ADHD. Developing routines and habits and using technology — such as ADHD-assisting smartphone apps — can also help.
• Don’t be afraid to ask for accommodations. These are policy changes or adjustments to your work/study environment that help you better manage your ADHD. Many places have laws (depending on where you live) that require employers or educational institutions to provide accommodations. Your healthcare provider can help you learn more about accommodations that might help you or direct you to resources that can assist you.

It’s important to remember that there’s no perfect way to manage ADHD. Some people may benefit from medication, therapy or a combination of the two. What works for one person may or may not work for you or your child. The timeline for you or your child to see results can vary, too. It’s also important to find what works for you and your child and take advantage of what you discover as best as you can.

Are women more likely to have the inattentive subtype of ADHD?

A common misconception is that women are more likely to have inattentive-type symptoms or receive a diagnosis of the inattentive type of ADHD. However, several studies show that’s not the case.

Instead, women have the same rates of inattentive-type symptoms as boys and men, but are less likely to have hyperactive/impulsive-type symptoms. That means women are just as likely as boys and men to have inattentive-type ADHD, but are less likely to have hyperactive/impulsive-type and mixed-type ADHD.

A note from Cleveland Clinic

Women and people assigned female at birth (AFAB) with ADHD are more likely to go undiagnosed or get a misdiagnosis, which can cause frustration or powerlessness. It’s important to know that ADHD is a condition that affects the way your brain works. That means the difficulties it causes are because of a medical condition, not a personality or character flaw.

If you suspect you or your child have ADHD, it’s important to talk to a healthcare provider who specializes in diagnosing and treating this condition. Together, you can develop a treatment plan to manage ADHD symptoms, so you can find a way to turn what makes you different into a strength.

NOTE: This article is about how ADHD affects women and people assigned female at birth (AFAB) regardless of affirmed gender identity. This piece refers to women using the terms “girls” (for those under 18) and “women” (for those over 18). That’s so this article is easier to read and understand. This article also refers to men and people assigned male (AMAB) at birth as “boys” (for those under 18) and “men” (for those over 18) for the same reason.