Attention Deficit Hyperactivity Disorder is a fairly common diagnosis in the United States. As of 2025, about 11% of children and adolescents and 6% of adults have a diagnosis of ADHD. ADHD diagnoses are more common in boys and men than in girls and women. Some providers suspect that this could be due to a difference in presentation and reported symptoms.
Related CE course for nurses: Women with ADHD: Clinical Insights and Effective Interventions
Guidelines for ADHD diagnosis
According to the National Institute of Mental Health, ADHD is a developmental disorder where a person has a pattern of inattention to tasks, hyperactivity, or an inability to stay still at appropriate times, and impulsivity. These symptoms can be mild or severe, depending on the person, and may have a major impact on a person’s ability to learn, focus on work, or even form relationships.
There is no single test that can give a definitive diagnosis of ADHD. Healthcare providers will use a variety of tools, including clinical evaluation, patient report of symptoms, how much symptoms interfere with functioning and relationships, and the DSM-5 criteria.
To be diagnosed with ADHD, symptoms must persist for at least 6 months, be developmentally inappropriate, and interfere with daily functioning. In addition, symptoms cannot be explained by another disorder, such as a mood disorder, anxiety, or depression.
Specific symptoms of women with ADHD
While many ADHD symptoms are shared between men and women, women with ADHD most often report the following symptoms:
- Disorganization
- Forgetfulness
- Difficulty with time management
- Losing things
- Distraction
- Trouble with tasks requiring sustained focus
- Excessive talking
- Restlessness
- Impulsive spending
- Risk-taking
- Emotional dysregulation
- Irritability and sensitivity
- Extreme response to rejection
- Co-occurring anxiety and depressive disorders
- Low self-esteem
- Hyperfocus
In general, women tend to report more inattentive problems and fewer hyperactivity symptoms of ADHD. Because symptoms in women with ADHD tend to be less disruptive than those in men, they are usually diagnosed later in life.
Cognitive overload vs ADHD
Cognitive overload is a pervasive problem in women and can be misinterpreted as ADHD. In cognitive overload, the brain is given too much information or has too many tasks to focus on at once. When this happens, people tend to shut down and stop focusing on anything at all. It can also lead to impulsivity, distraction, and an inability to make a decision, all of which can also be symptoms of ADHD.
Perimenopause is a major contributor to cognitive overload. An article published in Current Psychology Reports explains that women in perimenopause often struggle with verbal learning and memory. In fact, nearly 50% of women in perimenopause or post-menopause report difficulties remembering where they placed important items, what people told them, and things they had recently learned.
Hormonal fluctuations and symptoms
Hormonal fluctuations can play a major role in how symptoms of ADHD manifest. The drop in estrogen and dopamine in the week preceding menstruation can make impulsivity, forgetfulness, and emotional outbursts more severe.
Because of this, women with ADHD are at a higher risk of suffering from premenstrual dysphoric disorder (PMDD), a severe form of premenstrual syndrome. Some research shows that a diet high in fruits and vegetables, moderate exercise, and sunshine may help to lessen symptoms of ADHD and PMDD.
Related podcast for nurses: ADHD in Females: Misunderstood Symptoms & Delayed Diagnosis
Screening tools specific to women with ADHD
Many women do not receive a diagnosis of ADHD until later in life. Because of this, it is important that screening tools ask questions about a woman’s childhood to get an accurate diagnosis. Many adult women with ADHD overcompensate and become overachieving later in life, and can be misdiagnosed as having depression or anxiety due to their ability to function or even over-function at home, at work, and in relationships.
While most medical doctors and clinicians do not use screening tools specific to women wondering if they may have ADHD, there are many free online tests that women can take to point them in the right direction.
Treatment and management of ADHD symptoms
Getting a diagnosis of ADHD is just the first step toward a less stressful, more organized life for patients with attention deficit or hyperactivity symptoms. The most successful treatment for ADHD often combines medication with behavioral therapy.
Women may also need to track symptoms along with their menstrual cycle, and changing birth control methods or adding hormone replacement therapy can be added to first-line treatments for severe ADHD.
Therapy
Therapeutic strategies for attention deficit hyperactivity disorder typically focus on managing impulsivity and changing negative thought patterns. Managing impulsivity may look like delaying big decisions for 24 hours, counting to 30 before responding to someone in a heated argument, or using self-reflective questions such as, “Will this hurt me or someone else in the future?” These strategies are often effective.
Cognitive-behavioral therapy is the most commonly used method in the management of ADHD. This method teaches patients to stop negative thought cycles, manage impulsivity, and improve their self-esteem.
Medication
Stimulants are the first-line medications for the treatment of ADHD. These can include one of two categories:
- Methylphenidate-based drugs can include short-acting and long-acting forms, such as Ritalin (short-acting) and Concerta (long-acting)
- Amphetamine-based drugs that include short and long-acting options such as Adderall (short and long-acting) and Vyvanse (long-acting)
If stimulant medications are ineffective, non-stimulant medications can be used. These are usually used to help with sleeplessness and aggression associated with ADHD and include clonidine, Guenfacine, and Atomoxetine.
