Research suggests there may be a systemic underdiagnosis of ADHD in women
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A world first study of ADHD in women across their lifespan has found there may be systemic misdiagnosis and underdiagnosis of females, rather than a male disposition to ADHD.
More than 70 per cent of those surveyed said their ADHD symptoms worsened after having a baby and almost all women (97 per cent) said that their symptoms were exacerbated during menopause. Eighty-eight per cent of women surveyed reported changes in their ADHD symptoms during their menstrual cycle, particularly in the latter two weeks of the cycle as the body prepares for pregnancy (luteal phase).
ADHD in women is largely under-reported, and this is the first study to look at the hormonal impacts across the lifespan on women’s ADHD symptoms.
The study, led by Associate Professor Caroline Gurvich and her PhD student, Elyssa Osianlis from the HER Centre Australia at the Monash School of Translational Medicine and published in the Journal of Psychiatric Research, involved an online survey of 600 women between June and November 2023. The participants had been previously diagnosed with ADHD and experienced ADHD symptoms including inattention and/or hyperactivity/impulsivity. Importantly participants were also asked about perceived symptom changes at different hormonal life stages.
According to Ms Osianlis, people with ADHD can commonly experience impacts to functioning and quality of life; previous evidence suggests this may include academic failure or underachievement, difficulty maintaining employment or progressing, psychological effects including low self-esteem, social difficulties, and co-occurring conditions such as depression, anxiety, PTSD and substance use disorders. And more boys and men are diagnosed than women and girls. “ADHD is still largely considered a childhood disorder, however there is growing evidence of symptomatic ADHD in adulthood,” she said.
“Diagnostic rates are higher amongst boys than girls, occurring at a 2:1 ratio in childhood, though this margin lessens in adulthood to a 1.6:1 ratio in men compared to women. It’s thought this sex-based disparity in ADHD prevalence rates may reflect misdiagnosis and underdiagnosis of females, rather than a male disposition to ADHD.”
Associate Professor Gurvich added that many women are describing ADHD-like presentations around their menopause transition years. This is often associated with longstanding depression and anxiety. For some women, this could be related to a lack of recognition of ADHD outside of the male centric model.”
“These sex-based differences in ADHD could also suggest an influence of sex hormones, and there is growing recognition that ADHD symptoms may affect females differently throughout their lives during periods of hormonal fluctuations, as we have shown in this study.”
About Monash University
Monash University is Australia’s largest university with more than 80,000 students. In the 60 years since its foundation, it has developed a reputation for world-leading high-impact research, quality teaching, and inspiring innovation.
With four campuses in Australia and a presence in Malaysia, China, India, Indonesia and Italy, it is one of the most internationalised Australian universities.
As a leading international medical research university with the largest medical faculty in Australia and integration with leading Australian teaching hospitals, we consistently rank in the top 50 universities worldwide for clinical, pre-clinical and health sciences.
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