What to know about ADHD treatment for women

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that results in symptoms of inattention, hyperactivity, and impulsivity. While the disorder is common, symptoms are frequently overlooked in women and girls due to gender biases and often overlooked in adults as well, due to more subtle symptoms. People may go years misdiagnosed, resulting in ADHD causing continued struggles with executive functioning, relationships, and day-to-day life in general.  

Read on to learn about what causes ADHD in women, common ADHD symptoms, and how to treat it.  

What causes ADHD in women?

No matter your gender, there isn’t a single definitive known cause for ADHD.  

However, research points to genetics as a major contributing factor, which means you may be born with a predisposition to ADHD. The disorder has high heritability, ranging from 75% to 91%. So, if one or both of your parents have a diagnosis of ADHD, there’s a higher chance of you having it, too. It’s also likely that other family members may have ADHD.

Other potential risk factors for developing ADHD are:

• If you were exposed to environmental toxins like lead  

• If your mother smoked or drank alcohol during pregnancy

• If you were born prematurely

• Excessive exposure to blue light and internet  

Common ADHD symptoms in women and girls

According to The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (The DSM-5), general ADHD symptoms fall into three categories:  

• Inattention: Difficulty focusing, disorganization, trouble meeting deadlines, distractibility, forgetfulness, avoiding tasks that require sustained focus  

• Hyperactivity: Fidgeting, restlessness, trouble sitting still, talking excessively, always on the go

• Impulsivity: Trouble waiting your turn, interrupting conversations, or blurting out answers  

Based on these symptom groups and how they present in an individual, there are three presentations/types of ADHD:

• Predominantly inattentive presentation

• Predominantly hyperactive-impulsive presentation

• Combined presentation

Generally speaking, ADHD symptoms are the same regardless of gender. However, women and girls are more likely to have a predominantly inattentive presentation than a hyperactive-impulsive presentation or a combined presentation. Unlike hyperactive-impulsive symptoms, which are more noticeable, stereotypical signs of ADHD, inattentive symptoms may go undetected for longer periods, especially in girls. Inattentive symptoms can be misconstrued by family and loved ones as a lack of effort, lack of motivation, or laziness.

Additionally, girls and young women may be more likely to “mask” their ADHD symptoms to try to blend in with others. Both of these factors contribute to a later diagnosis of ADHD, ultimately resulting in delayed treatment. Plus, gender bias can make people write off girls’ ADHD symptoms, such as excessive talking and daydreaming, as personality traits rather than signs of the disorder.  

On top of all these ADHD symptoms, you may struggle with symptoms of other co-occurring conditions. Women with ADHD have higher rates of comorbidities than men do. This means these women are more likely to have a mental health condition on top of ADHD than men are.  

Some mental health struggles that are more likely to occur alongside ADHD are:

• Mood disorders (depression and bipolar disorder)

• Anxiety disorders

• Substance use disorder

• Personality disorders

• Schizophrenia  

• Self-harm

• Suicidal ideation

Do hormones affect symptoms of ADHD?

Although the link between women’s hormones and ADHD is understudied, some research points to fluctuations in estrogen affecting ADHD symptoms. Since estrogen levels rise and fall throughout the menstrual cycle, this means their symptoms can be affected at different times of the month. Researchers have found that low levels of estrogen at the middle of the cycle and end of the cycle can result in increased severity of ADHD symptoms.  

Additionally, since perimenopause and menopause result in falling estrogen levels, this time in adult women’s lives can also lead to worsening ADHD symptoms.

How do you treat ADHD in women?

ADHD treatment options are the same regardless of gender. There are two main approaches to treatment: medication and therapy.

Medication for ADHD

One type of treatment for ADHD is stimulant medication. Stimulants boost dopamine and norepinephrine, which are neurotransmitters that are linked to focus and motivation. By boosting these brain chemicals, you can more easily manage ADHD symptoms and function in your daily life.

Common stimulant medications are:

• Adderall (amphetamine/dextroamphetamine salts)

• Concerta (methylphenidate)

• Ritalin (methylphenidate hydrochloride)

• Vyvanse (lisdexamfetamine)  

Stimulants aren’t for everyone, though. They have a high potential for dependence and misuse, so if you have a history of a substance use disorder, your doctor might advise against stimulants. Additionally, stimulant side effects can be a concern for some. If a stimulant isn’t the best fit for you, you can try a non-stimulant option.  

Common non-stimulant medications are:  

• Strattera (atomoxetine)

• Qelbree (viloxazine)

• Intuniv (guanfacine)

• Kapvay (clonidine)

In some cases, your doctor might prescribe antidepressants as a part of your treatment plan, often alongside stimulants. Antidepressants that might be used off-label for ADHD treatment are:

• Wellbutrin (bupropion hydrochloride)

• Norpramin (desipramine)

• Tofranil (imipramine)

• Pamelor (nortriptyline)

Therapy for ADHD

Psychotherapy, AKA talk therapy, is helpful for people with ADHD. Cognitive behavioral therapy (CBT) is a specific therapy modality that can address unhealthy thought patterns and behaviors associated with ADHD.  

In general, CBT focuses on addressing how thoughts, feelings, and behaviors influence each other. Your therapist will help you identify your unhealthy, unhelpful thought patterns or beliefs. From here, you will learn to challenge these thought biases, known as cognitive distortions, to create healthier thoughts and behaviors. For example, many young girls and women with ADHD develop low self-esteem as a result of their struggles, especially with untreated, undiagnosed ADHD. CBT can help you address thought patterns feeding into poor self-esteem, allowing you to create healthier beliefs and build confidence.

Executive skills functioning

Additionally, another key aspect of CBT for ADHD is skill building to address struggles in executive functioning, which more directly addresses core ADHD dysfunction and higher level attention/concentration deficits. For example, you can learn skills and coping strategies related to:

• Time management  

• Problem-solving  

• Organization

• Coping with distractibility  

• Developing impulse control

• Healthy communication

What is the best ADHD medication for women?

There is no “best” ADHD medication for women and girls. Although there’s limited research, currently, the clinical guidelines for treating ADHD with medication are the same regardless of gender. However, some research has pointed towards the fluctuating hormones throughout the menstrual cycle affecting treatment response to ADHD meds. Ultimately, we need more extensive research exploring this to determine exactly how hormones affect ADHD and how to more effectively combat this with medications.  
In general, psychiatric medications are not one-size-fits-all. Everyone responds to medications differently. The ADHD medication that works best for you might not be the best for someone else, and vice versa. It might take some trial and error to figure out which medication is the most helpful for managing your ADHD symptoms.  

A psychiatrist will be your best guide to determining which ADHD medication is the best one for you. After confirming a diagnosis of ADHD, they will discuss the benefits and risks of treatment options to devise a plan that you’re comfortable with. From there, they’ll check in with you during follow-up visits to see how you're responding to the medication, such as if your executive functioning has improved, if your inattentive symptoms are reduced, and whether you’re having any bothersome side effects.  

Finding the right ADHD medication is a game-changer for coping with ADHD. If you’re looking for a psychiatrist to diagnose your ADHD and potentially prescribe you stimulants or non-stimulant medications, consider Talkiatry.  

We’re a national psychiatry practice that treats a wide variety of concerns, including ADHD and co-occurring conditions. We provide virtual, in-network services so you can get the care you need from the comfort of your home. Complete our free online assessment to get matched with a psychiatrist ASAP.  

FAQs

Here are more details about ADHD in women.

Are there gender-specific ADHD treatments for women?  

There are no official specific ADHD treatments based on gender differences. Ultimately, we need more research to determine whether any ADHD medications are actually more effective in women.

What is the best therapy for ADHD in women?

Regardless of gender, cognitive behavioral therapy (CBT) is one of the best types of therapy for ADHD. CBT can help you address unhealthy thought patterns and teach you skills related to:

• Time management  

• Problem-solving  

• Organization

• Coping with distractibility  

• Developing impulse control

• Healthy communication

The information in this article is for education and informational purposes only and should never be substituted for medical advice, diagnoses, or treatment. If you or someone you know may be in danger, call 911 or the National Suicide and Crisis Lifeline at 988 right away.