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ADHD

ADHD in women: signs, why it is often missed, and getting help

ADHD is thought to be under-recognised in girls and women[1]. On average their symptoms are more often inattentive and less visible[2], so ADHD can be missed in childhood[3] or come second to a diagnosis of anxiety or depression[4]. This guide covers how ADHD can look in women, why it is missed, what we know about hormones, and how to get assessed in the UK and the US.

By the Bliss Therapy editorial teamReviewed by the Bliss Therapy clinical team11 min read
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Key takeaways

  • ADHD is thought to be under-recognised in girls and women. They are less likely to be referred for an assessment and more likely to be given another diagnosis first.
  • On average, women with ADHD more often have inattentive symptoms, which are harder to spot. These are averages: many women have hyperactive or combined ADHD.
  • More boys than girls are diagnosed, but the gap is much smaller in adults. In a 2023 US survey, 44% of adults with a current ADHD diagnosis were women.
  • Many women say their symptoms change with their cycle, after a baby or around menopause, but the research is still early and the results are mixed.
  • Only a specialist can diagnose ADHD. On Bliss Therapy you can see a therapist who speaks your language, with no waitlist, for the anxiety, low mood and self-esteem that often come with it.

What ADHD is, and how it can look in women

The NHS says ADHD “is thought to be recognised less often in women than men”, possibly because women more often have inattentive symptoms, which are harder to recognise[2]. An expert group has urged clinicians to look beyond the idea of ADHD as a behaviour problem, and to notice “the more subtle and/or internalised presentation that is common in females”[7].

These are averages, not rules. Girls and women with ADHD show more inattention on average, and boys and men more hyperactive and impulsive symptoms, but the differences depend heavily on whether a study looks at clinic patients or the wider population[5]. Many women have hyperactive or combined ADHD. In one small clinic study of diagnosed adults, women and men reported similar levels of current symptoms[8].

Signs of ADHD in women

This is not a checklist for diagnosing yourself. Recognising yourself here is a reason to talk to a doctor, not a diagnosis. Only a specialist can decide whether these patterns add up to ADHD, after a full assessment that looks back to childhood[1][2].

Inattention: distracted, forgetful, losing track

Inattentive signs in adults include being easily distracted or forgetful, finding it hard to organise your time, and losing things often[2]. Doing well at school does not rule ADHD out: “satisfactory academic achievement should not rule out an ADHD diagnosis”[9]. When attention is the main difficulty, this is often called inattentive ADHD. It is the most common type in the population, “but individuals with the combined type are more likely to be referred for clinical services”[10], which helps explain why quieter ADHD gets missed.Evidence: official NHS information and a large review; these apply to everyone.

Restlessness on the inside

In adults, hyperactivity can lessen or turn into a strong inner restlessness[6]. A 1997 review found lower levels of hyperactivity in girls with ADHD than in boys[11], and the same pattern in women[5].Evidence: official guidance and two reviews, one of them old.

Strong emotions that are hard to manage

Strong feelings that are hard to manage are not traditionally part of ADHD screening criteria[12]. Yet a review of studies found much higher levels of emotional dysregulation in adults with ADHD than in other adults[13], and an expert consensus says these difficulties “may be more severe or common in girls and women with ADHD”[7]. In a UK study of nearly 10,000 young people, girls made up 38.7% of those whose ADHD had gone unrecognised, against 20.2% of those whose ADHD had been recognised[12].Evidence: a strong review for adults; for women, expert consensus and one large study based on parents’ reports.

Looking fine on the outside, working hard behind the scenes

Many women with ADHD find ways to compensate, and experts think this is one reason ADHD goes unnoticed[7][5]. That might mean over-preparing, relying on lists and routines, putting in extra hours or keeping quiet, so that from the outside things look fine. People sometimes call this “high-functioning ADHD”, but it is not a medical diagnosis or a separate type. One woman told the Royal College of Psychiatrists that “a lot of that is hidden, especially with the mental load of women juggling home, work, family”[14].

Why ADHD in women is often missed

UK guidance asks professionals to “Be aware that ADHD is thought to be under-recognised in girls and women”. It says they are less likely to be referred for assessment, and may be more likely to have undiagnosed ADHD or an incorrect diagnosis of another condition[1]. NIMH adds that symptoms in girls and women are “especially likely to have been missed in childhood”[3]. Researchers have suggested biological, diagnostic and social reasons[15]. These are possible explanations, not proven ones.

Less visible symptoms

An expert consensus says “Less overt ADHD symptoms are less likely to lead to referral which means that inattentive girls are more often missed”[7]. A review notes that girls’ presentation can be treated as “subthreshold” because inattention is more prominent than hyperactivity[9].Evidence: expert consensus and a narrative review.

Coping strategies that hide it (masking)

The Royal College of Psychiatrists says, about adults in general: “People with ADHD will often develop ways to hide their symptoms, and doing so can be very exhausting and negatively affect their mental health”[14]. For women, experts say “Compensatory behaviours may mask behaviour and impairments, and delay time to referral”, and that symptoms may become more obvious later, “often during periods of social or educational transition”[7].

In a survey of 329 women with ADHD in Poland, more camouflaging went with lower life satisfaction and more depressive symptoms. It was a one-off survey, so it shows a link, not that masking causes depression[16].Evidence: widely agreed in expert reviews and official information, but measured research on masking in ADHD is early and mostly surveys.

Bias in who gets referred

An expert consensus concludes that the gap between the number of boys and girls diagnosed is “due, at least in part, to lack of recognition and/or referral bias in females”, and lists “gender biases” among the barriers[7]. In a study of 283 children with high ADHD symptoms, girls seemed to need extra behavioural or emotional problems to meet full criteria, and parents under-rated diagnosed girls’ hyperactive and impulsive symptoms[17]. A Swedish study of 19,804 twins found females may be more easily missed unless they also have obvious behaviour problems[18].Evidence: expert consensus and two population studies.

Anxiety or depression diagnosed first

A study of everyone in Wales diagnosed with ADHD between the ages of 3 and 30 found that, before their ADHD was recognised, females were more likely than males to have been diagnosed with anxiety, depression or another mental health condition, and to have been prescribed antidepressants. The authors say this “may be partly because of diagnostic overshadowing from other mental health conditions, such as anxiety and depression, or initial misdiagnosis”[4]. The Royal College of Psychiatrists notes that when a diagnosis like anxiety or depression only explains part of someone’s difficulties, “underlying ADHD can be missed”[14].

This does not mean an earlier diagnosis was wrong. Anxiety and depression can sit alongside ADHD or overshadow it[7], and a specialist can look at both.Evidence: official guidance and a national study of health records.

ADHD in women vs men: what the numbers say

More boys than girls are diagnosed with ADHD, but the gap shrinks in adults. One major review sums it up: girls meet the criteria “at just under half the rates of boys, a ratio that becomes much closer to equal by adulthood”[5]. We found no good evidence for the claim, common online, that women are just as likely as men to have ADHD.

Who was studiedWhat was found
US children, national parent survey (2022–2023)13% of boys and 7% of girls had ever been diagnosed[19]
Young people: parent ratings in 29 studies and teacher ratings in 24“roughly two-to-one male/female ratio in youth”[20]
A community sample aged 7 to 29 (9,380 people)2.28 males for every female[21]
Clinic referrals of children (older studies)From 3 to 16 boys for every girl, against around 3 to 1 in community samples[7]
Everyone diagnosed in Wales aged 3 to 30 (16,458 people)3.9 to 1 overall; 4.8 to 1 among those diagnosed before 12; 1.9 to 1 among those diagnosed as adults[4]
US adults with a current diagnosis, national survey (2023)44.2% women and 55.8% men[22]

Ratios are lower in the community than in clinics, which researchers read as a sign that girls are under-diagnosed[21]. In the US survey, about 6% of adults (15.5 million people) had a current ADHD diagnosis[22].

ADHD and hormones: periods, pregnancy and menopause

Many women with ADHD say their symptoms change with their menstrual cycle, after having a baby, or around perimenopause and menopause[23]. Researchers think changes in hormones such as oestrogen may play a part[24][25]. But the research is still early. Most studies are small, many rely on women’s own reports, and some results conflict[24][26].

  • A 2025 review of 11 studies found the evidence “largely suggestive” of a link with sex hormones, mainly in puberty and across the menstrual cycle, but most studies were small, and the authors call for research on menopause[24].
  • A study that tracked 32 women’s hormones and symptoms daily for 35 days found more ADHD-type symptoms the day after oestrogen fell while progesterone or testosterone rose. None of the women had an ADHD diagnosis[25].
  • In an online survey of 600 women who said they had an ADHD diagnosis, most felt their symptoms got worse after having a baby (70.4%) and around menopause (97.5%). Of those still having periods and not on hormonal treatment, 88.6% noticed changes across their cycle, mostly worse after ovulation. But when symptoms were measured with a questionnaire, scores showed “similar symptom severity in all hormonal life phases”[23].
  • A clinic study of 209 women with ADHD found high rates of PMDD (severe mood symptoms before a period) and postnatal depression, compared with the general population. It had no matched comparison group[27].
  • The largest comparison we found, of 656 women aged 45 to 60 (245 with ADHD), concluded that “women with ADHD do not experience greater menopausal complaints than women without at any menopausal stage”. Across all the women, though, more ADHD-type symptoms went with more menopause complaints[26].
  • In interviews, 19 women with ADHD in Ireland described emotional, thinking and physical changes in perimenopause[28]. Research on ADHD in pregnancy and after birth is limited[29].

Experts say symptoms “may be exacerbated by hormonal changes during menstrual cycle, pregnancy and menopause”, and advise a review of care around pregnancy and menopause[7]. If your symptoms seem to shift with your cycle or life stage, keep a simple note and take it to your doctor. If you take ADHD medication and are pregnant, planning a pregnancy or going through menopause, talk to your prescriber; do not change or stop it on your own.

ADHD, mental health and other conditions

The NHS says people with ADHD “may be more likely to have mental health issues such as anxiety and depression”[2]. Compared with men with ADHD, problems such as anxiety and depression “are more often reported in females”, and an expert consensus lists lower self-esteem among the features that often come with ADHD in women[7]. If anxiety or low mood is the bigger problem right now, see our pages on therapy for anxiety and stress and therapy for depression.

People with ADHD are also more likely to have an eating disorder: a review of 12 studies of men and women found a pooled odds ratio of 3.82[30]. But a long-term study of girls with ADHD found no significant difference in eating problems compared with other girls[31]. If eating is a worry, see our page on therapy for eating disorders, which is offered alongside medical care.

Diagnosed later in life

Many people are diagnosed as adults. In the US, more than half of adults with ADHD got their diagnosis in adulthood[22]. In Wales, among people diagnosed by the age of 30, females were diagnosed later on average: at 12.6 years, against 10.9 for males[4].

A late diagnosis can bring mixed feelings. The Royal College of Psychiatrists says “You might also feel relief at knowing that you aren’t ‘lazy’, ‘unwilling’, ‘messy’ or any other labels”. Alongside relief, some people feel frustration that it was not found sooner[14]. And as NIMH says, “It is never too late to seek a diagnosis and treatment for ADHD”[3].

How to get an ADHD assessment as a woman

Only a specialist can diagnose ADHD: a psychiatrist or another healthcare professional “with training and expertise in diagnosing ADHD”[1]. “It cannot be diagnosed by rating scales alone”[20]. Our ADHD self-test is a screening questionnaire. It can help you decide whether to talk to a doctor, but it cannot diagnose ADHD.

In the UK

The NHS says: “If your ADHD symptoms are affecting your studies, work or relationships, make an appointment with a GP”. The GP can refer you to a specialist, who will ask about the history of your symptoms, “particularly if they started when you were a child”. Waits vary, and “you may have to wait several months or years”. In England, the Right to Choose scheme may help[2]. If you pay for a private assessment, check first that it “will be accepted by your local NHS service”[14].

In the US

Talk to a primary care provider or a mental health professional. A provider may diagnose ADHD themselves or refer you to a mental health provider[6], and may “ask to talk to people who know you well”[3]. NIMH points to SAMHSA for help locating mental health services[3].

What to tell your doctor

Write a few notes before the appointment. It is fine to say you think your symptoms may have been missed, as ADHD is under-recognised in women[1]. Things to cover:

  • what your difficulties are now, and whether they go back to childhood
  • how they affect your work, studies, home life and relationships
  • any past diagnoses of anxiety or depression, and the treatment you had
  • any changes you have noticed across your cycle or life stage
  • the ways you cope, even if they mean things look fine from the outside

What helps

Treatment is planned with a specialist. The NHS says ADHD “can be managed in many ways, including lifestyle changes, changes at work, or medicines”, and that talking therapies such as CBT or mindfulness “may be recommended for adults with ADHD”[2]. A Cochrane review found “low-quality evidence” that CBT-based treatments may help adults with ADHD in the short term, and may also ease depression and anxiety[32].

Medication is one treatment option to discuss with a doctor or ADHD specialist; in the UK it should only be started by a professional with training and expertise in ADHD[1]. Not everyone needs or wants it[2]. NIMH notes that “Effective treatment often involves a combination of elements”[3].

For women, experts suggest tailoring support to difficulties at home, at work and in relationships, with follow-up “at key points of transition”[7]. Research on support designed for women is very thin. The only women-specific trial we found had 23 women: a 7-week programme on routines, organisation, time and stress lowered their stress and self-rated symptoms a week later, but it was too small to be sure[33]. A 2025 review says “tailored treatments are lacking”[34]. For day-to-day strategies, see our guide to managing adult ADHD.

Therapy on Bliss Therapy

Bliss Therapy offers therapy only. We do not assess or diagnose ADHD, prescribe medication or offer ADHD coaching; for an assessment or medication you need a doctor or an ADHD specialist. Therapy can help with things that often come with ADHD in women, such as anxiety and low mood[32], low self-esteem[7], the strain of hiding symptoms[14], and the mixed feelings that can follow a late diagnosis. If you have not been diagnosed, ask the therapist whether they work with people without a diagnosis. On Bliss Therapy you choose a therapist who speaks your language, by video, with no waitlist, alongside whatever care you and your doctor decide on. 20 psychologists and counsellors list ADHD, with sessions from €35 (about £29); 18 of them list CBT and 14 list mindfulness-based therapy.

Therapists for adult ADHD

20 therapists on Bliss Therapy list this. Sessions are 50 minutes by video, and you pay per session.

See all 20 therapists

Our therapists are based outside the UK and the US, so they are unlikely to be on UK registers or covered by US health insurance. Ask any therapist about their training and their registration in the country where they practise.

When to get help

Talk to a GP or doctor if ADHD-type difficulties are affecting your studies, work or relationships[2], or if anxiety or low mood is building up. People with ADHD are at higher risk of suicide[2], and a review found women with ADHD have a heightened risk of self-harm[5]. If you are having thoughts of ending your life, or feel you might harm yourself, get help now.

Questions people ask

What are the common symptoms of ADHD in women?

On average, women with ADHD more often have inattentive symptoms, such as being easily distracted or forgetful and finding it hard to organise time[2]. Restlessness may be on the inside[6], and strong emotions may be harder to manage[7]. This is not a checklist: only a specialist can diagnose ADHD[1].

What does it mean to have high-functioning ADHD?

It is not a medical diagnosis or a separate type. People use it for someone who copes well on the outside while working very hard behind the scenes. Experts think coping like this is one reason ADHD in women gets missed[5], and hiding symptoms can be exhausting[14].

Is ADHD more common in men or women?

More boys than girls are diagnosed, roughly two to one in population studies of young people[20]. The gap is much smaller in adults: in a 2023 US survey, 44% of adults with a current diagnosis were women[22].

What are the symptoms of ADHD in women over 50?

Research on ADHD around menopause is still limited[24]. In one survey, most women with ADHD said their symptoms got worse around menopause[23], but the largest comparison found women with ADHD did not have more menopause complaints than other women[26]. If things change, talk to your doctor.

What are the treatment options for ADHD symptoms in women?

Treatment is planned with a specialist. It can include changes at home and work, talking therapy such as CBT and, for some people, medication discussed with a doctor or ADHD specialist[2][3]. Treatments tailored to women are still lacking[34]. On Bliss Therapy, sessions with therapists who list ADHD start from €35 (about £29).

Keep reading

Sources and how we checked (34)

On 30 October 2026 we read the NICE guidance, the NHS, NIMH and Royal College of Psychiatrists pages and the research summaries (abstracts) listed below, plus the full text of three open papers. The CDC pages could only be read through a page summariser, so we paraphrase them rather than quote them. Where the evidence is small, early, mixed or only shows a link, we say so, and we label the kind of evidence behind each sign and reason. This post gives no advice on medication or hormone treatment. Bliss Therapy figures are read from our directory when this page loads, for psychologists and counsellors who list ADHD.

  1. NICE, “Attention deficit hyperactivity disorder: diagnosis and management” (NG87), recommendations (last updated 13 September 2019)
  2. NHS, “ADHD in adults” (page last reviewed 19 March 2025)
  3. National Institute of Mental Health (NIMH), “ADHD in Adults: 4 Things to Know” (NIH Publication No. 24-MH-3573, 2024)
  4. Martin J, et al. Sex differences in ADHD diagnosis and clinical care: a national study of population healthcare records in Wales. Journal of Child Psychology and Psychiatry, 2024 (abstract read 30 October 2026)
  5. Hinshaw SP, et al. Annual Research Review: ADHD in girls and women: underrepresentation, longitudinal processes, and key directions. Journal of Child Psychology and Psychiatry, 2022 (abstract read 30 October 2026)
  6. Centers for Disease Control and Prevention (CDC), “ADHD in Adults” (read 30 October 2026 through a page summariser, so we paraphrase it)
  7. Young S, et al. Females with ADHD: an expert consensus statement taking a lifespan approach. BMC Psychiatry, 2020 (abstract and full text read 30 October 2026)
  8. Stibbe T, et al. Gender differences in adult ADHD: cognitive function assessed by the test of attentional performance. PLoS One, 2020 (abstract read 30 October 2026)
  9. Quinn PO, Madhoo M. A review of attention-deficit/hyperactivity disorder in women and girls: uncovering this hidden diagnosis. Primary Care Companion for CNS Disorders, 2014 (abstract read 30 October 2026)
  10. Willcutt EG. The prevalence of DSM-IV attention-deficit/hyperactivity disorder: a meta-analytic review. Neurotherapeutics, 2012 (abstract read 30 October 2026)
  11. Gaub M, Carlson CL. Gender differences in ADHD: a meta-analysis and critical review. Journal of the American Academy of Child & Adolescent Psychiatry, 1997 (abstract read 30 October 2026)
  12. Barclay I, et al. Reasons behind a later or missed ADHD diagnosis in young people: population cohort. JCPP Advances, 2025 (abstract read 30 October 2026)
  13. Beheshti A, et al. Emotion dysregulation in adults with ADHD: a meta-analysis. BMC Psychiatry, 2020 (abstract read 30 October 2026)
  14. Royal College of Psychiatrists, “ADHD in adults” (June 2023)
  15. Martin J. Why are females less likely to be diagnosed with ADHD in childhood than males? Lancet Psychiatry, 2024 (abstract read 30 October 2026)
  16. Wicherkiewicz F, Gambin M. Social camouflaging, life satisfaction and depression among Polish women with ADHD. Journal of Autism and Developmental Disorders, 2024 (abstract read 30 October 2026)
  17. Mowlem F, et al. Do different factors influence whether girls versus boys meet ADHD diagnostic criteria? Psychiatry Research, 2019 (abstract read 30 October 2026)
  18. Mowlem FD, et al. Sex differences in predicting ADHD clinical diagnosis and pharmacological treatment. European Child & Adolescent Psychiatry, 2019 (abstract read 30 October 2026)
  19. CDC, “Data and Statistics on ADHD” (page dated 8 July 2026; survey data 2022–2023; read 30 October 2026 through a page summariser, so we paraphrase it)
  20. Faraone SV, et al. The World Federation of ADHD International Consensus Statement: 208 evidence-based conclusions about the disorder. Neuroscience & Biobehavioral Reviews, 2021 (abstract and full text read 30 October 2026)
  21. Ramtekkar UP, et al. Sex and age differences in attention-deficit/hyperactivity disorder symptoms and diagnoses. Journal of the American Academy of Child & Adolescent Psychiatry, 2010 (abstract read 30 October 2026)
  22. Staley BS, et al. ADHD diagnosis, treatment, and telehealth use in adults: National Center for Health Statistics Rapid Surveys System, United States, October–November 2023. MMWR, 2024 (read 30 October 2026 through a page summariser, so we paraphrase it)
  23. Osianlis E, et al. ADHD in females: survey findings on symptoms across hormonal life stages. Journal of Psychiatric Research, 2026 (abstract read 30 October 2026)
  24. Osianlis E, et al. ADHD and sex hormones in females: a systematic review. Journal of Attention Disorders, 2025 (abstract read 30 October 2026)
  25. Roberts B, Eisenlohr-Moul T, Martel MM. Reproductive steroids and ADHD symptoms across the menstrual cycle. Psychoneuroendocrinology, 2018 (abstract read 30 October 2026)
  26. Chapman L, et al. Examining the link between ADHD symptoms and menopausal experiences. Journal of Attention Disorders, 2025 (abstract read 30 October 2026)
  27. Dorani F, et al. Prevalence of hormone-related mood disorder symptoms in women with ADHD. Journal of Psychiatric Research, 2021 (abstract read 30 October 2026)
  28. Kini-Seery C, et al. “Hormones rule me”: a qualitative exploration of the impact of perimenopause on women with ADHD. Women’s Health, 2026 (abstract read 30 October 2026)
  29. Kittel-Schneider S, et al. Parental ADHD in pregnancy and the postpartum period: a systematic review. Neuroscience & Biobehavioral Reviews, 2021 (abstract read 30 October 2026)
  30. Nazar BP, et al. The risk of eating disorders comorbid with attention-deficit/hyperactivity disorder: a systematic review and meta-analysis. International Journal of Eating Disorders, 2016 (abstract read 30 October 2026)
  31. Hinshaw SP, et al. Prospective follow-up of girls with ADHD into early adulthood: continuing impairment includes elevated risk for suicide attempts and self-injury. Journal of Consulting and Clinical Psychology, 2012 (abstract and full text read 30 October 2026)
  32. Lopez PL, et al. Cognitive-behavioural interventions for attention deficit hyperactivity disorder (ADHD) in adults. Cochrane Database of Systematic Reviews, 2018 (abstract read 30 October 2026)
  33. Gutman SA, et al. Effectiveness of a tailored intervention for women with ADHD and ADHD symptoms: a randomized controlled trial. American Journal of Occupational Therapy, 2020 (abstract read 30 October 2026)
  34. Kooij JJS, et al. Research advances and future directions in female ADHD: the lifelong interplay of hormonal fluctuations with mood, cognition, and disease. Frontiers in Global Women’s Health, 2025 (abstract read 30 October 2026)