How to Recognize ADHD in Women

Table of Contents
View All
Table of Contents

Gendered words are used throughout this article to refer to people who identify as female and have the typical reproductive organs of a cisgender female. We recognize that some people who identify as female do not have the same anatomy as that depicted in this article.

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by symptoms of inattentiveness, hyperactivity, and impulsivity. Studies show ADHD is more prevalent in men than women, but emerging research suggests that ADHD is underdiagnosed in women and that women tend to be diagnosed later than men. Prevalence of ADHD may be closer to equal between men and women than previously recognized.

Increasing awareness about how ADHD presents differently in girls and women vs. boys and men is resulting in more ADHD diagnoses in girls, although discrepancies still exist.

Read on to learn about how ADHD presents in girls and women.

Signs of ADHD in Girls

Verywell / Danie Drankwalter

How ADHD Differs in Women vs. Men

Girls and women tend to show more inattentive symptoms than hyperactivity/impulsivity. They are also more likely to present with internalizing symptoms than externalizing. Because these symptoms are less disruptive and don't fit the ADHD stereotype, ADHD is often missed in girls.

Girls are often able to develop coping strategies that mask their ADHD symptoms, particularly when they are younger. When they do show noticeable symptoms, they are are often diagnosed with other conditions, such as anxiety or depression (both of which are common co-occurring conditions for girls and women with ADHD), instead of being accurately diagnosed with ADHD.

Studies have shown teachers are less likely to refer girls for ADHD assessment, which can lead to delayed diagnosis and treatment. When assessed, girls and women tend to meet fewer of the diagnostic criteria outlined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) for ADHD, as these criteria were developed based on predominantly male samples.

These delays in diagnosis and treatment often hinder basic skills that are acquired in elementary school and can lead to impairments in academics and in psychosocial functioning in girls and women.

ADHD symptoms in girls and women tend to:

  • Fall into the category of inattentive (though girls and women can also present with hyperactive/impulsive symptoms)
  • Appear less severe than in boys and men
  • Be pervasive and impairing rather than transient or fluctuating
  • Become more obvious later, often during times of social or educational transition
  • Be noticed by adult women, leading them to seek assessment and treatment (instead of being referred)
  • Be exacerbated by hormonal changes, such as puberty, menstruation, pregnancy, and menopause

Common Signs of ADHD in Girls and Women

Although ADHD begins in childhood and often continues into adulthood, it can present differently in girls than in women.

ADHD in Girls

Although not universal, girls with ADHD tend to present with inattentive type. Symptoms of inattentive ADHD include:

  • Not paying close attention to details/making "careless" mistakes in school work
  • Trouble staying focused on or not completing tasks or activities
  • Appears not to be listening when spoken to
  • Not following through on instructions
  • Difficulty organizing, including problems with time management, messiness, and missing deadlines
  • Avoids/dislikes tasks that require sustained mental effort
  • Frequently loses needed items, such as school papers, books, keys, and eyeglasses
  • Is easily distracted
  • Forgets to do routine tasks, such as chores

Girls with ADHD may show hyperactive/impulsive type symptoms, especially "internal" hyperactivity. These may include:

  • Fidgets, taps hands or feet, squirms, or has difficulty staying seated
  • Talks excessively and has difficulty playing quietly
  • Has difficulty waiting for their turn, such as in line, or waiting to speak in conversations
  • Blurts out answers before a question is finished or finishes people's sentences
  • Interrupts or intrudes, such as cutting into conversations, joining others' games uninvited, or using other people's things without asking
  • Acts impulsively/speaks before thinking
  • Has racing thoughts and trouble keeping their mind on one topic
  • Makes friends easily but has trouble keeping them
  • Engages in self-harming activities, or ones that require extreme and unhealthy self-discipline
  • Works harder than their peers in order to be equally successful
  • Fears rejection by peers or friends, clings to other people, or remains in unhealthy relationships

Girls with ADHD are more likely than boys (or girls without ADHD) to:

  • Have low self-esteem
  • Be more impaired in social behaviors, peer functioning, and interpersonal relationships
  • Have trouble making and/or maintaining friendships
  • Blame themselves for their frustrations
  • See failures as evidence of negative personal attributes, particularly if their ADHD is missed or treatment is delayed
  • Do well academically, but struggle and become stressed in the process
  • Have symptoms that become more noticeable as they reach puberty (as opposed to earlier in childhood, as often seen in boys)

Girls may also experience symptoms that manifest in sexual situations, including:

  • Becoming sexually active at a younger age than their peers
  • Being less likely to use or insist their partners use contraception/STI prevention methods
  • Being at greater risk of being pressured into unwanted sex or becoming a victim of sexual violence

How Do Gender Norms and Stereotypes Play a Role?

In media, portrayals of male characters with ADHD-associated traits are frequently viewed positively (they are creative, energetic, spontaneous, etc.). Negative traits of ADHD, such as disorganization, tend to be looked on more judgmentally in women and more easily "forgiven" in men.

Many girls and women with ADHD try hard to suppress behaviors that may be counter to the norms of feminine behavior, such as hyperactivity, impulsiveness, disruptive behavior, and disorganization, for fear of judgment.

ADHD in Adult Women

For women whose ADHD was missed in childhood, symptoms of inattention can become more noticeable in structured educational settings, such as high school, college, or university. Coping strategies used to compensate for symptoms in younger grades may be harder to maintain in these environments.

As with girls who have ADHD, women with ADHD tend to show more inattentive and internalized symptoms. These include:

  • Difficulty paying close attention to details/making "careless" mistakes
  • Trouble focusing on long tasks or engaging in activities that require sustained mental effort (preparing reports, completing forms, reviewing long papers, etc.)
  • Difficulty listening closely when someone is speaking
  • Trouble following instructions or finishing workplace duties
  • Organization difficulties, such as time management, keeping workspace/home clean, or organizing tasks and activities
  • Frequently misplacing common things, such as keys, wallet, phone, etc.
  • Easily distracted by unrelated thoughts or stimuli
  • Forgetfulness in daily activities, such as paying bills, meeting deadlines, going to scheduled appointments, or returning calls
  • Trouble making realistic and manageable plans
  • Trouble making decisions
  • Procrastinating/doing things last minute
  • Difficulty regulating emotions, especially when stressed

Hyperactive/impulsive symptoms are less common than inattentive ones, both for women and adults in general. These symptoms often become more "internal" when they persist. Hyperactive/impulsive symptoms adult women may experience include:

  • Restlessness/difficulty sitting still for extended periods (fidgeting, tapping hands or feet, squirming in their seat, getting out of their seat, etc.)
  • Talking excessively or finding it difficult to be quiet during leisure activities
  • Answering questions before they are finished being asked, interrupting, or intruding on others
  • Having trouble waiting turns, waiting in line, etc.

Women with ADHD may be more likely than women without ADHD to:

  • Have poor self-esteem
  • Have co-occurring conditions, such as anxiety and depression
  • Feel a lack of control over situations
  • Have difficulties coping with home/work life
  • Experience physical symptoms such as headaches, stomachaches, and/or sleep problems
  • Have communication and relationship difficulties

How Does Motherhood Affect ADHD?

Some women with ADHD note that symptoms, such as distractibility and difficulties returning to a task after an interruption, became more pronounced once they became mothers. For many, having children bring additional challenges and worries that their ADHD could affect their children. More studies on the impact of ADHD on parenting and vice-versa are needed.

How to Treat Symptoms of ADHD in Women

Medication is typically the first line of treatment for ADHD.

Two classes of medication are available for use in ADHD treatment: stimulants and non-stimulants.

Stimulants are more common and generally considered more effective. They include:

  • Non-amphetamines: methylphenidate (MPH), dexmethylphenidate (dexMPH)
  • Amphetamines: dextroamphetamines (dexAMP)
  • Mixed amphetamine salts (MAS-XR)

Non-stimulant medication is used when stimulants do not adequately control symptoms or when stimulants are not tolerated or are contraindicated. These include:

  • Atomoxetine (ATX)
  • Clonidine HCL extended-release
  • Guanfacine extended-release

Despite the effectiveness, research suggests girls and women with ADHD are less likely to be prescribed medication for ADHD than boys and men with ADHD, although the use of ADHD medication in women appears to be increasing.

Some studies suggest girls and women may respond differently to ADHD medication than boys and men. More research could provide suggestions for tailoring treatment.

There is no evidence to indicate that women should receive different ADHD medication treatment, but prescribers should be mindful of the presence of co-occurring conditions and potential interactions with other drugs.

Therapy for ADHD

In addition to medication, it may be beneficial to engage in ADHD-focused therapies that address a broad range of issues, such as self-esteem, interpersonal and family relationships, health habits, stress levels, and life management skills.

While it may be difficult, it's important to find a therapist that is knowledgeable and experienced in treating girls and women with ADHD.

Some therapies that may be helpful include:

  • Cognitive behavioral therapy (CBT): Focuses on identifying and changing problematic or maladaptive (negative) thoughts and behaviors. Can address emotional self-regulation, impulse control, and stress management. Can often be adapted to treat co-existing conditions along with ADHD. CBT programs developed specifically for adults with ADHD are available.
  • Neurocognitive psychotherapy: Combines aspects of CBT and cognitive rehabilitation to help develop life management skills to improve cognitive functions, learn compensatory strategies, and restructure the environment.
  • Dialectical behavioral therapy (DBT): Uses strategies such as radical acceptance, mindfulness, and emotional regulation, to help people learn and unstick themselves from ADHD patterns of thinking and reacting.

Treatment for ADHD should start as soon as a diagnosis of ADHD is received, even in young children.

Summary

ADHD often presents differently in girls and women than in boys and men. Girls and women are more likely to experience symptoms of inattention than of hyperactivity/impulsiveness. They are also more likely to exhibit internalizing behavior than externalizing.

Girls and women are often diagnosed late or misdiagnosed, leading to delays in treatment. Treatment for ADHD includes medication and therapies, such as cognitive behavioral therapy.

A Word From Verywell

If you identify as a girl or have a girl in your life that is experiencing signs of ADHD, talk to your healthcare provider or mental health professional. Getting a diagnosis and beginning treatment can greatly improve symptom management and daily functioning.

Frequently Asked Questions

  • What triggers ADHD?

    The exact cause of ADHD isn't known, but researchers believe ADHD is likely a result of a combination of factors, including genetics and environmental influences.

  • What happens if you leave ADHD untreated?

    Girls and women with ADHD who are not properly diagnosed and treated can experience negative consequences, such as poor academic performance, behavioral problems, low self-esteem, problems with self-image, and co-occurring conditions, such as anxiety and depression.

  • What are differences between ADHD in men and women?

    ADHD can manifest differently in girls and women than in boys and men. One significant difference is that girls and women are more likely to experience inattentive-type ADHD instead of hyperactive/impulsive type.

  • Can ADHD be cured?

    ADHD cannot be cured, but it can be managed. ADHD can diminish after childhood, but most people who experience ADHD in childhood will continue to experience at least some degree of symptoms into adulthood.

  • Is ADHD genetic?

    There is evidence to suggest that genetics are involved with ADHD. Three out of four children with ADHD have a relative who has ADHD.

11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. National Institute of Mental Health. Attention-deficit/hyperactivity disorder in adults: what you need to know.

  2. Young S, Adamo N, Ásgeirsdóttir BB, et al. Females with ADHD: an expert consensus statement taking a lifespan approach providing guidance for the identification and treatment of attention-deficit/ hyperactivity disorder in girls and women. BMC Psychiatry. 2020;20(1):404. doi:10.1186/s12888-020-02707-9

  3. Quinn PO, Madhoo M. A review of attention-deficit/hyperactivity disorder in women and girls: uncovering this hidden diagnosis. Prim Care Companion CNS Disord. 2014;16(3). doi:10.4088/PCC.13r01596

  4. Kok FM, Groen Y, Fuermaier ABM, Tucha O. The female side of pharmacotherapy for ADHD—a systematic literature review. PLoS ONE. 2020;15(9):e0239257. doi:10.1371/journal.pone.0239257

  5. Kok FM, Groen Y, Fuermaier ABM, Tucha O. Problematic peer functioning in girls with ADHD: a systematic literature review. PLoS ONE. 2016;11(11):e0165119. doi:10.1371/journal.pone.0165119

  6. Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD). Symptoms of ADHD in women and girls.

  7. American Psychiatric Association. What is ADHD.

  8. Holthe MEG, Langvik E. The strives, struggles, and successes of women diagnosed with ADHD as adults. SAGE Open. 2017;7(1):215824401770179. doi:10.1177/2158244017701799

  9. Child Mind Institute. How girls with ADHD are different.

  10. Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD). Treatment for ADHD in women and girls.

  11. Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD). Dialectical behavior therapy gets our attention.

By Heather Jones
Heather M. Jones is a freelance writer with a strong focus on health, parenting, disability, and feminism.