It is well recognized that girls and women with ADHD are underdiagnosed and undertreated compared with their male counterparts, in part due to differences in how ADHD presents in females. Hormonal changes across the lifespan, including menstrual cycles, pregnancy, postpartum, and menopause, can significantly influence ADHD symptoms.

For many women, the hormonal transition of menopause can exacerbate existing ADHD symptoms or unmask previously unrecognized difficulties with attention, executive function, and emotional regulation. As estrogen levels decline, women may experience cognitive changes often described as “brain fog,” alongside symptoms of anxiety or depression. These overlapping features can make it challenging to distinguish between menopausal cognitive changes, mood disorders, and ADHD, leading to confusion in diagnosis and management.

Understanding how ADHD presents in women, particularly during midlife hormonal transitions, is essential for clinicians to differentiate between these conditions and provide appropriate assessment, diagnosis, and treatment.