ADHD Can Look Different In Women, Here's Why
Why Many Women Don’t Know They Have ADHD — Until It’s Too Late
ADHD (Attention-Deficit/Hyperactivity Disorder) is a common neurodevelopmental condition that often begins in childhood and can persist into adolescence and adulthood. It affects a person’s ability to focus, manage impulses, and regulate hyperactive behavior. When not diagnosed early, its symptoms can be subtle and easy to overlook, especially in adults.
According to WebMD, more than 15 million American adults—about 5% of the population—are estimated to have ADHD. The condition is more commonly diagnosed in men, with 5.4% of adult males affected compared to 3.2% of females. However, research shows that women are often misdiagnosed or undiagnosed, with many not receiving a proper diagnosis until their 30s or 40s. In fact, the National Institute of Mental Health reports that while men are nearly twice as likely to be diagnosed, around 75% of women with ADHD remain undiagnosed.
ADHD symptoms are harder to spot in women.
Per the Mayo Clinic, ADHD has a variety of common symptoms that range from impulsiveness and disorganization, to poor time management skills and trouble multitasking. These typical symptoms can show up differently in women, according to Janina Maschke, a doctor and psychologist.
“ADHD often presents differently in girls than in boys,” Maschke told Newsweek during an interview published March 6. “Girls often internalize behavior versus boys who are more likely to externalize their behavior. This difference in symptom presentation can lead to boys being diagnosed more frequently than girls, as they externalize their symptoms and might disrupt others at school.”
RELATED CONTENT: Black Women And Invisible Disabilities: A Story Of Multi-Marginalization
Women with ADHD often exhibit the inattentive symptom presentation, which is one of the main ways ADHD can appear. Unlike the more noticeable hyperactive-impulsive type, inattentive symptoms are typically more subtle, non-disruptive and internal, making them harder to recognize, especially in women. Common signs include difficulty paying close attention to details, making careless mistakes, trouble sustaining focus on tasks, and frequently not following through on instructions.
Women may also struggle with organizing tasks, become easily distracted, and experience forgetfulness in daily routines. In addition to these cognitive challenges, many internalize their symptoms, which can manifest as anxiety, mood issues, or low self-esteem, AdditudeMag notes. Appearing withdrawn or shy, being verbally impulsive, crying easily, and frequently becoming upset are emotional signs that often go unnoticed in women with ADHD, Maschke added.
Because of how these symptoms present, women are frequently overlooked or misdiagnosed, and many don’t receive an accurate diagnosis until adulthood.
Gender bias can also lead to ADHD misdiagnosis in women.
Gender bias in the healthcare system plays a major role in the ADHD gender gap, shaping how clinicians perceive and diagnose women. Girls and young women with non-disruptive, inattentive symptoms rarely raise red flags in school or clinical settings, leading to fewer referrals for evaluation or diagnosis.
Additionally, diagnostic tools and rating scales for ADHD remain largely based on behaviors more commonly seen in boys, such as hyperactivity and impulsivity. As a result, internalized symptoms like daydreaming, difficulty focusing, emotional sensitivity, or anxiety often go unrecognized. Many of the assessment tools for ADHD are not normed for female experiences or values, leaving a gap in accurate diagnosis.
If left unaddressed, ADHD symptoms can intensify as women age, or during their menstrual cycles.
“During the premenstrual phase ADHD symptoms often worsen and become more prominent, as estrogen levels decrease during this phase,” Maschke told Newsweek.“Oestrogen increases dopamine, and when estrogen levels drop, this impacts dopamine production, which in turn affects ADHD symptoms.”
Get tested.
If you suspect you may be experiencing symptoms of ADHD, it’s important to seek a professional evaluation and advocate for yourself, says Maschke. Women can request an ADHD screening from their healthcare provider, which typically includes a behavioral interview, along with a medical, physical, or neurodevelopmental examination, according to Medline Plus. It may also be beneficial to have hormone levels tested, as hormonal fluctuations can influence symptoms. Some research has shown that low levels of dopamine—a key neurotransmitter involved in focus and motivation—may play a role in ADHD.
RELATED CONTENT: The Truth About ADHD—How Building Better Habits Helped Me And Other Black Women
