The Hidden Struggles of Women with ADHD: Hormones, Stigma, and Healing

ADHD in women is a complex, often misunderstood experience. While research and treatment models have long been built around hyperactive young boys, thousands of adult women today are only just beginning to recognize the symptoms that have shaped their lives for decades.

In my clinical practice in the Netherlands, and occasionally in Kosovo where I offer ADHD diagnostics and treatment in cases where I suspect ADHD, it’s not uncommon for at least one new female client per week—regardless of age—to seek help for symptoms that align with ADHD. These women often come in overwhelmed, burnt out, or misdiagnosed. What’s more striking: their symptoms seem to worsen drastically during certain hormonal phases—PMS, pregnancy, perimenopause, and menopause. Many of my clients in both countries have also experienced medical trauma, often having been dismissed, misunderstood, or gaslit by healthcare providers when they initially sought help. This adds another layer of trauma to their experience and deepens their distrust in the medical system.

So why does ADHD look and feel different in women? And why is it so often missed or misunderstood?

How ADHD Shows Up in Women

ADHD in women tends to fly under the radar because it rarely presents in loud, disruptive behaviors. Instead, it hides behind social niceties, perfectionism, and chronic overwhelm.

Mentally and cognitively, women with ADHD struggle with time blindness, forgetfulness, trouble starting or finishing tasks, disorganization, and frequent zoning out. These executive function difficulties make daily functioning feel like moving through heavy fog—slow, unclear, and mentally draining.

Emotionally, they often experience intense sensitivity to criticism, rejection, or failure. Emotional dysregulation is common—small stressors can lead to big emotional reactions.

Physically, the ADHD experience includes restlessness, mental hyperactivity, and sensory overload. Chronic fatigue is often reported, especially after social interaction or high-stimulus environments. Research also points to a higher prevalence of sleep disorders and migraines in women with ADHD.

Hormones & ADHD: A Double Whammy

What many people don’t realize is how profoundly female hormones interact with ADHD symptoms.

Estrogen boosts dopamine—the same neurotransmitter that is deficient in ADHD brains. So when estrogen levels drop (before menstruation, postpartum, or during menopause), dopamine drops too. For women with ADHD, that dip is enough to send their symptoms into overdrive.

Here's a look at the hormonal rollercoaster:

• Puberty: Often the first noticeable spike in symptoms.

• Menstrual Cycle: The week before menstruation can be unbearable. Many women report anxiety, memory issues, and emotional crashes.

• Pregnancy: Some experience symptom relief during the second trimester. But after delivery, many face an ADHD crisis when hormones plummet.

• Perimenopause & Menopause: Possibly the most intense period. Estrogen drops permanently, and so do cognitive and emotional coping capacities.

ADHD medication, too, fluctuates in effectiveness depending on estrogen levels. What works during ovulation may feel like a sugar pill during PMS.

The Cost of Masking and the Weight of Stigma

From a young age, girls learn to suppress their ADHD symptoms to conform to societal expectations of being "good," "organized," and "helpful." This is known as masking—and it comes at a cost.

Women with ADHD often appear high-achieving but are emotionally exhausted. The price of appearing "fine" includes:

• Chronic anxiety and burnout

• Delayed diagnoses

• Misunderstood relationships

• Deep-rooted shame and low self-worth

They internalize the belief that they are lazy, crazy, or broken. Over time, this leads to trauma—the nervous system becomes wired for hypervigilance, making executive function even harder to access.

ADHD and Trauma: The Nervous System Toll

ADHD in women doesn’t exist in a vacuum—it’s often tangled with trauma. Years (or decades) of being misunderstood, dismissed, or gaslit can lead to complex trauma and nervous system dysregulation. In many cases, clients report being told their symptoms were "in their head," "just anxiety," or "a phase," which has left long-lasting psychological scars.

Many women are stuck in a survival loop:

• Struggling to function

• Feeling "too much" or "not enough"

• Unable to ask for help

• Blaming themselves for failing to meet impossible standards

This trauma directly impairs executive functions like memory, planning, and task initiation. Without healing, no amount of productivity strategies will stick.

The Body Keeps the Score: Physical Conditions Linked to ADHD

In my practice, I’ve noticed a significant overlap between ADHD and certain physical health conditions in women. Beyond the well-documented associations with endometriosis, PCOS, and fibromyalgia, research also points to increased rates of other chronic health issues in women with ADHD. These include autoimmune diseases such as Hashimoto’s thyroiditis and lupus, chronic fatigue syndrome (CFS/ME), irritable bowel syndrome (IBS), chronic pelvic pain, migraine, interstitial cystitis, and metabolic disorders including insulin resistance and type 2 diabetes. Mental health comorbidities such as anxiety disorders, depression, and eating disorders (especially binge eating and bulimia) are also highly prevalent. These overlapping conditions suggest that ADHD in women is not just a neurodevelopmental condition but a systemic issue affecting physical, emotional, and psychological well-being.

These conditions—marked by chronic pain, hormonal imbalance, and inflammation—frequently co-exist with ADHD. This is more than coincidence. Scientific literature also notes elevated rates of irritable bowel syndrome (IBS), autoimmune disorders, and metabolic syndrome in women with ADHD, suggesting broader systemic involvement.

Healing Requires Community—and Coordination

The first step for every woman who walks through my door is psychoeducation. Understanding ADHD as a neurological, hormonal, and emotional condition—not a personal failure—is profoundly healing.

But ADHD treatment in women must be holistic. I often coordinate care with:

• Dieticians

• General practitioners

• OBGYNs and endocrinologists

• Acupuncturists and osteopaths

• TCM, Ayurvedic, and chiropractic practitioners

• Physiotherapists

In both the Netherlands and Kosovo, I've seen that building a supportive care network is essential—not just for symptom management, but also to repair the trust broken by years of invalidation. For general practitioners and mental health professionals reading this: validation, curiosity, and collaboration go further than you might imagine. ADHD in women isn’t always obvious, but when seen clearly and treated comprehensively, the transformation can be life-changing.

A Final Note

To every woman who has felt like she's drowning in the invisible weight of her brain: you're not alone, and you're not broken.

ADHD in women is real, underdiagnosed, and often misrepresented. But with the right understanding, support, and compassion, it is absolutely possible to live a bold, connected, and meaningful life with ADHD.

And sometimes, the very traits that made you feel “too much” are exactly what the world needs more of.

References and Research Background

This blog draws on key insights from:

• Solden, S., Frank, M., & Littman, E. (2019). A Radical Guide for Women with ADHD: Embrace Neurodiversity, Live Boldly, Break Through Barriers. New Harbinger Publications.

• Webinar and clinical material based on research from PsyQ, Netherlands—a multidisciplinary mental health organization recognized for its specialized diagnostic and treatment services for ADHD across the lifespan.

Scientific literature and clinical research were also referenced to support information on hormonal interactions, trauma impacts, and physical comorbidities in women with ADHD.