ADHD in Women Is Often Missed—Until It’s Too Loud to Ignore

Why ADHD in Women Gets Missed—Across Every Life Stage

If you’re a woman who’s always felt a bit disorganized, forgetful, or mentally overloaded—but never found a name for it—you’re not alone. For decades, ADHD was viewed through a male, childhood-centered lens. As a result, many women are only recognized later in life—not because ADHD appears then, but because it finally becomes impossible to ignore.

In our Fempower Health interview, clinical psychologist and ADHD researcher Maggie Sibley, Ph.D. shared how ADHD shows up across the lifespan, why it’s so often missed in women, and what you can do to get clarity—no matter your age or life stage.

Hormones and ADHD in Women: What Changes in Midlife?

The Estrogen–Dopamine Connection

Estrogen plays a key role in dopamine regulation—the brain chemical involved in focus, reward, and motivation. As estrogen levels decline during perimenopause and menopause, dopamine activity can drop, leading to increased executive dysfunction.

That’s why women in their 40s and 50s may experience a dramatic worsening of ADHD symptoms—or encounter them for the first time.

A Surge in Symptoms

Women in midlife may report:

• Brain fog and forgetfulness

• Trouble focusing or prioritizing

• Emotional overwhelm or reactivity

• Increased anxiety or irritability

• Difficulty completing tasks

And many are misdiagnosed with anxiety or depression—without ever being screened for ADHD. One survey of women with ADHD found that the most difficult period of life was between ages 40–60.

ADHD vs. Executive Dysfunction: What’s the Difference?

Not all brain fog is ADHD. And not all ADHD is obvious. Dr. Sibley breaks it down like this:

ADHD

• Typically has childhood onset (even if mild or unnoticed)

• Symptoms may persist but evolve over time

• Often includes a mix of inattentiveness, impulsivity, and emotional sensitivity

• Can worsen during hormonal shifts

Executive Dysfunction

• May emerge in midlife due to hormone changes

• Involves difficulty with planning, focus, memory, or organization

• Might not meet the criteria for ADHD—but still affects quality of life

Why So Little Research Exists on ADHD in Women

Despite a surge in adult ADHD diagnoses, funding remains shockingly low.

Women’s experiences, especially in midlife, are often excluded from research. That means no FDA-approved guidance for how to treat ADHD in the context of hormonal shifts—and little understanding of whether hormone therapy could help.

ADHD Treatment Options for Adult Women

Evidence-Based Treatments

• Stimulant medications: Still the gold standard, and helpful for both ADHD and hormone-related executive dysfunction

• Non-stimulant options: For those who can’t tolerate stimulants or prefer alternatives

• Cognitive Behavioral Therapy (CBT): Especially effective for managing procrastination, building structure, and supporting emotional regulation

Lifestyle Strategies

While not a cure, lifestyle changes can make a difference:

• Exercise (especially early in the day)

• Consistent sleep routines

• Reducing screen time and digital overwhelm

• A protein-rich, low-sugar diet

• Mindful scheduling and use of external reminders

How to Advocate for a Proper ADHD Diagnosis

Don’t Settle for a Checklist

If you’re seeking answers, don’t accept a five-minute screening form as your full evaluation.

A real evaluation should:

• Include a full clinical interview

• Explore your history across life stages

• Rule out other explanations (anxiety, trauma, hormone-related changes)

• Last at least an hour

Where to Find Help

Look for clinicians with deep ADHD expertise—especially in adult women. Two trusted directories:

• CHADD.org: Children and Adults with ADHD

• ADDA.org: The Adult ADHD community with support groups and resources

Final Thoughts: You’re Not Imagining It

Whether you’ve had ADHD your whole life or are just starting to struggle with focus and follow-through, you deserve real answers.

You’re not lazy, and you’re not making it up. What you’re experiencing may be the result of overlooked biology and outdated assumptions.

🎧 Listen to the full episode with Dr. Maggie Sibley here for insights, tools, and next steps.

🎧 Learn about ADHD and family dynamics with Dr. Tamara Rosier.

📋 Contribute to the ADHD in Menopause Survey.