ADHD in Girls and Women: What We Miss and Why It Matters

For many women, the journey to an ADHD diagnosis doesn’t begin until adulthood, sometimes after a child’s diagnosis, sometimes during the emotional and hormonal rollercoaster of perimenopause. But ADHD has been there all along , just hidden under layers of coping strategies, expectations, and mislabelling.

In girls and women, ADHD can look very different from the stereotype. People tend to think of ADHD as loud, disruptive, or hyperactive — but many women grew up being labelled as “daydreamy,” “anxious,” “oversensitive,” or “lazy.” They may have been the ones who got good grades but stayed up until 3am finishing homework they couldn’t get started. The ones who talked too much, interrupted, or fidgeted constantly, and got told off for it.

Why Do We Miss ADHD in Girls and Women?

Girls often learn to mask early. We can become people-pleasers, perfectionists, or just exist, quietly overwhelmed. Many develop anxiety or depression as a result of unrecognised ADHD, especially if they’ve spent a lifetime feeling like they’re “too much” and “not enough” all at once.

The signs are often internal:

• Emotional overwhelm and sensitivity

• Chronic disorganisation or time blindness

• Difficulty with transitions or routines

• Trouble focusing on things that feel boring — but hyperfocusing on things we love

• Feeling constantly behind, even when others say we’re “doing fine”

  
  

As Dr. Edward Hallowell explains, ADHD in girls often presents with internalised symptoms that are “less likely to be disruptive in a classroom and more likely to be missed” (Hallowell & Ratey, 2023). This can delay diagnosis by decades.

Then Come the Hormones: The ADHD–Perimenopause Link

Many women I coach describe hitting a wall in their late 30s or 40s. Tasks they used to manage (just about) suddenly feel impossible. It’s not laziness, it’s a neurological and hormonal storm.

Oestrogen plays a key role in regulating dopamine, a neurotransmitter already underactive in ADHD brains. During perimenopause and menopause, when oestrogen levels drop, many women experience a noticeable increase in ADHD symptoms (Barkley, 2023).

You might notice:

• Increased forgetfulness

• Difficulty following conversations

• Losing track of time, even more than usual

• Emotional outbursts or shutdowns

• Heightened anxiety or irritability

Psychologist Nancy Doyle reminds us that the workplace and home can become sites of “invisible struggle,” particularly for neurodivergent women during these hormonal changes (Doyle & McDowell, 2022).

Sometimes, this shift is what finally brings ADHD to light.

But There’s Power in Knowing

A diagnosis, or even just the realisation that ADHD might be part of your story, can be the start of a huge shift in self-understanding. It doesn’t “fix” everything, but it reframes it. You are not broken, you’re neurodivergent.

With that knowledge comes the ability to:

• Understand and honour your energy cycles

• Use tools and routines that work with your brain

• Set boundaries and reduce overwhelm

• Build self-compassion instead of shame

As coach Julie Starr says, “Coaching begins with believing in people’s potential, not fixing their flaws.” And when we understand ADHD through a neurodiversity-affirming lens, we stop trying to mould ourselves to a system that was never built for us.

If Any of This Resonates — You're Not Alone

As a neurodivergent coach, I work with women who are navigating late diagnosis, motherhood, burnout, and the messy beauty of real life with an ADHD brain. If you’re wondering whether ADHD could be part of your story, or you already know and want to explore what comes next, I’m here.

👉 Book a free discovery call👉 Learn more about ADHD coaching

References

• Barkley, R. A. (2023). Taking Charge of Adult ADHD (2nd ed.). Guilford Press.

• Doyle, N., & McDowell, A. (2022). Neurodiversity at Work. Kogan Page.

• Hallowell, E. M., & Ratey, J. J. (2023). ADHD 2.0. Ballantine Books.

• Starr, J. (2021). The Coaching Manual (5th ed.). Pearson.