Women and ADHD, Why It’s Missed For Years

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Disclaimer: This article is for informational purposes only and does not constitute medical advice. ADHD affects individuals differently, and diagnosis or treatment should always be discussed with a qualified healthcare professional. If you believe you may have ADHD or are struggling with your mental health, please seek guidance from your GP or an appropriate specialist.

The invisible struggle behind late diagnosis, masking, and misunderstood symptoms

Attention Deficit Hyperactivity Disorder (ADHD) is still widely misunderstood, and nowhere is this more evident than in women. For decades, ADHD has been stereotyped as a childhood condition affecting disruptive young boys. As a result, countless girls grow up undiagnosed, learning to mask their difficulties, internalise their struggles, and blame themselves for challenges that have a neurological basis.

Many women only discover they have ADHD in adulthood, often after years of anxiety, burnout, depression, or repeated cycles of overwhelm. By then, the emotional toll can be profound.

So why is ADHD in women so often missed?

ADHD Doesn’t Always Look the Same in Women

Traditional diagnostic criteria were developed largely from studies on boys. These focused on visible hyperactivity, impulsivity, and behavioural disruption, traits more commonly expressed externally.

Women and girls, however, are more likely to present with:

• Inattention rather than hyperactivity
• Daydreaming and mental “drift”
• Chronic disorganisation
• Emotional sensitivity
• Low self-esteem
• Perfectionism
• Internalised anxiety
• Exhaustion from masking

Instead of running around classrooms, many girls sit quietly, struggling silently. Teachers may describe them as “bright but distracted” or “not reaching their potential,” rather than recognising neurodivergence.

Because their symptoms are less disruptive to others, they are less likely to be referred for assessment.

The Role of Masking

From an early age, many girls learn to hide their difficulties in order to fit in. This process, known as masking, involves consciously or unconsciously copying socially accepted behaviours while suppressing natural responses.

Masking might look like:

• Over-preparing to compensate for forgetfulness
• Becoming people-pleasers
• Working twice as hard to appear organised
• Hiding emotional overwhelm
• Avoiding situations that expose struggles

While masking can help someone survive socially, it comes at a cost. Over time, it can lead to chronic stress, burnout, anxiety, depression, and a deep sense of inadequacy.

By adulthood, many women appear to be “coping,” which further delays recognition and diagnosis.

Hormones Matter, But Are Rarely Discussed

Female hormones significantly affect ADHD symptoms, yet this is still poorly acknowledged in clinical settings.

Oestrogen plays a key role in dopamine regulation, the very neurotransmitter involved in ADHD. Fluctuations across the menstrual cycle, pregnancy, postpartum, perimenopause, and menopause can dramatically worsen symptoms such as:

• Brain fog
• Emotional dysregulation
• Fatigue
• Memory problems
• Executive dysfunction

Many women first seek help during perimenopause, believing something is “suddenly wrong,” when in reality ADHD has been present all along, now intensified by hormonal change.

Misdiagnosis Is Common

Rather than ADHD, women are frequently diagnosed with:

• Anxiety disorders
• Depression
• Borderline personality disorder
• Burnout or stress-related conditions

While these may coexist with ADHD, they are often treated in isolation, leaving the underlying neurodevelopmental condition unaddressed.

This can result in years of ineffective treatment, mounting frustration, and a growing belief that the problem lies with the individual rather than the system.

The Emotional Cost of Late Diagnosis

Receiving an ADHD diagnosis later in life can be both validating and heartbreaking.

Many women grieve for:

• Missed opportunities
• Struggles at school or work
• Relationships affected by misunderstandings
• Years spent feeling “lazy,” “broken,” or “not good enough”

At the same time, diagnosis can bring clarity, self-compassion, and access to appropriate support, often for the first time.

Understanding that your brain simply works differently can be life-changing.

Moving Forward: Awareness, Compassion, and Better Systems

Improving outcomes for women with ADHD starts with:

• Greater public awareness
• Updated diagnostic criteria that reflect female presentations
• Clinician training on adult and hormonal ADHD
• Earlier screening in schools
• Workplace understanding and reasonable adjustments
• A shift away from stigma and towards neurodiversity acceptance

No one should have to wait decades to understand their own mind.

Conclusion

ADHD in women is not rare; it is routinely overlooked.

Behind many “high-functioning” women are years of invisible effort, exhaustion, and self-doubt. By recognising the unique ways ADHD presents in women, we can begin to replace silence with understanding, misdiagnosis with clarity, and isolation with support.

Late diagnosis should not be the norm. Every woman deserves to be seen, heard, and supported, not just taught to cope.

Further Reading & Resources

• Understanding ADHD in Women | Symptoms, Diagnosis, Treatment
• ADHD testing and treatment for women
• ADHD in adults – NHS
• ADHD in Women: Signs and Symptoms
• ADHD in Women: Full Symptom Checklist & Signs
• ADHD in Women: Symptoms, Diagnosis & Treatment
• ADHD Symptoms in Women: Misunderstood, Overlooked, Undertreated
• https://disabledentrepreneur.uk/category/adhd/
• https://disabledentrepreneur.uk/category/womenshealthawareness/
• ADHD in Women: Signs, Symptoms, and Treatment – ADDA – Attention Deficit Disorder Association