Researchers in the Netherlands surveyed 209 women aged 18 to 71 who were patients at a clinic for adult ADHD. Most were of reproductive age. The women answered questions about premenstrual mood, depression after a first childbirth and menopause symptoms.
Nearly half reported signs of premenstrual dysphoric disorder, a severe form of premenstrual mood change (45.5%). The authors say this seems high next to a general-population study (28.7%). Among the 85 women with a child, more than half reported signs of depression after their first birth (57.6%). Neither rate was tested against the general population, and the authors say both should be read with caution.
Women past reproductive age reported far more menopause symptoms than Dutch norm groups. Within the sample, women using hormonal contraceptives reported fewer premenstrual symptoms, and those using antidepressants reported more. These are links, not proof of cause. Sleep timing was not related to any of the measures.
The authors call this a preliminary study. All answers were self-reported, some looking back in time. The study could not show whether these rates are specific to ADHD or shared by women with other psychiatric conditions.
The authors suggest clinicians be aware that many women with ADHD of reproductive age may have significant premenstrual symptoms, while noting that studies on treatments for this are still lacking.
Talk to a clinician about your own situation, including any questions about treatment.
The numbers Stats and what the terms mean
The statistics behind the plain-language claims above.
- Dorani, 2021: contraceptive use in women with versus without signs of premenstrual dysphoric disorder, 50.6% vs. 68.1%, χ2 (1) = 5.82; p = .016, OR = 2.09 (Table 1 prints χ2 = 5.531, p = .019).
- Dorani, 2021: contraceptive use and a lower number of premenstrual symptoms, after accounting for age and education, p = .006.
- Dorani, 2021: antidepressant use and a higher number of premenstrual symptoms, β 1.372, SE 0.627, p = .030.
- Dorani, 2021: menopause symptom total score versus Dutch norms, perimenopausal women 50.06 (3.02) vs 15.78 (9.09), d = 5.06; postmenopausal women 48.02 (2.56) vs 15.33 (9.01), d = 4.94; both p <.001. What the terms mean:
- p A number from a statistical test that shows how unusual a result would be if there were really no effect; here, small values mean the differences were unlikely to be down to chance alone.
- χ2 A test that checks whether two groups differ in how often something happens, here how often they used contraceptives.
- OR An odds ratio, which compares the odds of something between two groups; 1 means no difference.
- β How much the number of premenstrual symptoms changed with antidepressant use, with SE showing how uncertain that estimate is.
- d An effect size, a number that shows how big a difference is, here between the ADHD group and the norm group. Roughly, 0.2 is small, 0.5 is moderate and 0.8 is large. A minus sign shows the direction of the change, not its size.
- The figures in brackets after each score are standard deviations, which show how spread out the scores were.
Source: Dorani F, Bijlenga D, Beekman A, et al.. Prevalence of hormone-related mood disorder symptoms in women with ADHD. Journal of Psychiatric Research (2021). doi:10.1016/j.jpsychires.2020.12.005