This narrative review looked at stimulant medicine in adult women with ADHD who menstruate. One reviewer searched a single database and included 12 publications, from one case report to a survey of 209 women with ADHD. Some studies were in women without ADHD.
Knowledge here is limited. Two studies looked at how stimulants affect female sex hormones in women with ADHD. Four studies suggested that ADHD symptoms get worse in the luteal phase. Two studies tested a treatment tailored to the menstrual cycle.
In women without ADHD, three studies found that d-amphetamine had a stronger felt effect in the follicular phase than in the luteal phase. Two of them linked a stronger effect to higher estrogen. One also found the effect in the luteal phase was weaker than in men.
In the largest study, 45.4% of the 209 women with ADHD reported PMS. The authors say this seems high, while citing general population rates of 20% to 50%. These women filled in one questionnaire, not daily symptom reports.
In a study of 9 women, all reported better ADHD and mood symptoms after a higher stimulant dose, with minimal side effects. In another study of 18 women, all said a female-specific treatment helped them.
The authors conclude that research cannot yet tell whether worsening before a period means more severe symptoms or a less effective medicine. They call for larger studies with equal gender representation.
Talk to a clinician about your own situation.
Source: Findeis H, Strauß M. The effects of psychostimulants in menstruating women with ADHD – A gender health gap in ADHD treatment?. Progress in Neuro-Psychopharmacology and Biological Psychiatry (2025). doi:10.1016/j.pnpbp.2025.111261