ADHD and the female reproductive stages: menstruation, perinatal and menopause

PURPOSE: Gender differences in the presentation of Attention-Deficit/Hyperactivity Disorder (ADHD) are well-documented, yet the interaction between ADHD and female reproductive stages remains underexplored. This study investigates how ADHD impacts menstruation, perinatal experiences, and menopausal symptoms in females. METHODS: A cross-sectional study was conducted with 602 females (mean age = 39.52; SD = 10.21), including 377 with self-reported ADHD and 225 without, recruited through ADHD support groups, social media, Volunteer Ireland, and Prolific. Participants reported their menstrual regularity and completed the Premenstrual Symptoms Screening Tool (PSST). Retrospective postpartum depression levels were measured using the Edinburgh Postnatal Depression Scale (EPDS), and peri- and post-menopausal symptoms were evaluated using the Greene Climacteric Scale (GCS). RESULTS: Females with ADHD exhibited significantly higher rates of menstrual irregularity (χ2 = 14.2, p < .001), more severe premenstrual symptoms (χ2 = 204.7, p < .001), elevated postpartum depression levels (t = 7.89, p < .001) with increased risk of unplanned pregnancies and pregnancy-related complications, and greater menopausal symptom severity (t = 9.61, p < .001) compared to their non-ADHD counterparts. CONCLUSIONS: These findings highlight a higher prevalence of reproductive-related challenges in females with ADHD, underscoring the need for further research in this area and more in-depth analysis. They emphasise the importance of integrating ADHD considerations into female health research and clinical practice.