Abstract

Stimulant medications are an established treatment option for attention-deficit hyperactivity disorder (ADHD). In clinical practice, treatment success depends on identifying the optimal dose for the individual patient, meaning a dose that provides sufficient control of ADHD symptoms while remaining acceptable and well tolerated. This dose can vary significantly between individuals.

For girls and women treated with stimulant medication for ADHD, balancing symptom control and tolerability may be more complex than has historically been recognised. ADHD has often been studied and described without consideration of female-specific symptom patterns, hormonal fluctuations, or reproductive life stages. These aspects are highly relevant, as many of the difficulties commonly reported by girls and women with ADHD, including inattention, executive dysfunction, emotional dysregulation, fatigue, irritability, and mood-related symptoms, may overlap with symptoms that also vary in relation to hormonal changes.

A focused literature review was undertaken to examine whether hormonal fluctuations during the menstrual cycle, and hormonal changes across reproductive life stages, are associated with changes in ADHD symptoms, stimulant treatment response, tolerability, or dose needs in girls and women with ADHD.

This is an emerging research field where the available literature is limited and often qualitative rather than quantitative. For that reason, the current evidence should be interpreted carefully.