The Hidden ADHD Symptoms in Women That Delay Diagnosis

For years, she thought it was a personal failing. The missed deadlines, the lost keys, the chronic overwhelm that no amount of planners, podcasts, or self-help books could fix. 

She was told she was disorganized, anxious, emotional. Lazy. And she believed it.

Boys are twice as likely to be diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) than girls (15% vs 8%). But behind those numbers is a quieter reality: women with ADHD don’t fit the mold. 

Girls and women may not necessarily present the same as boys or men. They’re not impulsively blurting out in meetings or constantly on the move—Rather, they internalize. They overcompensate. And they suffer in silence while their thoughts are racing at a mile a minute.

When it comes to ADHD, women face unique challenges.  We’re often under- or misdiagnosed, plus the added pressure to meet societal expectations, which can exacerbate feelings of inadequacy and low self-esteem. One of the hidden factors for women is actually hormonal fluctuations and stages of the menstrual cycle that can also play a significant role in the severity of ADHD symptoms.

Many women are only now realizing, often decades later, that their struggles are not character flaws. Instead, these issues are a neurological condition that was overlooked.

Diagnosed at unprecedented rates, women are finding not just a label, but a long-overdue sense of clarity—and a grief for the years they spent not knowing.

Is ADHD different in men and women?

Yes and no. While the diagnostic criteria are the same for men and women, the presentations can be vastly different. According to the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders (DSM-5), symptoms of ADHD include: 

• Trouble paying or keeping attention (shown by five or more symptoms of inattention, listed below) 
• Significant impulsivity or hyperactivity (shown by five or more symptoms of hyperactivity, listed below)

Symptoms of inattention include: 

• Easily distracted
• Poor organization
• Trouble paying attention
• Frequently forgetful in daily activities
• Not listening when spoken to directly
• Careless mistakes or low attention to detail
• Difficulty following through on tasks and instructions
• Avoiding or disliking tasks that require high mental effort
• Frequently losing essential items (like keys, wallet, etc.)

Symptoms of hyperactivity include: 

• Restlessness
• Talking excessively
• Blurting out answers
• Difficulty waiting for a turn
• Frequent fidgeting or squirming
• Has difficulty with quiet activities
• Often interrupts or intrudes on others
• Acts "on the go" or as if "driven by a motor”
• Often leaves the seat in situations when remaining seated is expected (e.g., church or school)

For someone to be diagnosed with ADHD, their symptoms must cause significant distress or impairment, meaning they interfere with daily life. But because some symptoms can come across as harmless quirks or personality traits, many people go undiagnosed until later in life. Symptoms of ADHD can affect various aspects of life, including relationships, work, school, and leisure time. 

A person experiencing symptoms of ADHD may be diagnosed with one of the three types of ADHD: 

1. Inattentive Type– mostly inattention symptoms
2. Hyperactive-Impulsive Type– mostly hyperactivity/impulsivity symptoms
3. Combined Type – a mix of both 

Girls and women are more often diagnosed with the Inattentive Type, which doesn’t disrupt classrooms or meetings—it disrupts confidence. Symptoms like disorganization, forgetfulness, and mental fatigue are easy to miss or mislabel as anxiety, laziness, or simply “not trying hard enough.” 

Meanwhile, boys are more frequently diagnosed with Hyperactive-Impulsive, where the signs are louder, more physical, and more likely to raise concern.

The result? Girls are often left to cope alone, internalizing the belief that something is wrong with them—not realizing they’re navigating a neurological condition that’s simply been overlooked.

Why ADHD diagnosis is often delayed for women

Girls and women are diagnosed with ADHD at just half the rate of boys and men. Could it be because women just don’t experience ADHD at the same rate? 

Maybe. But we also know that researchers overlooked the study of ADHD in women for years. Once it started receiving some much-needed attention, it became clear that female presentations were being missed in both clinical and research settings. 

ADHD symptoms manifest differently for women
Unlike boys, symptoms of ADHD in girls and women are less noticeable. Co-author of a foundational longitudinal review on ADHD in women, Emily Rosenthal, notes that “compared to boys and men, girls and women with ADHD may have symptoms that are less noticeable to others… with symptoms such as difficulties with organization, focus, and attention to detail.” 

Socialization and societal expectations
Societal expectations may lead women to develop coping strategies that mask their ADHD symptoms. For instance, women are often socialized to be organized and nurturing, which can help them compensate and disguise their difficulties in areas like focus and organization. 

Variables in diagnostic criteria
The current diagnostic criteria and standards may not fully capture the nuances of how ADHD manifests in women. Traditional assessments may overlook these differences, leading to underdiagnosis. Additionally, clinicians may overlook these symptoms in females because of these less overt manifestations and their adoption of compensatory strategies, frequently referred to as “masking” in popular culture, which is a common cause of burnout and contributes to worsening mental and physical health.

Co-occurring conditions
Many women with ADHD may also experience co-occurring conditions. These can include autism spectrum disorder (ASD), bipolar disorder (BPD), and eating disorders. Clinicians may focus on these co-occurring conditions rather than identifying ADHD as the root issue.

Rewriting the narrative around adult women and ADHD

Dr. Mary Claire Haver, hailed as the Queen of Menopause, is outspoken about the effects of menopause on women in the workforce. On the Huberman Lab podcast, she cites a survey showing that 1 in 5 women consider leaving their job due to menopause symptoms. One of the most disruptive is diminished executive function—a struggle also common among those with ADHD.

While research is still limited, it’s clear that the connection between perimenopause and ADHD is real. As estrogen levels fluctuate, they impact key neurotransmitters like dopamine and serotonin—chemicals closely tied to focus, memory, and mood. This shift in brain chemistry helps explain why many women notice worsening ADHD symptoms or new struggles with attention and executive function during midlife. 

From quiet classrooms to boardrooms and through the hormonal shifts of midlife, women have carried the weight of symptoms they couldn’t name—often blaming themselves for what was never a personal failing. In the workplace, it might look like missed deadlines, forgotten meetings, or difficulty staying organized—followed by comments like “She’s so scattered,” “Why can’t she just focus?” or “She’s great, but a bit all over the place.” As awareness grows, so does the opportunity to rewrite the narrative. 

Whether the diagnosis comes in childhood or well into adulthood, understanding ADHD through a gender-informed lens is not just overdue—it’s essential. Because when women are finally seen, heard, and supported, the real work of healing and thriving can begin.

Whether you're already diagnosed or just starting to notice potential symptoms, you're not alone. Talk to your doctor or mental health provider about treatment options like therapy for ADHD to get the support you need.