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Background <p>Attention-Deficit/Hyperactivity Disorder (ADHD) and associated comorbidities in women are poorly recognised and often late diagnosed or misdiagnosed. This has significant negative impacts on the health and wellbeing of girls and women across their lifespan.</p> Aim <p>This integrative literature review aims to synthesize existing studies on the impacts of ADHD and associated comorbidities, as well as the challenges of delayed diagnosis and misdiagnosis for women and girls, focussing on critical life stages such as adolescence, perinatal, postnatal and (peri)menopause. Additionally, this review aims to identify evidence-based strategies for improving diagnosis, treatment, and support for this vulnerable population.</p> Methods <p>An integrative literature review was conducted using Whittemore and Knafl’s framework. Searches were performed in Embase, Cumulative Index for Nursing and Allied Health Literature (CINAHL), PubMed, National Library of Medicine (Medline), Scopus and Google Scholar (March - April 2025). Studies were selected based on defined inclusion and exclusion criteria, focussing on women and girls diagnosed with ADHD and their experience regarding diagnosis, comorbidities and treatment outcomes, were peer-reviewed, and published in English. Data was managed in Covidence and appraised using MMAT and AGREE II.</p> Results <p>The review identified and included ten studies (five qualitative, four cohort, one mixed-methods) and one guideline, published between January 2023 - April 2025, revealing five key developmental domains: Childhood and adolescence - late diagnosis and early comorbidities, Adulthood - hormonal impacts and comorbidities, Perinatal period - outcomes and challenges, Menopause and later life - hormonal transitions and late diagnosis, Cross-developmental treatment considerations - evidence gaps and women-specific approaches. Girls and women with ADHD frequently experience delayed diagnosis, leading to heightened risk of anxiety, depression and maladaptive coping strategies. Hormonal fluctuations were found to exacerbate ADHD symptoms, particularly during critical developmental phases such as puberty, the perinatal period, menopause and later life. Highlighting the need for tailored assessment, treatment and care approaches.</p> Conclusion <p>The findings highlight the urgent need to improve awareness of specific ADHD presentations in women and girls and better training for healthcare providers, aiming for earlier diagnosis and comprehensive individualised, tailored treatment strategies. Future research should focus on understanding the interplay between ADHD and its comorbidities, as well as exploring sex specific treatment options to improve health outcomes for women with ADHD.</p>

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Integrative literature review – the impact of ADHD across women’s lifespan

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  • 发表日期：

    2025年12月8日

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  • Kati Krebs,
  • Roslyn Donnellan-Fernandez

摘要

Background

Attention-Deficit/Hyperactivity Disorder (ADHD) and associated comorbidities in women are poorly recognised and often late diagnosed or misdiagnosed. This has significant negative impacts on the health and wellbeing of girls and women across their lifespan.

Aim

This integrative literature review aims to synthesize existing studies on the impacts of ADHD and associated comorbidities, as well as the challenges of delayed diagnosis and misdiagnosis for women and girls, focussing on critical life stages such as adolescence, perinatal, postnatal and (peri)menopause. Additionally, this review aims to identify evidence-based strategies for improving diagnosis, treatment, and support for this vulnerable population.

Methods

An integrative literature review was conducted using Whittemore and Knafl’s framework. Searches were performed in Embase, Cumulative Index for Nursing and Allied Health Literature (CINAHL), PubMed, National Library of Medicine (Medline), Scopus and Google Scholar (March - April 2025). Studies were selected based on defined inclusion and exclusion criteria, focussing on women and girls diagnosed with ADHD and their experience regarding diagnosis, comorbidities and treatment outcomes, were peer-reviewed, and published in English. Data was managed in Covidence and appraised using MMAT and AGREE II.

Results

The review identified and included ten studies (five qualitative, four cohort, one mixed-methods) and one guideline, published between January 2023 - April 2025, revealing five key developmental domains: Childhood and adolescence - late diagnosis and early comorbidities, Adulthood - hormonal impacts and comorbidities, Perinatal period - outcomes and challenges, Menopause and later life - hormonal transitions and late diagnosis, Cross-developmental treatment considerations - evidence gaps and women-specific approaches. Girls and women with ADHD frequently experience delayed diagnosis, leading to heightened risk of anxiety, depression and maladaptive coping strategies. Hormonal fluctuations were found to exacerbate ADHD symptoms, particularly during critical developmental phases such as puberty, the perinatal period, menopause and later life. Highlighting the need for tailored assessment, treatment and care approaches.

Conclusion

The findings highlight the urgent need to improve awareness of specific ADHD presentations in women and girls and better training for healthcare providers, aiming for earlier diagnosis and comprehensive individualised, tailored treatment strategies. Future research should focus on understanding the interplay between ADHD and its comorbidities, as well as exploring sex specific treatment options to improve health outcomes for women with ADHD.