Puberty and ADHD Symptoms in Girls

The hormonal changes can cause an escalation of symptoms

Girl reading books.
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Adolescence can be notoriously difficult, for both parents and children. Fluctuating hormone levels can lead to mood swings, impulsiveness, and trouble concentrating on growing teens. Unfortunately, for teens with attention deficit/hyperactivity disorder (ADHD), the transitions of puberty can be further complicated by ADHD itself. 

Kids with ADHD tend to lag behind their peers who do not have ADHD in terms of emotional maturity. This means that for both boys and girls with ADHD—though their bodies are growing and developing similarly to their peers—they are having to deal with all the changes puberty brings at a "younger" emotional level.

In addition, research is showing that girls with ADHD face unique challenges during the onset of puberty. In fact, the disorder becomes easier to detect in girls at this time when the flood of hormones begins to cause dramatic changes in behavior. If you have an adolescent girl with ADHD at this age, you may be wondering how the hormonal changes at this stage of life might affect her disorder. If you notice that she has become more dramatic and emotional about little things, there is a good reason.

Understanding How Puberty Can Affect Girls With ADHD

Research is showing that the symptoms of ADHD often intensify for girls during puberty when estrogen increases in their bodies. As you already know, puberty is a time of great change in a girl's life as she begins the transition from childhood into adulthood. Her body is growing and developing both physically and sexually and she may experience a wide range of emotions that go along with the biological, cognitive, and social changes that are taking place.

Teen girls may feel that they are on an emotional roller coaster, and parents may be on the receiving end of moodiness and emotional volatility as they sort out the issues and internal confusion that their developing bodies, minds, and changing social relationships give rise to. These hormonal changes may cause mood and behavioral difficulties for girls with ADHD especially.

Many girls with ADHD become more over-reactive emotionally and hyper-irritable during puberty, and may have problematic mood swings, anxiety, and even feelings of panic.

Sleep problems may develop or worsen, and difficulties such as distractibility, inability to focus, disorganization, and feeling overwhelmed may become more prevalent. All of this can lead to increased self-consciousness and feelings of inadequacy. Self-esteem may plummet as a girl begins to internalize negative thoughts about herself.

It is helpful to be aware that the hormonal fluctuations that occur throughout a female's menstrual cycle can also worsen symptoms of ADHD. Girls with ADHD also tend to have more problems with PMS symptoms, which can further compound the problem.

How to Support Your Daughter

Just being aware of the effect puberty can have with your daughter is important. When you understand this, you can consciously be more sensitive and proactive in helping your daughter navigate and overcome these challenges and develop positive coping skills that will help her throughout her life. If your daughter lashes out or demonstrates other behavioral issues at home, modulating your own emotional responses can be helpful, keeping in mind that she is struggling within herself and not intentionally trying to be difficult.

Now is not the time to let structure and expectations slide, however. All children crave consistency and require boundaries to be set. Children with ADHD especially benefit from routine and predictability as well as regular downtime. 

Ellen Littman, Ph.D., a licensed clinical psychologist specializing in attentional disorders, recommends some of the following strategies:

  • Validate her perspective, even if you don't agree
  • Don't change plans suddenly; build in time for her to acclimate to it
  • Help her identify or embrace one of her strengths
  • Listen to her frustrations without offering solutions

There are some wonderful books that can be a help. Attention Girls! A Guide to Learn All About Your ADHD by Patricia O. Quinn, M.D., is geared towards girls age 8 to 13 and is a great resource to help girls better understand their own ADHD. Dr. Quinn has another book called 100 Questions & Answers About ADHD in Women and Girls. She is also co-author with Kathleen G. Nadeau, Ph.D., and Ellen B. Littman, Ph.D., of Understanding Girls with AD/HD. These are three information-packed books that we highly recommend.

4 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Berger I, Slobodin O, Aboud M, Melamed J, Cassuto H. Maturational delay in ADHD: evidence from CPT. Front Hum Neurosci. 2013;(7):691.  doi:10.3389/fnhum.2013.00691

  2. Matlen T, Solden S. The Queen of Distraction: How Women with ADHD Can Conquer Chaos, Find Focus, and Get More Done. New Harbinger Publications. 2014.

  3. Quinn PO, Madhoo M. A review of attention-deficit/hyperactivity disorder in women and girls: uncovering this hidden diagnosis. Prim Care Companion CNS Disord. 2014;(16)3.  doi:10.4088/PCC.13r01596

  4. Chronis-Tuscano A, Wang CH, Woods KE, Strickland J, Stein MA. Parent ADHD and Evidence-Based Treatment for Their Children: Review and Directions for Future Research. J Abnorm Child Psychol. 2017;(45)3:501-517.  doi:10.1007/s10802-016-0238-5

Additional Reading
  • Greatschools.org. Parenting. Attention disorders. Understanding girls with ADHD: symptoms and strategies. 
  • Smartkidswithlg.org. Girls with ADHD face unique challenges. Ellen Littman, Ph.D. 

By Keath Low
 Keath Low, MA, is a therapist and clinical scientist with the Carolina Institute for Developmental Disabilities at the University of North Carolina. She specializes in treatment of ADD/ADHD.