Undiagnosed ADHD in Women: Why It’s So Often Missed

Short answer: ADHD is underdiagnosed in girls and women.¹² Girls are more likely to have quieter, inattentive symptoms, to mask their difficulties, and to be treated for anxiety or depression before anyone considers ADHD.³ As a result, women tend to be diagnosed years later than men⁴ — and many only find out as adults.

Is ADHD underdiagnosed in women?

The numbers suggest so. In clinic samples, ADHD is diagnosed in boys 2 to 9 times as often as in girls. In population studies — which sample people from the community rather than only those referred to a clinic — the gap is 2 to 3 times, and in adults it’s less than double (about 5.4% of men and 3.2% of women).³

An expert consensus statement on girls and women with ADHD points to evidence that this gap is due, at least in part, to ADHD in girls not being recognised or referred, and warns that a large number of girls with ADHD are likely to remain unidentified and untreated.¹

Australia’s 2023 Senate inquiry into ADHD heard the same: that gender bias in assessment has led to under- and misdiagnosis of ADHD in girls and women, and that it’s common for them to be misdiagnosed with another mental health condition first.²

Why ADHD is missed in girls and women

Quieter, inattentive symptoms

Girls and women with ADHD are more likely to have the inattentive presentation — trouble focusing, forgetfulness, disorganisation — than obvious hyperactivity.⁵ A student who daydreams and struggles quietly is easier to overlook than one who disrupts the class. In one US survey, four in ten teachers said they found ADHD symptoms harder to recognise in girls.⁶ Read more about inattentive ADHD in adults.

ADHD masking in women

Many girls learn early to hide or make up for their difficulties — over-preparing, copying how others cope, or working much harder than everyone else just to keep up. Experts describe these compensatory strategies as masking, and they make ADHD harder to see from the outside.¹ In a survey submitted to the Senate inquiry, 86% of more than 570 respondents said they had tried to mask or hide their ADHD at school or work to fit in, and the inquiry heard that masking can lead to burnout.²

Being treated for something else first

Girls with ADHD who present with anxiety or depression may be treated for those conditions without ADHD ever being considered. Research has found that more young girls than young boys were treated with antidepressants before receiving treatment for ADHD (14% vs 5%).³ Girls and women are also more likely to be given a different primary diagnosis — such as anxiety, depression or a personality disorder — which delays the ADHD diagnosis.¹

That doesn’t mean the anxiety or low mood wasn’t real. ADHD often occurs alongside other mental health conditions,⁷ so a thorough assessment looks at both. If you’re not sure what you’re dealing with, read ADHD burnout vs depression.

Hormones change the picture

ADHD symptoms can shift with hormones. Clinicians report that symptoms in women often get worse in the lead-up to a period — and that it’s easy to put that down to premenstrual syndrome rather than ADHD.⁸

Undiagnosed ADHD and menopause

For some women, ADHD only becomes obvious in midlife. Many women with ADHD report that their symptoms got worse around menopause, and clinicians say a lot of women are “unmasked” at that stage.⁸ Research is still catching up: the Senate inquiry called for more research into the role of hormonal change, including pregnancy and menopause.⁹

ADHD starts in childhood — symptoms must have been present before age 12¹⁰ — so an assessment looks back over your whole life, not only at recent changes. If problems with focus or memory are new in midlife, talk to your GP, because menopause itself and other health issues can cause similar symptoms. See also does ADHD get worse with age?

How late are women diagnosed?

A Swedish population register study found that females were, on average, about four years older than males at their first ADHD diagnosis (23.5 vs 19.6 years).⁴

Australian data points the same way. From 2018–19 to 2023–24, the rate of females dispensed ADHD medication rose five-fold, from 4 to 19 per 1,000 people, while the rate for males more than doubled. By 2023–24, adult women were being dispensed ADHD medication at higher rates than adult men.¹¹ That’s prescription data rather than diagnoses, but it fits the same picture: many women are only being recognised as adults.

What untreated ADHD can mean for women

A systematic review of research on women living with undiagnosed ADHD found common themes: effects on social and emotional wellbeing, difficult relationships, and a sense of lack of control — and, after diagnosis, self-acceptance.¹² A broader review of research on adults with ADHD found that, among those diagnosed later in life, regret at not being diagnosed sooner came up again and again.¹³

A diagnosis doesn’t change the past, but it can help explain it, and it opens up options for treatment and support.

Signs it may be worth getting assessed

These are common experiences, not a diagnosis:

• You’ve struggled with focus, organisation or time for as long as you can remember, even when you try hard.
• You feel you work much harder than others to keep up, and it’s exhausting.
• You’ve been treated for anxiety or depression, but something still doesn’t add up.
• Your symptoms seem worse before your period, or harder to manage around perimenopause.
• A child or close relative has recently been diagnosed with ADHD — it runs strongly in families.¹⁴

For a fuller picture of how ADHD tends to show up in women day to day, read ADHD in women. If several of these sound familiar, our free ADHD self-assessment can help you decide whether a full assessment is worth it — it can’t diagnose ADHD on its own.

Getting assessed as an adult woman

ADHD can be assessed at any age. Your GP will look at your symptoms now and how far back they go, so you’ll also be asked about your school years — usually with a childhood history form completed by someone who knew you then, such as a parent.

Since December 2025, appropriately trained GPs in Queensland can diagnose and treat adult ADHD.¹⁵ We see adults anywhere in Queensland by telehealth — no referral needed — and we’re working on opening in other states. See how it works.

Frequently asked questions

Is ADHD underdiagnosed in women?

The evidence says yes. In clinic samples, boys are diagnosed with ADHD 2 to 9 times as often as girls, but in population studies the gap is only 2 to 3 times, and in adults it’s less than double. Experts put part of that difference down to ADHD in girls not being recognised or referred.

Why is ADHD missed in girls and women?

Girls are more likely to have the quieter, inattentive presentation and less likely to be disruptive, and many learn to mask their difficulties. They’re also often treated for anxiety or depression first, and hormonal changes can make symptoms come and go.

What is ADHD masking?

Masking means hiding or compensating for ADHD symptoms to fit in — for example by over-preparing, or working much harder than others just to keep up. It can make ADHD hard to spot from the outside, and it’s often exhausting.

Can ADHD be mistaken for anxiety or depression?

Yes. Girls and women with ADHD are often diagnosed with anxiety, depression or another mental health condition first and treated for that without ADHD being considered. The conditions can also occur together, so a thorough assessment looks at both.

Can menopause unmask ADHD?

It can. Many women with ADHD report that their symptoms got worse around menopause, and clinicians say a lot of women are unmasked at that stage. ADHD starts in childhood, though, so an assessment also looks back at your earlier life.

Is it too late to be diagnosed with ADHD as an adult woman?

No. ADHD can be assessed at any age, and many women are first diagnosed as adults — on average several years later than men.

Next steps

Not sure if you have ADHD? Start with our free ADHD test (the 18-question ASRS self-assessment). When you’re ready, our GPs offer telehealth assessments for adults in Queensland — no referral needed. Book an assessment or see how it works.

This article is general information only and is not medical advice. Only a qualified health professional can diagnose ADHD. ADHD GP is a private telehealth clinic staffed by AHPRA-registered Australian GPs. We currently see patients in Queensland.

Book your ADHD assessment

References

1. Young S, Adamo N, Ásgeirsdóttir BB, et al. Females with ADHD: An expert consensus statement taking a lifespan approach providing guidance for the identification and treatment of attention-deficit/hyperactivity disorder in girls and women. BMC Psychiatry. 2020; 20:404. PubMed PMID 32787804 — Expert consensus: the gap between males and females diagnosed with ADHD is due at least in part to lack of recognition and referral bias in females; many girls with ADHD are likely to remain unidentified and untreated, often mask with compensatory behaviours, and are more likely to first be diagnosed with an internalising or personality disorder, delaying the ADHD diagnosis.
2. Parliament of Australia — Senate Community Affairs References Committee. Assessment and support services for people with ADHD — Chapter 3: barriers to assessment and diagnosis. 2023. www.aph.gov.au — Almost all adult ADHD assessment and diagnosis in Australia is done through the private sector, and cost is a barrier to diagnosis. The committee heard that gender bias has led to under- and misdiagnosis of ADHD in girls and women, who are commonly misdiagnosed with other mental health conditions first and often learn to mask their symptoms.
3. Quinn PO, Madhoo M. A Review of Attention-Deficit/Hyperactivity Disorder in Women and Girls: Uncovering This Hidden Diagnosis. Primary Care Companion for CNS Disorders. 2014; 16(3):PCC.13r01596. PubMed PMID 25317366 — ADHD is 2–9 times more common in boys than girls in clinical samples but 2–3 times in population samples, and less than twice as common in men as women (5.4% vs 3.2%); women tend to be older than men when diagnosed, girls with anxiety or depression may be treated without ADHD being considered, and more girls than boys were treated with antidepressants before ADHD treatment (14% vs 5%).
4. Skoglund C, Sundström Poromaa I, Leksell D, et al. Time after time: failure to identify and support females with ADHD — a Swedish population register study. Journal of Child Psychology and Psychiatry. 2024. PubMed PMID 38016697 — Females were about four years older than males at first ADHD diagnosis (23.5 vs 19.6 years).
5. Hinshaw SP, Nguyen PT, O’Grady SM, Rosenthal EA. Annual Research Review: Attention-deficit/hyperactivity disorder in girls and women: underrepresentation, longitudinal processes, and key directions. Journal of Child Psychology and Psychiatry. 2022. PubMed PMID 34231220 — Review of presentation, under-identification and outcomes of ADHD in girls and women, including the predominance of inattentive symptoms.
6. Quinn P, Wigal S. Perceptions of girls and ADHD: results from a national survey. MedGenMed. 2004. PubMed PMID 15266229 — Four in ten teachers reported more difficulty recognising ADHD symptoms in girls; most believed girls with ADHD are more likely to go undiagnosed.
7. Kessler RC, Adler L, Barkley R, et al. The prevalence and correlates of adult ADHD in the United States: results from the National Comorbidity Survey Replication. American Journal of Psychiatry. 2006. PubMed PMID 16585449 — Estimated prevalence of current adult ADHD 4.4%; ADHD significantly correlated with other DSM-IV disorders.
8. RACGP newsGP. How do hormones alter women’s ADHD symptoms?. 2026. www1.racgp.org.au — ADHD symptoms in women often worsen before a period and can be unmasked at menopause.
9. Parliament of Australia — Senate Community Affairs References Committee. Assessment and support services for people with ADHD — Chapter 8. 2023. www.aph.gov.au — ADHD in older people is poorly understood; the committee called for research into the role of hormonal change including pregnancy and menopause.
10. American Psychiatric Association. What is ADHD?. 2022. www.psychiatry.org — ADHD is one of the most common mental disorders affecting children; symptoms must be present before age 12; an estimated 8.4% of children and 2.5% of adults have ADHD.
11. Australian Institute of Health and Welfare. ADHD medications dispensed over time. 2025. www.aihw.gov.au — PBS-dispensed ADHD medication rose from 2 patients per 1,000 population in 2004–05 to 22 in 2023–24; over 4.6 million prescriptions to just under 600,000 patients in 2023–24, 87% psychostimulants. From 2018–19 to 2023–24 the rate for females rose five-fold (4 to 19 per 1,000) while the rate for males more than doubled (11 to 26); by 2023–24 rates for adults were higher in females than males.
12. Attoe DE, Climie EA. Miss. Diagnosis: A Systematic Review of ADHD in Adult Women. Journal of Attention Disorders. 2023; 27(7):645–657. PubMed PMID 36995125 — Systematic review of the impact of living with undiagnosed ADHD and adult diagnosis on women; themes were impacts on social-emotional wellbeing, difficult relationships, lack of control, and self-acceptance after diagnosis.
13. Ginapp CM, Macdonald-Gagnon G, Angarita GA, Bold KW, Potenza MN. The lived experiences of adults with attention-deficit/hyperactivity disorder: a rapid review of qualitative evidence. Frontiers in Psychiatry. 2022; 13:949321. PubMed PMID 36032220 — Review of 35 qualitative studies of adults with ADHD; regret at not having been diagnosed earlier was a ubiquitous finding among adults diagnosed later in life.
14. Parliament of Australia — Senate Community Affairs References Committee. Assessment and support services for people with ADHD — Chapter 1. 2023. www.aph.gov.au — ADHD occurs in about 6–10% of Australian children and adolescents and 2–6% of adults; heritability is estimated at 70–80%; Deloitte estimated 814,500 Australians living with ADHD in 2019 at a cost of $20.42 billion.
15. Queensland Health. Prescribing psychostimulants for ADHD — expanded prescribing rights. 2025. www.health.qld.gov.au — Queensland GPs can diagnose and treat adult ADHD, including prescribing psychostimulants, under the expanded prescribing rights in force from December 2025.

Sources were last checked on 5 October 2026. See all sources used on this site on our Sources page.