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Women diagnosed with ADHD five years later than men
Women are diagnosed with ADHD around five years later than men, despite symptoms appearing at the same age, new research has revealed.
The delay in diagnosis is linked to worse outcomes for women with attention-deficit/hyperactivity disorder (ADHD), which affects concentration and impulse control.
It is associated with higher rates of depression, anxiety and everyday impairment.
Scientists analysed 900 adults (54.9 per cent male, 45.1 per cent female, average age 36.94) newly diagnosed with ADHD at a specialised outpatient programme in Barcelona.
Women were diagnosed at an average age of 28.96 years compared to 24.13 for men, despite symptoms starting at similar ages.
By the time of diagnosis, women showed more severe symptoms, with higher rates of depression and anxiety and poorer daily functioning.
Men, meanwhile, were around three times more likely to have legal issues, with 18.1 per cent reporting such problems compared to 6.6 per cent of women.
“ADHD affects millions of people, but our understanding of how it presents and impacts males and females differently remains limited,” said Dr Silvia Amoretti, lead researcher from Barcelona.
“We found that females are underdiagnosed, often receiving a diagnosis years later than males.
“This delay may lead to worse clinical outcomes, including depression, anxiety and functional impairment.
“Males, on the other hand, showed a higher level of involvement in delinquent behaviours such as legal problems and driving-related difficulties.
“We believe that a better understanding of these sex-based differences might improve diagnosis and treatment.”
The research compared males and females across factors such as age at diagnosis, symptom severity, psychiatric comorbidities, psychosocial functioning and disability.
Participants underwent standardised clinical interviews and validated rating scales.
Dr Amoretti said the finding had not been expected: “We didn’t set out to compare the age of diagnosis in males and females.
“We were aiming to understand the general age when symptoms appear, regardless of sex.
“This difference emerged during the analysis, and the scale of it came as a surprise.”
Experts believe delayed diagnosis in women often results from differences in symptom presentation.
Boys tend to show more visible hyperactive or impulsive behaviour, making ADHD easier to spot. Girls are more likely to display inattentive traits that seem less disruptive.
“It’s likely that women are diagnosed later because ADHD manifests differently in men and women,” Dr Amoretti said.
“Boys are more likely to be hyperactive or impulsive, behaviour that is more obvious to parents, teachers and clinicians. Girls are more often inattentive and less disruptive.
“Clinically, this means women are not treated early enough and are sometimes not diagnosed at all. We have seen similar tendencies internationally, so it is likely this is a global problem.
“The nature of the condition leads to poorer diagnosis in women everywhere, meaning they can lose on average five years of treatment — five years of a better life.”
Professor Sandra Kooij from Amsterdam UMC/VUmc and PsyQ in The Hague, who was not involved in the research, said differences in symptoms, limited clinician awareness of ADHD in women and hormonal changes affecting mood all contribute to delays in diagnosis.
“Increasing awareness in both society and medicine helps girls and women to get earlier help when they need it,” Professor Kooij said.
A hormone sensor being developed in Australia could help reduce fertility treatment costs and patient pain during IVF.
When preparing for egg collection or an embryo transfer, IVF patients rely on clinicians to closely monitor hormone levels to ensure the procedure is timed precisely when progesterone, oestradiol and luteinising hormone levels are optimal, giving the patient the best chance at conception.
Currently, blood tests are the primary method of measuring progesterone levels, requiring patients to undergo multiple blood draws at a laboratory during certain stages of their menstrual cycle.
However, this approach has several limitations.
For example, if testing falls on a weekend, when most labs are closed, IVF providers are forced to choose a less optimal testing time, potentially affecting treatment precision.
University of Melbourne alumni Edgar Charry and Muhammad Umer, whose partners have lived experience of infertility, created a reproductive health solution by developing a biosensor that can detect progesterone and oestradiol levels using fluid found in the skin, rather than in the blood.
Their startup company Symex Labs has partnered with the University of Melbourne to translate their research into a commercial product.
“Previous research shows nearly all hormones that exist in blood, are also present in interstitial fluid,” said Symex Labs co-founder Charry.
“Interstitial fluid is clear fluid just under the skin that sits between cells, delivering nutrients and carrying away waste.”
“Our biosensor will eventually be worn as a patch and will work by penetrating the skin using small microneedles to attract progesterone molecules in the patient’s interstitial fluid.
“These molecules will bind to the surface of the probe, generating electrical activity. The technology then translates the electrical activity to progesterone levels, ultimately informing the IVF clinical team if the patient is ready for embryo transfer.
“This data will be sent directly to the clinic’s monitoring system, allowing IVF nurses to review the results and advise the patient.”
Monash IVF research director associate professor Mark Green said that, for Monash IVF, the investment in Symex Labs aligns with the company’s focus on innovation and improving the patient journey.
“This technology will save patients time and money as they can conveniently wear the patch in the comfort of their own home, resulting in fewer visits to the clinic and fewer painful injections,” associate professor Green said.
“The biosensor would also be a gamechanger for women living in regional areas, who often have to travel long distances for blood draws.”
As the exact amount of progesterone in interstitial fluid is not well understood, Symex Labs is conducting a world-first clinical study at Monash IVF to establish baseline levels by benchmarking them against concentrations measured in blood samples.
Researchers say their hormone tracking technology also has wider clinical applications beyond the IVF sector.
“Our wearable hormone biosensor has strong potential well beyond fertility care, particularly in PCOS management, perimenopause and menopause symptom management, where continuous hormone insight can replace today’s indirect, symptom-based tracking,” said Symex Labs co-founder Muhammad Umer.
“By integrating directly with consumer health apps, the technology can enable personalised, data-driven management of chronic hormonal conditions and life-stage transitions that currently lack real-time biomarkers.
“For example, if a woman’s oestrogen is going up and down constantly, that’s often a sign that she is getting into that stage, so having access to this health information could help women implement lifestyle changes earlier.”
The research has received A$2.5m in funding from the federal government, the University of Melbourne’s Genesis fund, Monash IVF, RMIT and Breakthrough Victoria.
The first in-human pilot study is expected to get underway within the next 12 months, with commercialisation plans slated for early 2028.
Pregnancy complications may leave women more vulnerable to the long-term heart effects of stress, a recent study suggests.
A study of more than 3,000 women in their first pregnancy found persistently higher stress levels were associated with higher blood pressure after pregnancy, specifically in women who had adverse pregnancy outcomes including preeclampsia, preterm birth, having a baby that was small for gestational age, meaning smaller than expected for that stage of pregnancy, or stillbirth.
Among women who experienced these complications, higher stress levels over time were associated with blood pressure that was 2 mm Hg higher than that of the low-stress group during the years two to seven after delivery.
This was not the case among women who did not experience adverse pregnancy outcomes.
Virginia Nuckols, lead author of the study and a postdoctoral fellow in the University of Delaware’s department of kinesiology and applied physiology, said: “For women who were having babies for the first time and had complications, referred to as adverse pregnancy outcomes, we found that higher stress levels over time were associated with higher blood pressure levels 2-to-7 years after delivery.
“This suggests that women who had pregnancy complications may be more susceptible to the negative effects of stress on their heart health, and taking steps to manage and reduce stress could be important for protecting long-term heart health.”
The researchers analysed records of 3,322 first-time mothers aged 15 to 44 who did not have high blood pressure before pregnancy.
The women were enrolled at 17 medical centres in eight US states, were pregnant with one baby and were having their first child. According to the authors, 66 per cent of participants self-identified as white, 14 per cent as Hispanic and 11 per cent as Black.
Blood pressure and stress levels were measured during the first and third trimesters, and again two to seven years after delivery.
Stress was assessed using the Perceived Stress Scale, a standard questionnaire that asks how often people feel situations are uncontrollable, unpredictable or overwhelming.
Those who experienced moderate to high stress levels were often younger, between 25 and 27 years of age, had higher body mass index, a measure based on height and weight, and lower educational attainment.
The authors said it is not yet clear exactly how higher stress leads to higher blood pressure in women who had pregnancy complications, and that several factors are likely to be involved.
Nuckols added: “Future studies should examine why women with a history of adverse pregnancy outcomes may be more susceptible to stress-driven increases in blood pressure and test whether stress reduction interventions can actually lower cardiovascular risk for these women.”
High blood pressure during pregnancy can have lasting effects on maternal health, including preeclampsia, eclampsia, stroke or kidney problems, according to the American Heart Association’s 2025 guideline for the prevention, detection, evaluation and management of high blood pressure in adults.
Monitoring blood pressure before, during and after pregnancy is crucial to help prevent and reduce the risk of long-term complications.
Laxmi Mehta is chair of the American Heart Association’s Council on Clinical Cardiology and director of preventive cardiology and women’s cardiovascular health at The Ohio State University Wexner Medical Center, and was not involved in the study.
Mehta said;’ “This study highlights the powerful connection between the mind and heart, emphasising the importance of stress management, particularly for those who have experienced adverse pregnancy outcomes.
“For the clinical care team, it reinforces the need to proactively assess and address stress as part of the comprehensive care we provide to our patients.
“Future research on whether targeted interventions to reduce or manage stress has a meaningful impact on long-term cardiovascular outcomes will be important as well.”
AI could help routine mammograms spot heart disease risk in women, as well as breast cancer, researchers have found.
A team from Emory University analysed regular screening scans from more than 123,000 women who had no prior history of cardiovascular disease.
Using an AI programme to quantify calcification and hardening in the arteries, they found women with severe cases had two to three times the risk of developing potentially fatal heart attacks, stroke and heart failure.
“This was true even in younger women under 50, a group often considered low-risk, and held up after accounting for other risk factors like diabetes and smoking,” said Hari Trivedi, Emory associate professor and co-director of the university’s Health Innovation and Translational Informatics lab, who described the research as the largest study of its kind.
“We wanted to test whether AI could use this to identify women at risk of cardiovascular disease at no extra cost or inconvenience.
“”For women, this means a mammogram you’re already having could also provide important information about your heart health, prompting a conversation with your doctor about preventive steps such as cholesterol testing or medication.”
The researchers’ work was published today in the European Heart Journal, from the European Society of Cardiology, which noted that women are largely underdiagnosed and undertreated for cardiovascular disease.
They wrote that the high resolution of routine mammograms could allow for essentially automatic, direct visualisation of the arterial beds within the breasts of nearly all adult women, with calcifications easy to detect and correlated with deposits found in other parts of the body.
The researchers said that, compared with imaging of the heart’s coronary arteries, where blockages narrow and impede the flow of oxygenated blood to the heart muscle, calcifications in breast tissue affect a separate layer of the vessel, resulting in increased artery stiffness, a measure typically linked to long-term hypertension.
They described the finding as an independent predictor of cardiovascular disease and a potentially useful addition to traditional cardiovascular risk factors.
In an accompanying editorial, Lori Daniels, a cardiologist and professor of medicine at the UC San Diego School of Medicine, said that while fewer than 40 per cent of women may know their cholesterol levels, many more are up to date with their breast cancer screening.
“Two-thirds of women aged 50-69 in the European Union reported a mammogram within the prior 2 years, and in the USA, nearly 70 per cent of women aged 45 years and older were up to date with mammography according to American Cancer Society screening guidelines,” Daniels wrote.
“Breast arterial calcification has the potential to reframe this mismatch, leveraging a widely adopted cancer-screening platform to identify cardiovascular risk in women who may not otherwise engage with prevention.”
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