If you live with both ADHD and difficult premenstrual symptoms, you're not imagining a connection — research is increasingly showing these two conditions are linked.
A 2025 study published in The British Journal of Psychiatry surveyed 715 women aged 18–34 in the UK to understand how common PMDD symptoms are among those with ADHD. The results were striking: about 31% of women with a clinical ADHD diagnosis and 41% of those who met a research-based threshold for ADHD reported symptoms consistent with PMDD. In comparison, only about 10% of women without ADHD reported similar symptoms. That means women with ADHD were roughly 3 to 4 times more likely to experience PMDD-level premenstrual problems.
The study also found that having depression or anxiety alongside ADHD raised the risk even further — those with all three conditions had the highest rates of provisional PMDD. Researchers suggest this pattern may be related to how the brain responds to normal hormonal shifts during the menstrual cycle. The drop in estrogen before your period can lower dopamine levels, and since dopamine is already involved in ADHD, this change may hit harder for those with the condition. This would also help explain why women with ADHD appear more vulnerable during other hormonal transitions, like postpartum or when starting hormonal birth control.
One important note: this study used a screening questionnaire rather than the gold-standard method of tracking symptoms daily over two cycles, so the results are considered "provisional" PMDD. Still, it adds to growing evidence that clinicians should actively screen for PMDD in women with ADHD. If you have ADHD and notice your symptoms getting significantly worse before your period, this research validates that experience and supports having a conversation with your healthcare provider.
Key findings
- 31.4% of females with a self-reported clinical ADHD diagnosis met criteria for provisional PMDD, compared with 9.8% in the non-ADHD reference group (RR 3.19, 95% CI 2.04–4.98, P < 0.001)
- 41.1% of females meeting ASRS-based ADHD criteria had provisional PMDD, corresponding to a 4.17-fold higher risk compared with the non-ADHD reference group (95% CI 2.87–6.07, P < 0.001)
- Females with ASRS-based ADHD plus comorbid depression and/or anxiety diagnoses had the highest risk for provisional PMDD (RR 4.53, 95% CI 3.10–6.61, P < 0.001)
- Females with ASRS-based ADHD only (no depression/anxiety) still had significantly elevated PMDD risk (RR 3.09, 95% CI 1.83–5.21, P < 0.001)
- PMDD symptom profiles were similar between ADHD and non-ADHD groups, except that ADHD groups endorsed insomnia at approximately twice the rate of the non-ADHD group
- The association between ADHD and provisional PMDD was similar regardless of hormonal contraceptive use
Methods, briefly
Cross-sectional online survey of N=715 females aged 18–34 assigned female at birth, recruited via Prolific.com in two waves (370 prescreened positive for ADHD, 370 prescreened negative). ADHD was assessed via self-reported clinical diagnosis (n=102) and the Adult ADHD Self-Report Scale with DSM-5-based symptom and impairment cut-offs (ASRS-based ADHD, n=229). Provisional PMDD was assessed using the Premenstrual Symptoms Screening Tool (PSST). Non-ADHD reference group n=305. Poisson regression with robust error variance was used to estimate relative risks. Sensitivity analyses examined hormonal contraceptive use.
Limitations to keep in mind
- Cross-sectional design precludes gold-standard PMDD diagnosis, which requires 2 months of prospective daily symptom tracking; retrospective reporting may include false positives
- Unable to distinguish PMDD from premenstrual exacerbation (PME) of existing ADHD, depression, or anxiety symptoms
- Self-reported clinical diagnoses of ADHD, depression, and anxiety were used rather than verified clinical records
- Sample recruited from an online research platform (Prolific) may not be demographically representative of the general population, with relatively high educational attainment
- Study description referencing mood changes during the menstrual cycle may have attracted participants who found this topic personally relevant, introducing selection bias
- No data collected on medications for depression or anxiety, which may affect PMDD symptoms
- Menstrual cycle regularity was not assessed
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