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High and Low Estrogen Exacerbate ADHD Symptoms in Females: New Theory

The impact of rising and falling hormone levels on ADHD symptoms is compounded for females beginning in puberty, according to a review article published in Hormones and Behavior.

ADHD symptoms correlate with hormonal fluctuations, especially declines in estrogen, argue the review authors, who present a new two-phase theory of hormonal sensitivity that asserts ADHD impairments spike during two points in the menstrual cycle:

  • Periovulatory (mid-cycle)
  • Perimenstrual (end-of-cycle)

Per the theory, females may be more likely to engage in risk-taking and reward-seeking behaviors in the days leading up to ovulation. These behaviors coincide with a steady rise in estrogen levels that drops off during ovulation. In contrast, withdrawal and/or depletion of estrogen at a cycle’s end may be characterized by increased negative affect, avoidant behaviors, and reduced executive functioning.

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