Relationship between sex hormones, reproductive stages and ADHD: a systematic review

Bettina Camara; Cintia Padoin; Blanca Bolea

doi:10.1007/s00737-021-01181-w

Relationship between sex hormones, reproductive stages and ADHD: a systematic review

Arch Womens Ment Health. 2022 Feb;25(1):1-8. doi: 10.1007/s00737-021-01181-w. Epub 2021 Sep 6.

Authors

Bettina Camara¹, Cintia Padoin², Blanca Bolea³

Affiliations

¹ Faculty of Medicine, Immunology Department, University of Toronto, Toronto, Canada. bettina.camara@mail.utoronto.ca.
² Women's College Hospital, Reproductive Life Stages Program and Child and Family Program, Division of Child and Youth Mental Health, University of Toronto, Toronto, Canada.
³ Psychiatrist Scope Program-Women's College Hospital, Telepsychiatry-CAMH, University of Toronto, Toronto, Canada.

PMID: 34487213
DOI: 10.1007/s00737-021-01181-w

Abstract

Objective: This systematic review aims to summarize current available evidence for the relationship between sex hormones or reproductive life stages (adrenarche in males and females, menarche, pregnancy, postpartum and menopause) and ADHD.

Methods: We systematically reviewed studies investigating the relationship between sex hormones and symptoms of inattention and/or hyperactivity in individuals with an ADHD diagnosis or equivalent assessment of symptoms with validated scales. Articles were screened sequentially by two reviewers who were clinically and academically familiar with ADHD. Studies were rated according to Oxford Levels of Evidence (CEBM 2009).

Results: Four studies matched inclusion criteria. One article was a case report of a female with ADHD and premenstrual syndrome experiencing worsening symptoms prior to each period (Quinn, J Clin Psychol 61:579-587, 2005). Another was a review article analysing literature relating to the effect of hormones on ADHD symptoms and supporting that a relationship exists between ADHD symptoms and sex hormone levels, without further characterization (Haimov-Kochman and Berger, Front Hum Neurosci 8, 2014). Giotakos and colleagues found no relationship between Wender Utah scores and sex hormone levels (Giotakos et al., J Forensic Psychiatry Psychol 16:423-433, 2005). An exploratory study by Ostojic and Miller found evidence for an association between early pubertal onset, inattention and risk-taking behaviour (Ostojic and Miller, J Atten Disord 20:782-791, 2016).

Conclusion: The literature on the relationship between sex hormones and ADHD is limited. Available studies present contradicting information. It is not known how this lack of evidence affects the treatment of ADHD during the lifespan. Further research is required to correctly characterize the mechanisms behind ADHD symptoms and its potential association with sex hormones.

Keywords: ADHD; Hyperactivity; Inattention; Puberty; Sex hormones.

Publication types

Case Reports
Review
Systematic Review

MeSH terms

Attention Deficit Disorder with Hyperactivity* / diagnosis
Female
Gonadal Steroid Hormones
Humans
Male
Menarche
Menopause
Pregnancy

Substances

Gonadal Steroid Hormones