Attention deficit hyperactivity disorder (ADHD) can cause hyperactivity, inattention, or a combination of both. In women, inattentive ADHD is the most common presentation.

The symptoms of inattentive ADHD mostly affect how a person thinks and focuses. Symptoms may include difficulty paying attention for long periods, frequent daydreaming, or being easily distracted.

In contrast, predominantly hyperactive ADHD causes more external symptoms, such as fidgeting. This may explain why there are more ADHD diagnoses in boys than in girls: Boys are more likely to have the hyperactive form of ADHD, according to the American Psychiatric Association (APA).

Read on to learn more about inattentive ADHD in women, including the signs, impact, and treatment.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

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ADHD is a neurodevelopmental disorder. This means it affects the brain during child development. There are three main subtypes of ADHD:

The inattentive type of ADHD causes difficulty with organization, planning, or concentrating. It may also affect memory and the ability to finish tasks.

Unlike the other types of ADHD, though, it does not cause as much impulsive behavior.

For a doctor to diagnose someone with inattentive ADHD, the APA states the person must frequently experience at least five of the following symptoms if they are over 17 years old or six symptoms if they are under 17 years old:

  • difficulty paying attention, especially to details
  • difficulty remaining focused on tasks or conversations
  • appearing not to be listening to others
  • difficulty following instructions and completing tasks
  • struggling with organization
  • avoiding or disliking tasks that require sustained mental effort
  • regularly losing important items, such as keys or wallets
  • being easily distracted
  • forgetting to complete daily tasks

Anecdotally, women with inattentive ADHD also sometimes report experiencing:

  • “internal hyperactivity,” which may cause racing thoughts
  • difficulty maintaining relationships long term
  • high sensitivity to rejection

People with ADHD also report experiencing positive traits, such as being passionate, expressive, and creative.

Learn more about the benefits and strengths of ADHD.

The above diagnostic criteria apply to children and adults with ADHD.

For outside observers, though, there may be other external signs that could indicate a child has inattentive ADHD. They include:

  • quiet daydreaming
  • hyperfocusing on certain activities, such as a hobby or game
  • avoiding or being unable to focus on other activities, such as homework
  • losing their train of thought or switching topics often
  • making friends easily but having trouble sustaining the relationship
  • having a messy bedroom or desk
  • getting distracted in class

Researchers are not completely sure why the symptoms of ADHD can differ between men and women, but there are some theories.

According to a 2021 review, some research suggests that women and girls are more likely to mask their symptoms than men or boys. Masking involves hiding or overcompensating for ADHD traits that others criticize.

For example, a person might:

  • smile and nod during a conversation, even though they are not following along
  • pretend to take notes in class or during a meeting to hide daydreaming
  • work late to compensate for being behind on work
  • avoid inviting people over so they do not see a messy house
  • guessing what a teacher’s instructions were because they cannot remember

Some people theorize that the reason women and girls are more likely to mask their ADHD symptoms is because of traditional gender roles.

Some people believe it is typical for boys to be more boisterous or less organized than girls, and so it is less socially acceptable to those people when girls display ADHD symptoms, notes Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD).

This can result in girls feeling like they do not fit in, which can continue into adulthood. Although most women in the United States work outside the home, there is still an expectation that they will be the “manager” of their household, whether as a partner, wife, or mother.

There could also be a physiological difference in males and females that affects ADHD symptoms.

For example, a 2020 review notes that scientists have previously observed changes in ADHD symptoms after menopause. Researchers also note there is some evidence hormone medications may alter the effectiveness of ADHD stimulants.

Because some women and girls with inattentive ADHD do not receive a diagnosis at all, or not until later in life, they may not get the support they need. This can have a wide range of effects on their life.

School or work may have been much harder for them than it would have been if they had received treatment. This could affect a person’s grades or career.

They may also have blamed themselves for the difficulty they faced, not understanding that their symptoms are not their fault.

This self-blame and shame, as well as the social pressure to mask, could also be why women with ADHD often experience mental health conditions, such as anxiety or depression, according to CHADD.

Masking, in itself, can also be part of the difficulty. While it can be a useful strategy when a person is in an environment unwelcoming of ADHD, it also requires a lot of energy. Masking can also make symptoms less apparent to doctors or teachers. This can contribute to delays in diagnosis.

But this does not mean that masking is wrong. It is a sign of a broader problem girls experience when it comes to expectations of their behavior and awareness of ADHD in girls.

With diagnosis and support, girls and women with inattentive ADHD can get the help they need to thrive.

An ADHD assessment involves talking with a qualified mental health professional. They may use a symptom checklist or questionnaire to gauge a person’s symptoms. They will also ask the person about their current and past behavior, such as how they managed school.

To get a diagnosis, it can help to provide evidence that the symptoms have been ongoing since childhood. If a person cannot remember, things like school reports or accounts from close family or friends may help.

Sometimes, a health professional may order tests to rule out other explanations. For example, in children, they may order tests for their sight or hearing.

Treatment of ADHD can include both medications and non-drug interventions. Which ones benefit a person will depend on their age and how they respond to the different options.

In younger girls with ADHD, the first approach doctors typically recommend is behavioral therapy. For example, parent-child interaction therapy involves both children and their caregivers to help them learn strategies to help with the symptoms.

In older children or adults, treatment may involve medications, behavioral therapy, or a combination. The first-line medications for ADHD are stimulants, which can help improve focus. Other options include:

  • alpha agonists
  • atomoxetine
  • viloxazine

Other interventions that could help include:

  • behavioral therapy
  • ADHD coaching
  • family and or couples’ therapy
  • self-care strategies, such as getting regular exercise
  • support groups

Inattentive ADHD is the most common form of ADHD in women and girls. It can cause distractibility, difficulty concentrating, and difficulty remembering things, but not much outward hyperactivity.

Girls with inattentive ADHD may appear anxious, daydream frequently, and seem to move from one topic or hobby to another. However, people with ADHD can also be creative and passionate, and develop a deep level of knowledge about the things they enjoy.

When people with inattentive ADHD get the right support, they can learn to manage their symptoms and use their ADHD traits to their advantage. This may involve medications, behavioral therapy, or ADHD coaching, among other strategies.