Menstrual health and Attention-Deficit/Hyperactivity Disorder (ADHD) symptoms: A scoping review

BackgroundLittle is known about how menstrual health characteristics may influence Attention-Deficit/Hyperactivity Disorder (ADHD) symptoms, despite evidence that hormonal fluctuations can affect attention, mood, and behaviour.ObjectiveThis scoping review examined the extent, nature, and quality of the evidence exploring the relationship between menstrual health features and ADHD symptom presentation.Eligibility CriteriaAll primary study designs were considered. Studies were included if they investigated ADHD diagnosis or symptoms in relation to menstrual health factors. Reviews, commentaries, theses, and conference abstracts were excluded.Sources of EvidenceA structured, keyword-based search was conducted on MEDLINE (Ovid), PsycINFO (Ovid), and Web of Science on July 18th, 2025. Titles, abstracts, and full texts were screened in Covidence.Charting MethodsData were extracted using a standardized form and synthesized narratively according to themes identified during data extraction. A critical appraisal of included studies was conducted using an adapted risk of bias tool.ResultsThe search yielded 691 records. 20 studies met inclusion criteria. Most were published after 2020 and employed non-randomized experimental, cross-sectional, qualitative, or case study designs. Sample sizes ranged from 1-405, with participants aged 13-49. Six themes emerged: (1) comorbid ADHD symptoms in individuals with menstruation-related disorders; (2) menstrual difficulties and ADHD symptoms; (3) menstrual phase-related worsening of ADHD symptoms; (4) menstrual side-effects of stimulant medication; (5) menstrual pain-related attentional interference; and (6) menstruation-tailored interventions. Quality appraisal indicated that half of the studies were rated Very Good. Gaps in reporting sample size justification and measures of gender identity were common.ConclusionsEmerging evidence links menstrual health and ADHD symptoms. Despite growing interest, the field is marked by small samples, heterogeneous methods, and limited attention to gender identity. Future research should justify sample sizes, integrate gender-sensitive measures, and further explore interventions tailored to menstruation-related ADHD symptom fluctuations.