ADHD Symptom Exacerbation Across the Menstrual Cycle: Effects on Medication Use, Sleep Quality, and Stress

This prospective diary study of 125 naturally cycling adult females with ADHD found that ADHD symptoms (inattention, hyperactivity, impulsivity) and functional impairment significantly increased during the late luteal phase compared to the follicular phase, with participants using nearly twice as much medication during this period. Sleep quality was reduced and perceived stress was elevated in the late luteal phase, both predicting increased next-day symptoms.