The NHS says ADHD is thought to be recognised less often in women than in men. NICE, whose guidelines cover England and Wales, tells clinicians to be aware that it is “thought to be under-recognised in girls and women”, while its own rationale says no evidence was found on the increased risk of missing a diagnosis in girls. This guide sets out what the sources say about how ADHD can look in women, why it can be missed, and how adults are assessed.

It is general information, not medical advice. NICE says ADHD should only be diagnosed by a specialist psychiatrist, paediatrician or other appropriately qualified healthcare professional with training and expertise in diagnosing ADHD.

Is ADHD under-diagnosed in women?

NICE’s ADHD guideline (NG87) asks clinicians to be aware that ADHD is thought to be under-recognised in girls and women. It lists three things: girls and women are less likely to be referred for assessment, may be more likely to have undiagnosed ADHD, and may be more likely to receive an incorrect diagnosis of another mental health or neurodevelopmental condition. The NHS pages on ADHD in adults and in children and teenagers say that ADHD is thought to be recognised less often in women than men, and in girls than boys.

NICE’s wording is “thought to be”, and its rationale says: “No evidence was found on the increased risk of missing a diagnosis of ADHD in girls.” The committee made the recommendation to raise awareness. A UK expert consensus statement on females with ADHD (Young and colleagues, BMC Psychiatry, 2020) says: “It is unknown how often a diagnosis of ADHD is being missed or misdiagnosed in females.”

What the numbers show depends on what was counted. These are the figures we found in published research, and they measure different things:

What was counted	Result	Source
Children and adolescents in population samples: a meta-analysis of 86 studies using older (DSM-IV) criteria	For every girl who met the criteria, between 1.9 and 3.2 boys did, depending on the method	Willcutt, Neurotherapeutics, 2012 (studies published 1994 to 2010)
Adults (19 and over; most samples under 25, most using self-reported symptoms) in population samples: 11 studies, same criteria	For every woman who met the criteria, 1.6 men did	Willcutt, 2012
Children (aged 3 to 17) with an ADHD diagnosis on record in UK primary care data by 2018	255 per 10,000 boys and 67.7 per 10,000 girls	McKechnie, BJPsych Open, 2023
Adults (aged 18 and over) with an ADHD diagnosis on record in UK primary care data by 2018	74.3 per 10,000 men and 20 per 10,000 women	McKechnie, 2023

The first two rows estimate how many people meet the criteria. The last two count people with an ADHD diagnosis on record in GP data, among more than 7.6 million people with at least one full year of data between 2000 and 2018, which is not the same as how many people have ADHD. Consensus statements describe the sex difference in adults as “closer to 1:1” (a European consensus statement, 2019) or “more modest or absent” (the UK consensus statement, 2020), while the recorded diagnoses above were far from equal in 2018. No source we read measures how many women are missed, so none of these figures should be read as that number.

What ADHD symptoms look like in women

The NHS lists the signs of ADHD in two groups and says they usually start before the age of 12. Signs of being inattentive include being easily distracted or forgetful, finding it hard to organise your time or to follow instructions and finish tasks, and often losing things. Signs of being hyperactive and impulsive include having a lot of energy or feeling restless, being very talkative or interrupting conversations, and making quick decisions without thinking about the result.

The NHS says most people with ADHD have symptoms of both types and some show signs of only one. It also says women with ADHD more commonly have inattentive symptoms, which can be harder to recognise than hyperactive ones. The World Health Organization’s ICD-11 guidance says something similar: females are more likely to show inattentive symptoms and males hyperactivity and impulsivity, “particularly at younger ages”.

That is a tendency, not a rule. In the 2012 meta-analysis above, 55% of adult women who met the criteria had the inattentive type, against 49% of adult men. That is a six-point difference, so saying that women have the inattentive type is too simple. We found no national guideline or national health body page (NICE, the NHS website, NHS England, the World Health Organization or the Royal College of Psychiatrists) that gives a checklist of signs specific to women: those sources describe tendencies, as above. For a longer list of signs in adults of any sex, see our guide to the signs of ADHD in adults.

Several expert sources add a point about hiding symptoms:

The Royal College of Psychiatrists says people with ADHD “will often develop ways to hide their symptoms, and doing so can be very exhausting and negatively affect their mental health”.
The UK consensus statement says some girls and women with ADHD become competent at camouflaging their struggles with compensatory strategies, which may lead to an underestimation of their underlying problems.
A European consensus statement on adult ADHD (Kooij and colleagues, 2019) says females appear to develop better coping strategies than males and are better able to mask symptoms throughout childhood, but that this “may no longer work well when they face salient life challenges”.

These are expert statements. Surveys that ask people with ADHD about masking do exist: a self-selected online survey of 1,056 Norwegian people aged 18 to 35 with ADHD, autism or both, 79% of them female, run from December 2022 to March 2023 and published in 2025, found that masking was commonly reported and varied by context (Wurth and colleagues, Frontiers in Psychiatry). Studies like this rest on what participants report about themselves, and we found none that estimates how common masking is among women with ADHD in the general population.

Why ADHD can be missed or mistaken for something else

The sources give several reasons, and they are reasons clinicians are asked to bear in mind rather than measured causes:

Less obvious symptoms. A 2022 review in the Journal of Child Psychology and Psychiatry (Hinshaw and colleagues) concluded that clinicians may overlook symptoms and impairments in females because they are less overt but still impairing.
Another diagnosis may be given first. NICE says girls and women may be more likely to receive an incorrect diagnosis of another mental health or neurodevelopmental condition. The Royal College of Psychiatrists says some people are diagnosed with a mental health problem such as anxiety, depression or a substance use disorder when this explains only part of their difficulties, and that underlying ADHD can then be missed. The NHS adds that people with ADHD may often have other conditions too, such as depression, anxiety or addictions, or a learning difficulty such as dyslexia, and that a GP may consider other conditions that could be causing your symptoms, such as autism, Tourette’s or anxiety.
Childhood records may not show it. The UK consensus statement says it may not be possible to rely on school reports when assessing females, as subtle hyperactive-impulsive symptoms may have been missed by teachers.

The same consensus statement says that adult women may become aware of their difficulties and go to their GP themselves.

How adults are assessed

NICE says ADHD should only be diagnosed by a specialist psychiatrist, paediatrician or other appropriately qualified healthcare professional. A GP’s role, in the NHS’s description, is to ask about your symptoms and how they affect your life, consider other conditions, and decide whether to refer you. NICE says the assessment itself should include a full developmental and psychiatric history, observer reports and an assessment of your mental state.

One set of criteria. NICE points to DSM-5 or ICD-11 for the criteria and says to consider ADHD in all age groups, with symptom criteria adjusted for age-appropriate changes in behaviour. It sets out no separate criteria for women.
Childhood onset, not a childhood diagnosis. The NHS says symptoms usually start before 12. NICE says adults who have no childhood diagnosis should be referred for assessment where there is evidence of typical features that began during childhood and have persisted throughout life, are not explained by other psychiatric diagnoses, and are associated with moderate or severe impairment. The American Psychiatric Association’s DSM-5 fact sheet describes the rule as several ADHD symptoms present before age 12, which is about symptoms, not about having been diagnosed.
If no one can describe your childhood. The NHS says the specialist may want to contact someone who knows you well, such as a family member or close friend. The Royal College of Psychiatrists says siblings, partners and school reports can all help where parents are unavailable. NICE says excluding a diagnosis because of an uncertain time of onset is not recommended, and the Royal College of Psychiatrists in Scotland says that, although obtaining corroborative history is regarded as essential, an inability to obtain it for reasons outside the patient’s control “should not necessarily exclude a diagnosis”. The WHO’s ICD-11 guidance adds that without corroborating information a diagnosis in adults should be made with caution.
A quiz is not an assessment. NICE says a diagnosis should not be made solely on the basis of rating scale or observational data. The Royal College of Psychiatrists says questionnaires can help but ADHD can only be accurately diagnosed with a comprehensive interview and a consultation-based assessment, and ADHD UK’s own online screening page says only a clinician can accurately diagnose ADHD. NHS England’s ADHD Taskforce notes that screening produces both false positives and false negatives.
What a good assessment includes. A 2024 consensus paper from the UK Adult ADHD Network (UKAAN) proposes a quality standard for adult assessments. It says assessments need a full psychiatric and neurodevelopmental review and a semi-structured interview that draws out real-life examples, and recommends 2 hours or more for the diagnostic assessment and initial post-assessment discussion.

Where to start: the GP, the NHS and private routes

ADHD UK, a charity, suggests starting with an open and frank conversation with your GP about why you think you have ADHD, and asking how long the waiting list is likely to be so that you can consider alternatives if needed. If a GP refuses to provide a referral, it suggests considering a second GP opinion.

England. The NHS says to make an appointment with a GP if your ADHD symptoms are affecting your studies, work or relationships. If you were diagnosed as a child and need help now, it says to talk to your GP about getting a referral. It says waiting times vary and you may have to wait several months or years to access ADHD specialist services.

The NHS also says you can ask for an NHS appointment at a clinic of your choice, including a private clinic, if it provides ADHD services for the NHS in England. This is the Right to Choose scheme. NHS England’s patient choice guidance says remote services such as ADHD assessments may fall within the legal right to choose a provider, but that the legal rights do not extend to self-referrals or any referral other than from or on behalf of a GP, dentist or optometrist. Our Right to Choose guide sets out the steps, including a GP letter template.

Scotland. NHS inform says there is no standard approach to assessing ADHD in Scotland and that how you are assessed depends on your health board area. It says to speak to your GP practice if you think you may have ADHD and it is having a negative effect on your life. If you are thinking about a private assessment, it says to make sure your local NHS health board and GP practice will accept an assessment from another provider before you get one.

Wales. NHS 111 Wales says to make an appointment with a GP if your ADHD symptoms are affecting your studies, work or relationships, and that the GP may decide to refer you for an assessment with a mental health professional specialising in ADHD.

Northern Ireland. In a freedom of information reply dated 30 June 2026, the Department of Health said there is currently no commissioned service for ADHD in Northern Ireland and so no regionally commissioned assessment pathway, and suggested contacting the Health and Social Care Trusts for further information. Your GP can tell you how referrals work where you live.

Private assessment. A Royal College of Psychiatrists blog (August 2026) says assessments outside the NHS can be entirely acceptable provided they meet the UKAAN standard it describes, in line with NICE guideline NG87 and Good Psychiatric Practice, and that a diagnosis resting on a self-report questionnaire or a simple proforma does not.

The blog’s list of what that standard says a proper assessment includes: a full clinical and psychosocial assessment, a developmental and psychiatric history from childhood onwards, a semi-structured interview, observer reports, validated rating scales, a mental state examination, an assessment of substance use and other risks, baseline blood pressure, pulse and weight, and a formulation that weighs ADHD alongside trauma and other conditions such as autism.

When you compare clinics, check who carries out the assessment and what it includes. If you want your GP to take over your care afterwards, check whether they will accept the report.

Common questions

Are hormones involved?

The UK consensus statement says symptoms “may be exacerbated by hormonal changes during menstrual cycle, pregnancy and menopause”. That is a hedged expert statement, not a measured effect. Our guide to ADHD and menopause looks at the evidence on menopause in particular.

Does ADHD run in families?

The NHS says ADHD may be caused by genetic differences and often runs in families, and NICE lists people with a close family member diagnosed with ADHD among the groups in which it is more common. The UK consensus statement on females says a decision to refer would be strongly supported if there is a first-degree relative with ADHD. A separate UK consensus statement on ADHD and autism occurring together (Young and colleagues, BMC Medicine, 2020) says it is not uncommon for people to present for a first diagnosis in adulthood prompted by a diagnosis of autism or ADHD in the family. A relative’s diagnosis is a reason to raise the question with a GP, not proof that you have ADHD.

Can a social media list or online quiz tell me whether I have ADHD?

No. A quiz can be a reason to talk to your GP, but the sources above are consistent that a diagnosis needs a full clinical assessment. NHS England’s ADHD Taskforce says there is no good evidence on what percentage of those waiting to see a clinician have self-diagnosed ADHD using social media and then do or do not meet the diagnostic criteria after a high-quality assessment.

If you need urgent help

The NHS says people with ADHD may often have other conditions too, such as depression or anxiety. If you feel you cannot cope, or you are thinking about harming yourself, get help now:

England: call 111 and select the mental health option, or use 111 online.
Wales: call 111 and press option 2 for urgent mental health support, available 24 hours a day.
Scotland: call NHS 24 on 111 and choose the mental health option.
Northern Ireland: call Lifeline on 0808 808 8000, free and open 24 hours a day.
Anywhere in the UK: call 999 or go to A&E if someone’s life is at risk. Samaritans are on 116 123, free from any phone, at any time.

Finding a clinic

If you would like to compare private assessment clinics, our adult assessment page lists clinics with each one’s own fee and wait. A private assessment is one route; your GP is another. This guide is general information, not medical advice.

Sources

Sources checked on 7 October 2026.

ADHD in women: symptoms and how it is assessed