What did the Dorani 2021 study find about ADHD and PMDD?

Dorani and colleagues assessed 209 consecutive women aged 18 to 71 attending an ADHD outpatient clinic in the Netherlands, using the PMDD section of the MINI Plus interview. As reported in a later 2025 paper, 45.5% met criteria for provisional PMDD, compared with 28.7% in a general population survey. Because the women were clinic patients, they may have had more severe ADHD than the general population.

Does ADHD cause PMDD?

Nobody has shown that. A 2026 Swedish register study of 3,630,028 women found the association runs in both directions: an ADHD diagnosis was linked to later premenstrual disorders, and premenstrual disorders were linked to later ADHD diagnosis. That pattern fits shared vulnerability better than one condition simply causing the other.

How can you tell PMDD symptoms from ADHD symptoms?

Timing is the test. PMDD symptoms appear in the week before a period and become minimal or absent in the week after it, while ADHD is present all month. If ADHD or mood symptoms simply worsen before a period without a clear week afterwards, researchers call that premenstrual exacerbation, which is a different thing from PMDD.

Is PMDD More Common With ADHD?

Q: Is PMDD more common in women with ADHD?

Yes, every study I could find points that way. In a 2025 UK survey of 715 women aged 18 to 34, 31.4% of those with a self-reported clinical ADHD diagnosis screened positive for provisional PMDD, compared with 9.8% of those without ADHD. Most of this evidence comes from screening questionnaires rather than confirmed diagnoses, so the true rates are likely lower.

Q: Is PMDD linked to ADHD in teenagers?

Two Japanese clinic studies suggest so. In 392 female psychiatric outpatients with a mean age of 15.3, suspected PMDD was found in 22.1% of those with ADHD versus 13.3% without. A separate review of 290 patients aged 10 to 19 found moderate to severe PMS was linked to ADHD with an odds ratio of 2.43.

Yes. Every study I could find shows PMDD is more common in women with ADHD, but nearly all of them measured provisional PMDD with a questionnaire, not the two cycles of daily tracking a confirmed diagnosis needs. In a UK survey published in the British Journal of Psychiatry in 2025, 31.4% of women with a self-reported clinical ADHD diagnosis screened positive for provisional PMDD, against 9.8% of women without ADHD.

So the link looks real. The exact size of it is much less certain than the headlines suggest, and the reasons matter if you are trying to work out what is happening to you.

I am not a clinician, and nothing here is about changing medication. It is a map of what the research actually says, with the limits left in.

Is PMDD more common in women with ADHD?

These are the studies I could find and read, with the numbers exactly as published.

Study	Who	How PMDD was measured	Finding
Dorani et al, 2021, Netherlands	209 consecutive women aged 18 to 71 at an ADHD clinic	PMDD section of the MINI Plus interview	45.5% provisional PMDD, versus 28.7% in a general population survey (as reported by Broughton et al, 2025)
Broughton et al, 2025, UK	715 women aged 18 to 34, recruited online	Premenstrual Symptoms Screening Tool (PSST)	31.4% with self-reported clinical ADHD diagnosis; 41.1% meeting a questionnaire-based ADHD threshold; 9.8% without ADHD
Tsuji et al, 2025, Japan	2,000 full-time employees aged 20 to 44, no contraception, never pregnant	PMDD scale based on DSM-IV-TR research criteria	ADHD traits linked to PMDD, adjusted odds ratio 6.49
Groenman et al, 2026, Netherlands	199 women aged 20 to 40, not on hormonal contraception: 89 ADHD, 39 autistic, 71 controls	PSST	Provisional PMDD significantly higher in both ADHD and autistic groups than controls
Lin et al, 2024, Taiwan	58 women with PMDD, 50 controls	Inattention and impulsivity rated in three cycle phases	Women with PMDD more likely to have comorbid ADHD

Two more large studies looked at it from the other side:

Zhou et al, 2026, Sweden: a register study of 3,630,028 women, 104,972 of them diagnosed with a premenstrual disorder, a broader category than PMDD alone. A prior ADHD diagnosis was linked to a later premenstrual disorder (odds ratio 2.01), and a premenstrual disorder diagnosis was linked to a later ADHD diagnosis (hazard ratio 3.55).
Jaholkowski et al, 2023, Norway: among 56,725 pregnant women, self-reported premenstrual symptoms were associated with genetic risk scores for ADHD, as well as for depression, bipolar disorder, schizophrenia and autism.

How reliable are these numbers?

Less reliable than they look, and the researchers say so themselves.

Provisional is not confirmed. A 2024 meta-analysis of 44 studies found pooled PMDD prevalence of 3.2% with confirmed diagnosis and 7.7% with provisional diagnosis, and concluded that provisional methods are "likely to produce artificially high prevalence rates". Broughton and colleagues note that retrospective reporting "is associated with false positives".
Clinic samples run high. Broughton's team suggest Dorani's higher figure may reflect recruiting from outpatient clinics, where ADHD may be more severe.
Recruitment shapes the answer. Groenman's team found "a strong indication of selection bias": women recruited for a study about premenstrual problems showed a much higher prevalence than women recruited for a study on sleep.
ADHD itself was often self-reported, in the UK study as a self-reported clinician diagnosis and in the Japanese study as traits on a self-report scale.
Premenstrual exacerbation looks the same on a questionnaire. Broughton's study could not separate PMDD from ADHD, depression or anxiety getting worse before a period.

What survives all of that: every design, in several countries, points the same way.

Why might ADHD and PMDD be linked?

Honestly, no one knows yet. What researchers have proposed:

Sensitivity to normal hormone changes. Broughton and colleagues write that PMDD is "not a result of abnormal levels of hormones, but of individual sensitivity to normative hormonal fluctuations", and suggest that sensitivity may underpin the ADHD link.
Dopamine. They also note that the premenstrual drop in oestrogen is associated with reduced dopamine availability, and since dopamine plays a key role in ADHD, that change "may be more likely to affect females with ADHD". This is a hypothesis, not a finding.
Other hormonal transitions. The same paper cites a Swedish national registry study in which women with ADHD had a sixfold higher risk of depression after starting combined oral contraceptives, and another registry study in which they were about fivefold more likely to be diagnosed with depression and anxiety after giving birth. That suggests the vulnerability may be about hormonal change in general, not periods specifically.
Shared genetics. The Norwegian and Swedish studies above, and a 2026 Korean study of 423 women with bipolar disorder, found overlap between genetic liability for ADHD and premenstrual symptoms.

Against all of that, a 2022 systematic review of sex hormones and ADHD found only four eligible studies and concluded that the literature "is limited" and that "available studies present contradicting information".

PMDD symptoms vs ADHD symptoms: how do you tell them apart?

By timing, not by the symptoms themselves. Difficulty concentrating, feeling overwhelmed and irritability all appear in the DSM-5 list of PMDD symptoms, and they are familiar to anyone with ADHD.

What separates them:

PMDD appears in the final week before your period and becomes minimal or absent in the week after it.
ADHD is there all month.
Premenstrual exacerbation is when ADHD, depression or anxiety gets worse before a period but never fully clears. Broughton's team point to the clear "asymptomatic window" after menses as the thing that distinguishes PMDD from exacerbation.

Two details from the research are worth knowing. In the UK study, the overall pattern of PMDD symptoms was similar with and without ADHD, and difficulty concentrating was endorsed at similar rates in both groups. Insomnia was the least common symptom, but women with ADHD and provisional PMDD reported it about twice as often as those without ADHD. And in the Taiwanese study, PMDD was linked to more impulsivity in the late luteal phase independent of ADHD, while women with both had higher inattention and impulsivity earlier in the cycle too.

I wrote the full criteria out in PMDD symptoms: the diagnostic criteria in plain English. If your worry is the overlap with BPD rather than ADHD, see PMDD or BPD?

Is PMDD linked to ADHD in teenagers?

The evidence here is thinner and comes from clinics:

Kondo et al, 2025, Japan: medical records of 290 patients aged 10 to 19. Moderate to severe PMS was associated with ADHD (odds ratio 2.43) and with ADHD plus autism (3.27). Autism alone was not.
Ogata et al, 2026, Japan: 392 female psychiatric outpatients, mean age 15.3. Suspected PMDD was found in 22.1% with ADHD versus 13.3% without. ADHD also predicted premenstrual "interpersonal anger". When the researchers looked at suicidal thoughts, overall depression severity was the strongest factor, and the anger link disappeared once depression was accounted for.

Both were retrospective and drew on clinic patients, so they say little about teenagers in general.

Do ADHD symptoms get worse before a period?

Many women report that they do. A 2025 clinical review by Wynchank, de Jong and Kooij in European Psychiatry says "many women report cyclical variations in symptom intensity and reduced psychostimulant efficacy during the late luteal phase". A 2026 Irish survey of 602 women (377 with self-reported ADHD) found more menstrual irregularity and more severe premenstrual symptoms in the ADHD group.

One Dutch clinic has tried raising stimulant doses in the premenstrual week. The published evidence for that is a case series of nine women from that clinic, which the authors call "preliminary". That is a conversation for your prescriber, not something to try yourself.

What should you track, and what should you tell your prescriber?

The same 2025 review recommends menstrual cycle tracking as part of assessing women with ADHD, and suggests considering hormonal status in ADHD diagnosis. In practice, that means:

Track daily for at least two cycles, marking the first day of each period. The free PMDD tracker stores everything in your own browser and prints a chart for your appointment.
Rate ADHD symptoms on the same days: focus, forgetting, impulsivity, and how well your usual routine is holding.
Look for the clear week. Is there a stretch after your period when things settle? That is the single most useful thing to show a doctor.
Tell your ADHD prescriber and your GP if your symptoms follow your cycle, and bring the chart. Let them decide whether anything should change.
Mention the overlap if you are being assessed for either condition, so one is not mistaken for the other.

For the UK diagnosis route, see how to get a PMDD diagnosis in the UK, and for what the guidelines say about treatment, PMDD treatment in the UK. If you are parenting with ADHD, my book Present is written for exactly that.

Sources

Broughton T, Lambert E, Wertz J, Agnew-Blais J. Increased risk of provisional premenstrual dysphoric disorder (PMDD) among females with attention-deficit hyperactivity disorder (ADHD): cross-sectional survey study. British Journal of Psychiatry, 2025;226(6):410-417. PMID 40528384.
Dorani F, Bijlenga D, Beekman ATF, van Someren EJW, Kooij JJS. Prevalence of hormone-related mood disorder symptoms in women with ADHD. Journal of Psychiatric Research, 2021;133:10-15. PMID 33302160.
Tsuji R, Watanabe K, Egawa M, et al. Association of ADHD/ASD traits with premenstrual dysphoric disorder among full-time employed women in Japan: a cross-sectional study. Journal of Psychiatric Research, 2026;192:371-377. PMID 41197219.
Groenman AP, Welling LE, Pieters S. The monthly spectrum: premenstrual symptoms across ADHD and autism. Women's Health, 2026;22. PMID 42617113.
Lin PC, Long CY, Ko CH, Yen JY. Comorbid attention deficit hyperactivity disorder in women with premenstrual dysphoric disorder. Journal of Women's Health, 2024;33(9):1267-1275. PMID 38836765.
Zhou J, Muse Z, Bränn E, et al. Bidirectional association between premenstrual disorders and psychiatric disorders. JAMA Network Open, 2026;9(5):e2611765. PMID 42101835.
Jaholkowski P, Shadrin AA, Jangmo A, et al. Associations between symptoms of premenstrual disorders and polygenic liability for major psychiatric disorders. JAMA Psychiatry, 2023;80(7):738-742. PMID 37163253.
Baek JH, Choi MJ, Shin Y, et al. Clinical and genetic association of comorbid provisional PMDD and ADHD in female patients with bipolar disorder. Journal of Affective Disorders, 2026;412:122163. PMID 42336326.
Reilly TJ, Patel S, Unachukwu IC, et al. The prevalence of premenstrual dysphoric disorder: systematic review and meta-analysis. Journal of Affective Disorders, 2024;349:534-540. PMID 38199397.
Camara B, Padoin C, Bolea B. Relationship between sex hormones, reproductive stages and ADHD: a systematic review. Archives of Women's Mental Health, 2022;25(1):1-8. PMID 34487213.
Kondo C, Ihara H, Ogata H, Saima S, Nakane E. Association between premenstrual syndrome or premenstrual dysphoric disorder and presence of ASD or ADHD among adolescent females: a retrospective study. Archives of Women's Mental Health, 2025;28(6):1483-1490. PMID 40699321.
Ogata H, Kondo C, Seki M, Saima S, Nakane E, Ihara H. Beyond general depression: premenstrual interpersonal anger as a unique pathway to suicidal ideation in adolescent females with ADHD. Journal of Psychosomatic Research, 2026;209:112907. PMID 42372671.
Wynchank D, de Jong M, Kooij SJJS. Practical tools for female-specific ADHD: the impact of hormonal fluctuations in clinical practice and from the literature. European Psychiatry, 2025;69(1):e1. PMID 41115846.
Boyd C, Wrigley M, Kilbride K, Mulligan A, Bramham J. ADHD and the female reproductive stages: menstruation, perinatal and menopause. Archives of Women's Mental Health, 2026;29(3):89. PMID 42207323.
de Jong M, Wynchank DSMR, van Andel E, Beekman ATF, Kooij JJS. Female-specific pharmacotherapy in ADHD: premenstrual adjustment of psychostimulant dosage. Frontiers in Psychiatry, 2023;14:1306194. PMID 38152361.
Miller C, Carlson K. Premenstrual Disorders. StatPearls [Internet]. StatPearls Publishing; updated 9 August 2026. PMID 30335340.

Read from the published abstracts and guidance on 5 October 2026. If something here is out of date or wrong, tell me.

Nothing here is medical advice, it's lived experience, meant to sit alongside real support, not replace it. If you're struggling, please see the support resources. If you're in crisis in the UK, call Samaritans free on 116 123, or dial 999 in an emergency.