Attention-deficit/hyperactivity disorder (ADHD) is one of the most common disorders among children, affecting about 3-10% of school-age children across the globe, with a reported higher rate of boys being diagnosed (Wang, et al., 2017). Researchers have studied the impact sex differences have on the etiology of ADHD, specifically the relationship between the neuroendocrine system. Sex hormones, also known as reproductive hormones, can have a diverse affect on the human body including sexual function, bone, brain and blood health. Experts are beginning to believe that there is a link between ADHD and hormones, particularly sex hormones (Martel, et al., 2009). Hormones like estrogen and testosterone, can significantly affect one’s mood and behavior across the lifespan. Though research is limited, recent findings have found that sex hormones may affect brain pathways that appear abnormal in ADHD. At this time, scientists have discovered that changes in hormone levels throughout life can have significant effects on men with ADHD.
How hormones impact ADHD over the lifespan
Hormones: Perinatal, Prenatal, and ADHD
Exposure to androgenic hormones (e.g. testosterone) at the beginning of life, can have an impact on the development of the nervous system and its corresponding behaviors. Testosterone specifically has organizational effects that can change neural structure early in life compared to hormone exposure during adolescence, which has a transient effect. When examining the impact androgenic hormones have on ADHD development, research has found that testosterone may influence dopaminergic circuits in a way that creates a greater risk for boys to develop inattention and disruptive externalizing behaviors (Martel, et al., 2009).
Researcher Dr. Norman Geschwind theorized that males are more likely to develop a learning disorder and hyperactivity due to testosterone slowing down neural development (Geschwind, 1985). Ultimately, making males more susceptible to greater rates of cell proliferation and death, decreased prenatal brain development, and greater lateralization of brain function (Geschwind, 1985). Additionally, testosterone might impact neural development by interacting with genotypes that impact brain development and behavior.
Hormones: Puberty and ADHD
During puberty, boys experience an influx of testosterone due to a surge of sex hormones released in the body. Research has found that high levels of testosterone can influence the communication between brain circuits and can cause ADHD symptoms to become more prevalent in boys, particularly externalizing behaviors (Martel, et al., 2009). Some researchers argue that male sex hormones might be the the reason ADHD is often reported in boys more than girls.
Examples of ADHD in males across the lifespan
- Boys (ages 0 to 11) might experience greater feelings of restlessness, impulsivity, and hyperactivity compared to their peers. This might look like a young boy struggling to focus in class, challenges with remaining seated in school, or even experiencing learning delays.
- Young adult males (ages 12 to 17) might find themselves easily distracted or bored with tasks before they are completed or may appear to not be listening when spoken to. He may have challenges with remembering and following instructions, not paying attention to details, making careless mistakes.
- Adult males (ages 18 and up) might find it challenging to focus and prioritize responsibilities, often having difficulty meeting deadlines in the workplace or forgetting responsibilities/social plans. The adult male may even struggle to control various impulses, finding themselves having outbursts of anger or experiencing impatience in traffic/waiting in line.
What’s a Man to Do?
- Diet and exercise–can help ease the impact of hormones on mood and executive functioning systems
- Talk therapy and meditation–can help create skills and increase awareness to moderate any ADHD related challenges
- Hormone replacement therapy and antidepressants–can help decrease pain and difficulties associated with mood and ADHD symptoms
- Schedule an ADHD assessment appointment
Get tested for ADHD
For those local to the Seattle area who want to learn more about if ADHD testing is right for you, please feel free to reach out to Relational Psych. We have a team of licensed psychologists and post-doctoral residents that specialize in helping people like you understand your functioning (and potentially your ADHD) so you can thrive in life. We offer comprehensive assessments to gather in-depth data about your experiences and integrate these into a holistic understanding of your sense of self with practical recommendations and a thorough report. We also have a team of therapists that can help support you after the evaluation if therapy is a recommended portion of your treatment.
Learn more about how to get tested for ADHD here, and if you’re ready to get help and are an adult in the Seattle area, schedule a free consultation today!
References
Geschwind, N. Galaburda, AM. (1985). Cerebral Lateralization: Biological Mechanisms, Associations, and Pathology: I. A Hypothesis and a Program for Research. Arch Neurol, 42(5):428–459. https://doi:10.1001/archneur.1985.04060050026008
Martel, M. M., Klump, K., Nigg, J. T., Breedlove, S. M., & Sisk, C. L. (2009). Potential hormonal mechanisms of attention-deficit/hyperactivity disorder and major depressive disorder: a new perspective. Hormones and behavior, 55(4), 465–479. https://doi.org/10.1016/j.yhbeh.2009.02.004
Wang, L. J., Chou, M. C., Chou, W. J., Lee, M. J., Lee, S. Y., Lin, P. Y., Lee, Y. H., Yang, Y. H., & Yen, C. F. (2017). Potential role of pre- and postnatal testosterone levels in attention-deficit/hyperactivity disorder: is there a sex difference?. Neuropsychiatric disease and treatment, 13, 1331–1339. https://doi.org/10.2147/NDT.S136717
