# Estrogen Effects on ADHD and Cognition

> **NIH NIH R01** · UNIVERSITY OF KENTUCKY · 2022 · $663,683

## Abstract

Females with Attention-Deficit/Hyperactivity Disorder (ADHD) remain dramatically understudied, even though
they exhibit increased impairment beginning around puberty. Estrogen rises rapidly at puberty and exerts
important effects on dopamine and cognition in both humans and animals. Both animal and human work
suggest that cognition and ADHD symptoms may be sensitive to hormonal effects, particularly in highly
impulsive females. Yet, the effect of estrogen on ADHD symptoms in young adult women remains virtually
unstudied. Our pilot data in 33 naturally-cycling young women suggest that among women with greater ADHD
symptoms, within-person declines in estrogen, particularly in the context of rising levels of progesterone, just
post-ovulation, are associated with clinically significant increases in ADHD symptoms. Yet, no published
empirical work has directly examined the role of circulating estrogen in relation to ADHD symptoms and
cognitive mechanisms in women with ADHD. The current study would pioneer a new stage of work by being
the first to utilize a rigorous quasi-experimental design that involves intensive longitudinal measurement across
the menstrual cycle in order to examine within-person estrogen effects on ADHD and cognitive mechanisms in
young women with ADHD. A sample of 120 young women ages 18 to 25 with inattention, overactivity, or
impulsivity problems will be recruited from the university health center and local ADHD clinic, psychology
department, and through social media. Participants will be comprehensively assessed for ADHD and exclusion
criteria (e.g., use of hormone-based medication or hormonal conditions). Female participants will complete
well-established assessment measures of ADHD and other psychopathological symptoms and diagnoses and
cognition and provide saliva samples of hormones in the laboratory during a baseline laboratory visit within the
first few days of the start of their menstrual cycle (i.e., during the mid-follicular phase, characterized by stable
low estrogen). Then, they will provide daily saliva samples for hormone assay each morning and complete
short daily assessments of ADHD and cognition every evening for up to 2 full menstrual cycles. They will also
complete laboratory cognitive testing of inhibition and working memory targeted to key cycle phases
characterized by declining estrogen (post-ovulatory, perimenstrual) and a cycle phase characterized by stable
high estrogen levels (midluteal), based on menses onset and ovulation test results. Multi-level modeling will
evaluate the clinical significance of within-person estrogen associations with ADHD and cognition with
consideration of progesterone as an interactive factor. Effects of comorbid disorders and affect will also be
explored. Study results have the potential to shift our understanding of ADHD in women by consideration of
dynamic hormone influences. In addition, results will change clinical practice by indicating the need to account
for cycle phase ...

## Key facts

- **NIH application ID:** 10476401
- **Project number:** 5R01MH119119-04
- **Recipient organization:** UNIVERSITY OF KENTUCKY
- **Principal Investigator:** MICHELLE M MARTEL
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $663,683
- **Award type:** 5
- **Project period:** 2019-09-10 → 2025-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10476401

## Citation

> US National Institutes of Health, RePORTER application 10476401, Estrogen Effects on ADHD and Cognition (5R01MH119119-04). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10476401. Licensed CC0.

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