Menstrual Cycle Exacerbation of ADHD Symptoms in Adults: Common, Person-Specific, and Not Confined to the Luteal Phase

Objective. Patients often describe menstrual-cycle worsening of attention-deficit/hyperactivity disorder (ADHD). We prospectively evaluated sample- and person-level cycle effects on ADHD symptoms and their independence from cyclical negative affect and pain. Methods. In an intensive longitudinal cohort (2019-2024), 106 naturally cycling adults meeting DSM-5 ADHD criteria on integrated assessment rated daily inattention and hyperactivity-impulsivity (Barkley Adult ADHD Rating Scale-IV), negative affect, and pain (median, 41 days) and provided daily salivary estradiol and progesterone for ovulat

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