Women Are Not Just Smaller Men!

Lets change the paradigm for female mental, physical and sexual health together!

by Lotta Borg Skoglund

serious african american woman flexing arms in beige colors. strong, power, proud concept.

The male body has been, and still is, the societal and medical norm. But females are not just smaller men. Even though an overwhelming number of girls and women testify to how much their hormones affect how they feel and function in their everyday life there is very little actual, scientific evidence of their experiences. Females have namely been less likely to be included in scientific studies on both physical and psychiatric disorders, generating a substantial knowledge gap between the sexes favoring boys and men. This lack of sex- and gender specific data is a risky business for females since inadequate knowledge of biological sex differences have long-term consequences for girls and women worldwide. For an extensive overview of how gender biased data creates a world designed by and for boys and men affecting everything from governmental policies, scientific research and medical practice to technological innovation, urban planning, and the media, I urge you to read award-winning Caroline Criado Perez´ loud and clear call for change, through her powerful book– Invisible Women1.

Almost three years ago, I wrote the book “ADHD – From Girls to Women, Getting on the Radar”. This book is for many reasons very close to my heart. Not the least since I was entrusted writing some of my patients’ lived experiences of being a girl and a woman with ADHD. I could never have imagined how well the book would be received. In countless emails, texts, phone calls, messages on social media, cheers on buses, and in jogging tracks you are all saying the same thing: finally, someone is taking girls’ and women’s ADHD symptoms and hormones seriously! Standing on the shoulders of giants and great role models such as Svenny Kopp, Sandra Kooij and Susan Young who fought for girls and women with ADHD long before I even knew what ADHD was, I set out to find others that were as passionate as I was to be part of the solution, of the movement.

Together with leading entrepreneurs and scientists, we have started the Letterlife-journey, our goal is to build the first digital tool for sex- and gender specific data collection to improve precision health for girls and women with ADHD. This blog will walk you through the back story of our passionate advocating for sex- and gender influenced mental health research and clinical practice and why we predict that empowering digital tools like Letterlife bare the potential to close the gaps in health outcomes between girls and boys, women and men.

The fact is that females with ADHD are un- or misdiagnosed years longer than males. This leaves a sizable group of girls and women on their own and at risk for developing psychiatric and somatic comorbidity, and considerable health care and pharmacological utilization. Even though women keep telling us that their hormones affect their mood, relationships, and quality of life little has been done to getting these female specific challenges of ADHD on the radar. But there is some light in the tunnel. A recent research article from Harvard Review, by Aril Handy and colleagues2 show clearly how the menstrual cycle affect female mental health. In short, this article show that women are more likely to experience symptoms of relapse in psychiatric disorders during the luteal phase of their menstrual cycle (i.e., when estrogen is overshadowed by increasing progesterone). Even though ADHD was not specifically explored in this article, testimonies from women with ADHD of all ages strongly suggest that hormones interplay with ADHD-symptoms as well. Many of my patients refer to the days leading up to menstruation, the postpartum period, and the years around menopause as “the danger zone” and that their ADHD is “out of control” during these periods. Unfortunately almost everyone also tells me that it’s almost impossible to realize this as it’s going on, but rather they look back at the terrible consequences of family conflicts, embarrassing work related meltdowns or regrettable and impulsive decisions and wonder “how the h..l” they ended up in this mess (again). Indeed, a study by Dorani and collegues3 support their testimonies showing that females with ADHD suffer from PMS/PMDD, experience postpartum depression severe climacteric symptoms more often than women without ADHD.

Needless to say, we feel very strongly about changing a society and standard of care that continues to act as if the male is the norm. To this end we will, together with lead patient users, patient organizations, leading researchers, clinicians, social entrepreneurs, and data engineers, develop the first tool for self-monitoring of ADHD-symptoms, hormonal fluctuation and lifestyle factors with the specific aim of:

  1. Reducing the time from symptom to diagnosis and treatment in females with ADHD.
  2. Improving precision medicine, mitigate co-morbid mental and somatic health problems, optimize, and tailor ADHD-medication and increase the use of tolerable contraceptives for female ADHD.
  3. Increasing self-awareness, facilitate informed self-care, decrease polypharmacy, and optimize health care utilization for girls and women with ADHD.

Letterlife operate beyond the diagnostic criteria for ADHD and focus on individual ADHD-profile and neuropsychological processes. This, together with daily tracking of hormonal fluctuation, medication intake and real-life health factors such as diet, sleep, exercise, relationships, and addictive behaviors we can create a unique brain map for every single person with ADHD. The goal? To improve physical, mental, and sexual health and quality of life through improved self-awareness!

By understanding how your ADHD-brain is wired you can start connecting the dots on the most important things in your life. For many, increased self-knowledge is sufficient and empowering enough to start making the preferred and long-term lifestyle changes. Many appreciate the transparent and realistic shared decision making and the pragmatic and holistic focus on what is relevant in your unique life. Again, the goal is always the same: better health, restored self-esteem and improved quality of life!

We look forward to change the paradigm for female physical, mental and sexual health together with you!

  1. Invisible women, Criado-Perez Caroline, Abrams Press 2019, ISBN: 9781419729072.
  2. Handy et al., Psychiatric Symptoms across the Menstrual Cycle in Adult Women: A Harv Rev Psychiatry. 2022 Mar-Apr 01;30(2):100-117. doi: 10.1097/HRP.0000000000000329.
  3. 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.

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