Testosterone and ADHD

The gender bias in diagnosing ADHD (more common in boys) has led some to wonder whether testosterone has a role in the development of the condition. The data so far is inconclusive regarding whether exposure to either high or low levels of testosterone in utero is associated with an increased rate of developing ADHD, although multiple studies suggest that high in utero testosterone increases the risk of developing ADHD.
Testosterone, the major male sex hormone, is active in both men and women, with different levels and different effects across the course of life, and in different genders. In addition to being produced in the testes and ovaries, brain cells also synthesize small amounts of testosterone. Testosterone shapes the developing brain, and also can alter brain function later in life.
Most of the research on testosterone and behavior indicate protective effects against depression, anxiety and memory loss, as well as an association with aggression and criminality. Very few studies have looked at the impact of testosterone on attention or other executive function of ADHD. A handful of case studies in adults with ADHD indicate that for some individuals, testosterone treatment can result in marked, rapid, and reversible improvement in ADHD symptoms.
References:
Improvement of attention deficit/hyperactivity disorder (ADHD) in three adult men during testosterone treatment: a case series
jmedicalcasereports.biomedcen...
Potential role of pre- and postnatal testosterone levels in attention-deficit/hyperactivity disorder: is there a sex difference?
www.ncbi.nlm.nih.gov/pmc/arti...
Second-to-Fourth Digit Ratio (2D:4D) in Psychiatric Disorders: A Systematic Review of Case-control Studies
www.cpn.or.kr/journal/view.ht...
Association between tendencies for attention-deficit/hyperactivity disorder (ADHD) and the 2D:4D digit ratio: a cross-cultural replication in Germany and China (2020)
www.sciencedirect.com/science...
Testosterone Replacement Therapy in the Treatment of Depression
www.ncbi.nlm.nih.gov/pmc/arti....
General:
Psychiatrist, neuroscientist, and author John Kruse, MD, PhD presents practical, actionable, well-researched information about treatment options that scientists and clinicians recommend for adult ADHD and other mental health conditions. Subscribe if you're curious about how neuro-atypical brains can optimize their functioning in our shared, and somewhat strange, world.
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[@KJDogluv]

Thank you.

[@Greynarl1234]

Great info on the link to testosterone and people on ADHD meds.

[@dr.johnkruse6708]

I'm glad that you found it useful.

[@privacymatters4714]

Hi Dr Kruse I'm a 46/female my husband is a psych pharmacist. I'm very aspy so I'm hyper aware of my body. I noticed physical and mental decline in my 40s so I started HRT on estradiol and had a marked improvement of everything from anxiety, dysthymia, bones and skeletal aches and pains so I put my head down and read tons on T. I was previously diagnosed with in-attentive ADD in my 40s.I declined treatment because I could function but it was noticeable for me. Turns out it was just perimenopause. My T tested very low and it was nearly impossible to get a doctor to treat my T. Finally I did within 2-3 days I noticed improved brain fog, I am sharper, I am more confident, and my workout recoveries are lightning fast. I'm at 3 weeks my sex drive feels like it make come back. We really need to understand T and it's function. It may be the missing link for women living longer and healthier. Thanks for covering this and please keep talking. We still appear to have strange sigmas in society. I am happy to tell every woman T is vital like E. It's a beautiful dance.

[@dr.johnkruse6708]

I really appreciate you sharing your positive experience with testosterone, and am glad that you kept looking until you found what helped.

[@elba363]

Hello Dr, would Vyvanse affect testosterone as it affects serotonin, Thank you for all of the great information you provide!

[@dr.johnkruse6708]

The pharmacologists haven't identified any major interactions between testosterone and Vyvanse. On Reddit, several people report using them safely together.

[@elba363]

Thank you so much for the response@@dr.johnkruse6708

[@settingfeedback321]

good topic

[@dr.johnkruse6708]

Thanks, if you have ideas for other topics, let me know.

[@GKovacs-pp7xt]

Could having add and low test suggest a low acting pituitary gland?

[@dr.johnkruse6708]

Low T itself can be associated with pituitary problems, but I am not aware of ADHD adding to that risk.

[@Systemlord30]

There's no such thing as female sex hormones, there's sex hormones that play a part in both male and female, sharing the same types of hormones, only in different ratios. Women have testosterone and estrogen as do men.

[@dr.johnkruse6708]

Yes, I'm aware of this and it is discussed in the video. Many reproductive endocrinologists, who are familiar with this point as well, continue to use the terms male and female sex hormones as shorthand for addressing groups of hormones.