Health records suggest girls with ADHD were about 70% more likely to have an STI or unwanted pregnancy before 20, highlighting the need to include sexual health support in routine care.
A Swedish study has found that girls with attention deficit hyperactivity disorder face a markedly higher risk of sexually transmitted infections and unwanted pregnancy before the age of 20, reinforcing concerns that ADHD can affect more than school and home life. Researchers analysing health records from Stockholm reported that girls with ADHD were about 70% more likely than matched peers to have one of those outcomes recorded, with the clearest increase seen in unwanted pregnancy. The findings were published in BMJ Mental Health.
The study followed 18,776 girls aged four to 20 who had been diagnosed with ADHD or first prescribed ADHD medicine between 2011 and 2021, and compared them with 93,880 girls of the same age and social background who did not have ADHD. The median age at the start of follow-up was 13. Among the girls with ADHD, 1,787 had either a sexually transmitted infection or an unwanted pregnancy recorded before age 20. The corresponding rate in the comparison group was lower, and the difference remained after researchers adjusted for other health conditions and earlier healthcare contact.
The link was not explained away by other mental health problems. Even among girls with ADHD who did not have anxiety, depression or a substance use disorder, the risk remained roughly double that of girls without those conditions. The highest risk was seen in those who also had a substance use disorder, whose odds were more than four-and-a-half times higher than those of girls with none of these diagnoses. Earlier research has also suggested that adolescents with ADHD are more likely to experience early pregnancy, while healthcare professionals have pointed to difficulties with relationships, risk-taking and contraception as part of the picture.
The study also found a pattern linking longer treatment with ADHD medicine to lower risk. Compared with girls who used medication for a year or less, those who stayed on treatment for longer tended to have fewer recorded adverse sexual and reproductive health outcomes, although the step from one to two years was not statistically significant. Girls who had taken medication for more than five years had odds about a third lower. The researchers suggested that treatment may improve planning and self-control, making it easier to use contraception consistently and respond to sexual health risks.
There are limits to what the findings can prove. The records showed prescriptions that were filled, not whether the medicines were actually taken, and the researchers could not measure how severe each girl’s symptoms were. Girls who stayed in treatment longer may also have had more family support, and those with ADHD may have had more contact with doctors, meaning more opportunities for infections or pregnancy-related care to be recorded. Even so, the authors argued that sexual health advice and screening should be considered as part of routine ADHD care for teenagers.
Sweden’s system of free youth clinics and abortion care may also make the findings hard to compare directly with other countries. But the broader message is likely to matter well beyond Stockholm: for some girls with ADHD, support may need to extend beyond classroom adjustments and into sexual and reproductive health.
Disclaimer: This content is for informational purposes only and is not intended to be a substitute for professional medical judgment, advice, diagnosis, or treatment.
