For a long time, ADHD and autism were considered conditions that mainly affected boys and men. The general belief was that these neurodivergies occurred almost exclusively in the male population, and even today boys are diagnosed with ADHD and autism at a rate about five times that of girls. However, we now know that these conditions also affect girls and women, but they are often underdiagnosed.
Most neuropsychiatric research has been conducted on boys, leaving girls and women behind. This is something that Dr. Lotta Borg Skoglund, a Swedish psychiatrist and associate professor at Uppsala University, is determined to change. Dr. Skoglund is the founder of Smart Psychiatry, a Swedish clinic specializing in ADHD and autism. She recently launched a new company, Letterlife, specifically designed to support women with neurodivergia.
Letterlife: helping women gain control
Letterlife is an app tailored to women who suffer from ADHD and/or autism, which Dr. Skoglund calls ‘AuHDH’. This term reflects the overlap in symptoms between autism and ADHD and the unique challenges women face in managing these conditions. The app aims to give users more control over their lives, helping them track symptoms, manage medications and better understand the impact of their hormones on daily life.
An important feature of Letterlife is the focus on the menstrual cycle. Hormonal fluctuations during the cycle affect most women, but these effects can be even more pronounced in women with ADHD or autism. Many autistic girls report struggling with the physical changes that come with puberty. They find it more difficult than girls of the same age to deal with fluctuations in their body and mood. Likewise, women with ADHD often experience more severe premenstrual syndrome (PMS), and Dr. Skoglund assumes that women with autism may face similar challenges.
Research conducted by Dr. Skoglund and her team showed that women with ADHD are five times more likely to develop depression if they use hormonal contraception. This connection between hormones and mental health is something that Letterlife addresses head-on. It helps women adjust to their hormonal changes and provides insight into how these shifts can affect their medications and daily activities.
A broader focus on women’s health
There is an ongoing debate about whether too many people are being diagnosed with ADHD/autism these days. According to Dr. Skoglund, it is important to note that people are not asking for a diagnosis, but for help. They want to understand how to live their lives in a world that often feels like it wasn’t built for them. Society’s increasing cognitive demands have left many people, especially neurodivergent women, struggling to keep up.
The goal of Letterlife is to draw attention to the turbulence in the lives of these women. Their experiences are often dismissed as exaggeration or imagination. That’s why Dr. Skoglund ensure that women get the support they need to manage their health.
In one of their studies, they enrolled 40,000 women from Stockholm who had been diagnosed with neurodivergent disorders, and more than half of them also suffered from anxiety. Healthcare costs are enormous, but the real price is paid by women themselves, who often feel unsupported and misunderstood. Like Dr. Skoglund notes, helping young women feel good today is the key to building a healthier, more functional society. Women play a crucial role not only in their families, but also in the labor market, especially in sectors such as healthcare. When women don’t feel well, it reverberates throughout society.
What’s next for Letterlife?
Since launch, Letterlife has grown rapidly, increasing fivefold in the last three months and growing 20% month-on-month, indicating the app is clearly filling a gap in the market with 55% of women continuing to use it after three months . The team is now planning a randomized controlled trial (RCT) to investigate the effectiveness of the app and its impact on users’ daily lives.
One of the most important aspects of the app is its ability to help women understand how their medications interact with their menstrual cycle. This can be challenging for many women, especially those with AuHDH, as they have difficulty remembering their medication schedule or noticing how different phases of their cycle affect their treatment.
Looking ahead, Dr. Skoglund is excited about the future of Letterlife and hopes to further expand its reach. She is committed to bringing greater attention to the unique needs of women with neurodivergent conditions, both through her clinical work and research. In her words, the focus of future research must shift to women to truly understand the full spectrum of neurodivergence and find the best way to support those affected.