Does Vyvanse Mess with Hormones? A Pharmacological Review

October 6, 2025 •

4 min read

Over 4% of U.S. adults have a lifetime diagnosis of ADHD, with many prescribed stimulant medications like Vyvanse [1.6.4]. A common question that arises is, does Vyvanse mess with hormones? The answer involves a complex interaction between neurotransmitters and the body's endocrine system.

Quick Summary

Vyvanse can influence hormones by affecting neurotransmitters that regulate the endocrine system. It may increase stress hormones like cortisol and interact with sex hormones, particularly in women, by altering medication effectiveness.

Key Points

Cortisol Increase: Vyvanse, as a stimulant, can activate the HPA axis, leading to a short-term increase in stress hormones like cortisol [1.3.1, 1.3.2].
Female Hormone Interaction: The effectiveness of Vyvanse can be influenced by hormonal fluctuations during the female menstrual cycle, potentially requiring dose adjustments [1.2.1, 1.2.3].
Male Testosterone Effects: Evidence is mixed; some human studies show no short-term change in testosterone [1.4.5], but other research suggests a potential risk with long-term use [1.4.3].
Puberty and Growth: Most studies conclude that Vyvanse and other stimulants do not have a clinically significant impact on a child's final adult height or the timing of puberty [1.6.4, 1.6.5].
Neurotransmitter Pathway: Vyvanse's hormonal effects are indirect, stemming from its primary action of increasing dopamine and norepinephrine in the brain, which in turn regulate the endocrine system [1.3.7, 1.8.6].
Thyroid Conditions: Vyvanse is contraindicated for individuals with hyperthyroidism as its stimulant effects can worsen symptoms [1.7.3, 1.7.5].
Contraceptive Interaction: Hormonal contraceptives may interact with Vyvanse, potentially altering the drug's effectiveness and side effects [1.2.1].

Vyvanse, the brand name for lisdexamfetamine, is a central nervous system (CNS) stimulant primarily prescribed to treat Attention-Deficit/Hyperactivity Disorder (ADHD) and binge eating disorder [1.5.3]. It works by increasing the levels of dopamine and norepinephrine in the brain, which are neurotransmitters that help with attention, concentration, and impulse control [1.3.7]. While its primary action is on the brain, these changes can have downstream effects on the body's endocrine system, which is responsible for hormone regulation.

The Neuro-Endocrine Connection: How Vyvanse Interacts

Vyvanse's influence on hormones is mostly indirect. The brain's hypothalamic-pituitary-adrenal (HPA) axis acts as the command center for the endocrine system. By altering dopamine and norepinephrine levels, Vyvanse can stimulate this axis, leading to changes in the production of various hormones [1.3.2, 1.8.6].

Impact on Stress Hormones: Cortisol and ACTH

The most documented hormonal effect of amphetamines like Vyvanse is on the HPA axis, which controls the body's stress response.

Increased Cortisol: Studies show that lisdexamfetamine can significantly increase plasma levels of cortisol and adrenocorticotropic hormone (ACTH), the hormone that stimulates cortisol release [1.3.2]. As a stimulant, Vyvanse can elevate cortisol levels in the short term, similar to how the body responds to stress [1.3.1, 1.3.3].
Clinical Context: It's noteworthy that some research indicates children with ADHD may have lower baseline cortisol levels, which can normalize after receiving stimulant treatment [1.3.4]. However, the effects can be inconsistent across studies [1.3.5].

Vyvanse and Sex Hormones: Estrogen and Testosterone

The relationship between Vyvanse and sex hormones is complex and appears to differ between genders.

For Women:

Menstrual Cycle Interaction: Fluctuations in female hormones, particularly estrogen, during the menstrual cycle can change how Vyvanse is metabolized, potentially making women more sensitive to the drug's effects at certain times [1.2.1]. Some women report that their ADHD medication is less effective during the premenstrual week [1.2.3].
Hormonal Contraceptives: Birth control pills can interact with Vyvanse, potentially influencing its effectiveness and enhancing side effects [1.2.1].
Menopause: Women undergoing menopause may also need dose adjustments, as hormonal shifts can alter the medication's impact [1.2.1, 1.2.6].

For Men:

Testosterone Levels: The evidence here is mixed. One clinical study found that lisdexamfetamine did not alter plasma levels of testosterone compared with a placebo [1.4.5, 1.4.7]. However, other research on amphetamines suggests a potential link between long-term stimulant use and an increased risk for testicular hypofunction (low testosterone) [1.4.3]. Another study in rats showed that prolonged use of lisdexamfetamine led to a dramatic decrease in testosterone [1.5.4]. The increase in dopamine from stimulants may inhibit GnRH neurons, which can lead to a decrease in luteinizing hormone (LH), the hormone that stimulates testosterone production [1.8.6].

Growth and Puberty

Concerns often arise about the impact of stimulants on growth and pubertal development in children and adolescents.

Growth Hormone: Stimulants have the potential to decrease growth hormone secretion because of their effect on dopamine [1.6.6]. This has led to concerns about slowed growth.
Pubertal Development: The majority of research suggests that while there might be a minor, clinically insignificant effect on growth during treatment, stimulant medications like Vyvanse do not appear to affect final adult height or cause significant delays in puberty [1.6.4, 1.6.5]. Some studies reported no safety concerns regarding pubertal development for lisdexamfetamine [1.6.2]. However, one study noted that girls with a history of stimulant use started menstruating slightly later than those who had not taken stimulants [1.6.6].

Thyroid Function

Vyvanse is generally not recommended for individuals with hyperthyroidism (an overactive thyroid) [1.7.3, 1.7.5]. The stimulant effects of the medication, such as increased heart rate and anxiety, can aggravate the symptoms of hyperthyroidism [1.7.1, 1.7.2]. Furthermore, dopamine is known to inhibit the release of Thyroid-Stimulating Hormone (TSH), which could theoretically affect thyroid function [1.7.6].


Hormone System	Potential Effect of Vyvanse	Supporting Evidence Summary
HPA Axis (Stress)	Increases cortisol and ACTH levels.	Clinical studies show a significant enhancement of plasma glucocorticoids [1.3.2].
Female Sex Hormones	Medication effectiveness can fluctuate with the menstrual cycle.	Hormonal fluctuations can affect drug metabolism and efficacy [1.2.1, 1.2.3].
Male Sex Hormones	Mixed results: Some studies show no change in testosterone, while others suggest a long-term risk.	One study found no change in testosterone [1.4.5], but others link long-term use to hypogonadism [1.4.3] and reduced testosterone in animal models [1.5.4].
Growth/Puberty	Minimal to no effect on final adult height or puberty timing.	Large-scale studies show no clinically significant impact on adult height or maturation [1.6.1, 1.6.4].
Thyroid Hormones	Can worsen symptoms of hyperthyroidism.	Vyvanse is contraindicated in patients with hyperthyroidism [1.7.3, 1.7.5].

Conclusion

So, does Vyvanse mess with hormones? Yes, it can, primarily by influencing the neurotransmitters that regulate the endocrine system. The most direct impact is the elevation of stress hormones like cortisol. Its interaction with sex hormones is more nuanced, with significant considerations for women due to the menstrual cycle and a conflicting picture for male testosterone levels. While concerns about growth are common, most evidence suggests the impact is not clinically significant in the long term. As with any medication, it is crucial for patients to discuss any concerns about hormonal side effects with their healthcare provider, who can monitor their progress and make adjustments as needed [1.5.3].

For further reading on stimulant mechanisms, consider this article from the National Institutes of Health: Dopamine dysfunction in stimulant-use disorders

Frequently Asked Questions

The evidence is inconclusive. A clinical study on lisdexamfetamine found it did not alter testosterone levels compared to a placebo [1.4.5, 1.4.7]. However, some research on long-term amphetamine use suggests a potential link to lower testosterone [1.4.3], and animal studies have shown a decrease [1.5.4].

Vyvanse doesn't directly change the cycle itself, but hormonal fluctuations during your cycle can affect how the medication works. Some women report their ADHD symptoms worsen or the medication feels less effective in the week before their period [1.2.1, 1.2.3].

Yes, studies have shown that lisdexamfetamine, the active ingredient in Vyvanse, can significantly increase plasma levels of cortisol and other stress-related hormones [1.3.2]. This is a typical effect of CNS stimulants [1.3.1].

While there has been concern that stimulants might affect growth, long-term studies suggest that they are not associated with significant changes in growth or differences in final adult height [1.6.4, 1.6.5].

Vyvanse should not be taken by individuals with hyperthyroidism (overactive thyroid) because its stimulant effects can exacerbate symptoms like rapid heart rate and anxiety [1.7.3, 1.7.5]. Always discuss your full medical history with your doctor.

Hormonal contraceptives can interact with Vyvanse. This interaction may influence the medication's effectiveness and could enhance some of its side effects. It's important to discuss your contraceptive use with your doctor [1.2.1].

While not a directly listed side effect, Vyvanse can increase stress hormones like cortisol [1.3.2]. Elevated cortisol is sometimes linked to acne flare-ups in susceptible individuals. If you notice skin changes, consult your doctor.