ADHD and menopause: What every woman should know

One of the striking patterns I’ve noticed working with many women as a counsellor is the discovery of their neurodivergence during the transition to menopause. It was never not present, it was just hidden by the clients’ learned ways of masking all of their symptoms. This late realisation can be both enlightening and emotionally complex for people.

Why menopause can reveal neurodivergence

Neurodivergent conditions like autism, ADHD, or sensory processing sensitivity frequently go unnoticed in women. This is largely due to gendered socialisation, girls are often conditioned to suppress their natural tendencies to conform to expected behaviours. Over time, many develop highly effective “masking” strategies: mimicking others in social settings, over-preparing to compensate for attention difficulties, or avoiding overstimulation in subtle ways.

However, during menopause, declining oestrogen levels significantly impact cognitive and emotional regulation. These changes often disrupt previously effective coping methods. Women may experience heightened emotional sensitivity, reduced tolerance for sensory input, and decreased executive functioning, all of which can magnify underlying neurodivergent traits.

The sudden difficulty in managing everyday tasks, social interactions, or overstimulation can lead many to question what’s changed, and for some, it prompts the realisation: “I’ve always been different - maybe I’m neurodivergent.”

The emotional toll of a late diagnosis

For clients I work with who come to understand their neurodivergence in midlife, the emotional impact can be profound. While there is often relief in finally having a framework that explains lifelong challenges, it can also spark grief. Many reflect on missed opportunities, misunderstood struggles, and the invisible labour of trying to "keep up" with neurotypical expectations.

It’s common to mourn what might have been, relationships that could have been easier, careers that might have been different, or the energy lost in constant self-monitoring. The sense of loss is real, even as understanding grows.

For those already diagnosed: A new set of challenges

Even women who already know they are neurodivergent often find menopause unexpectedly destabilising. Coping strategies that once worked, routines, self-soothing techniques, focus tools, may suddenly feel inadequate. Many describe it as if “the wheels fall off,” leaving them feeling vulnerable or overwhelmed.

The biological shifts of menopause directly influence neurotransmitters like dopamine and serotonin, which are essential for mood regulation, focus, and motivation. For someone with ADHD, this may manifest as worsening attention and emotional dysregulation. For autistic individuals, sensory sensitivities may become more intense or harder to manage. The need to renegotiate familiar routines can be disorienting and frustrating.

What kind of support helps?

Navigating menopause as a neurodivergent woman requires an integrated approach, one that addresses both neurological differences and hormonal change.

1. Affirmation and validation

Being heard and believed is a vital first step. Many clients I work with seek professional support simply to have their experiences validated. Recognising that their difficulties are legitimate and not a personal failing can be deeply empowering.

2. Adapting coping strategies

Support often involves reassessing what works. New or modified routines, mindfulness practices, and energy-conservation strategies can help manage sensory overwhelm and emotional fatigue. Some women benefit from breaking tasks into smaller, more manageable parts or using visual supports to maintain structure.

3. Hormonal and medical interventions

Medical support may also play a role. Hormone Replacement Therapy (HRT) or other treatments may help mitigate some of the cognitive or emotional symptoms linked to menopause. Collaboration between mental health providers and healthcare professionals is key in tailoring an effective care plan. Ensure you seek out the medical care you need and don't settle for anything less.

Many clients I work with feel like they are being a nuisance continuing to go back to the doctors when they haven't had the proper medical attention they require, you are not a nuisance, you are worthy and deserve to feel well, at any age.

4. Peer and community connection

Connecting with others who share similar experiences can reduce feelings of isolation. Group support, whether in person or online, offers a space to share stories, strategies, and humour in the face of shared challenges.

Moving forward with compassion

In conclusion, menopause can be a disruptive time, but it also offers an opportunity for self-discovery. For many neurodivergent clients, it is the first time they fully understand themselves, their needs, their sensitivities, their strengths. It’s important women seek support and reach out, you don’t have to suffer alone. The ‘new you’ could be the best version yet!