Why does neurodivergence become apparent during menopause?

Over my 26 years of experience as a counsellor, I have worked with countless women navigating the complexities of both neurodivergence and menopause. One of the striking patterns I've noticed is that many women first discover they are neurodivergent during the transition into menopause.

This revelation often brings with it a profound sense of clarity, but also a period of mourning as they reevaluate their past through the lens of their newfound understanding. It is important to emphasise that menopause does not cause neurodivergence, but it often acts as a catalyst for this self-awareness.

This article explores why so many women uncover their neurodivergent traits during this phase of life and offers strategies for support.

Why does neurodivergence become apparent during menopause?

Neurodivergence, including conditions such as autism, ADHD or sensory processing disorders, often goes undiagnosed in women for a significant portion of their lives. This is largely due to social conditioning and the subtle ways women are taught to "mask" their differences. 

From an early age, women are expected to conform to societal norms, often suppressing their true selves in order to fit in. They learn to cope with their neurodivergent traits by adopting compensatory strategies—whether it’s through mimicking social behaviours, over-preparing for tasks to compensate for focus issues or avoiding sensory triggers in ways that aren't easily noticeable to others.

As women transition into menopause, hormonal changes significantly affect brain chemistry. Many neurodivergent women report that their usual coping mechanisms start to falter during this time, as they experience heightened sensitivity, anxiety or a lack of focus. The decline in oestrogen, for example, has been linked to changes in cognitive functioning, which can exacerbate underlying neurodivergent traits. Suddenly, the "mask" that these women have worn for decades no longer fits as seamlessly and they find themselves grappling with challenges they once had under control.

For many women, menopause is the first time they are forced to confront the fact that they might be neurodivergent. They may have always known they felt different from their peers, but couldn't quite pinpoint why. 

The increased difficulty in masking combined with the hormonal changes of menopause forces them to recognise patterns that have been there all along.

Mourning the past: The emotional impact of a late diagnosis

For women who discover their neurodivergence in midlife, there is often a profound sense of loss. I have sat with many clients as they reflect on their past, asking, "What if I had known sooner?" This realisation brings a complex blend of emotions, grief for the years spent struggling to meet neurotypical expectations, frustration at the lack of understanding from those around them and a deep sense of exhaustion from a lifetime of masking.

This mourning process is an essential part of their journey. In many cases, women come to me feeling overwhelmed, both by their neurodivergence and by the physical and emotional changes brought on by menopause. 

They begin to reframe their entire life experience, understanding for the first time why certain situations were so difficult, why they felt disconnected or overwhelmed, and why they needed more time alone to recharge. They often say to me, "If only I had known, I could have done things differently." The realisation of how much energy they have spent adapting to a world that wasn’t built for them can be both liberating and heartbreaking.

Why are the wheels falling off?

For women who have long known they were neurodivergent, menopause can still come as a shock. They have likely spent years building coping strategies to manage their traits, only to find that these methods are no longer working. Many of my clients who have been diagnosed with autism or ADHD earlier in life describe menopause as a time when "the wheels fall off." The structure they once relied on starts to crumble, leaving them feeling lost and overwhelmed.

So why does this happen? As mentioned earlier, the hormonal fluctuations during menopause can exacerbate neurodivergent traits. Lower levels of oestrogen can affect neurotransmitters like dopamine and serotonin, which are critical in regulating mood, attention and executive functioning. For someone with ADHD, this can result in increased difficulty with focus and time management. For someone on the autism spectrum, heightened sensory sensitivities can become unbearable. The coping mechanisms that once worked become insufficient, leading to a sense of frustration and helplessness.

How can we help?

Support for neurodivergent women going through menopause requires a multifaceted approach that addresses both their neurodivergent needs and the hormonal changes they are experiencing.

Validation and understanding:

Many women come to counselling seeking validation that what they are experiencing is real. Acknowledging their neurodivergence, whether newly discovered or long-known, can be incredibly empowering. This is a time when they need to be heard, not dismissed.

Relearning coping mechanisms:

Women need to develop new strategies that align with both their neurodivergence and their changing bodies. For example, mindfulness and grounding techniques can help with sensory overload, while restructuring daily routines can provide a sense of control during a time when everything feels like it’s changing.

Hormonal support:

Collaborating with medical professionals to manage the physical aspects of menopause is critical. Hormone Replacement Therapy (HRT) or other medical interventions might be useful for managing the cognitive and emotional challenges brought on by hormonal shifts.

Community and peer support:

Creating spaces where neurodivergent women can connect and share their experiences is crucial. Knowing they are not alone in their struggles can provide immense relief.

In conclusion, menopause is a transformative time for many women and for those who are neurodivergent, it often brings with it the first clear understanding of their neurodivergence. By acknowledging the unique challenges they face and offering tailored support, we can help them navigate this life stage with more compassion and clarity. While the road ahead may still be difficult, it is also an opportunity for growth and self-acceptance.