Shining a Neurodivergent Light on Menopause Support in the Workplace
Menopause is a deeply individual experience, with symptoms affecting people in vastly different ways. While discussions around menopause have increased, there remains a gap in understanding how it intersects with neurodivergence. By adopting an intersectional approach, we can foster better workplace support and ensure that neurodivergent individuals navigating menopause receive the accommodations they need to shine.
Understanding Neurodivergence and Its Relevance to Menopause
Neurodivergence refers to natural variations in brain development and function, affecting how individuals think, process information, and interact with the world. It includes conditions such as ADHD, autism, dyslexia, and dyscalculia. Rather than being a deficit or disorder, neurodivergence is simply a different way of experiencing life.
In the UK, at least 20% of adults are neurodivergent. However, these individuals often face additional barriers to healthcare and in the workplace, particularly when dealing with life transitions like menopause. The intersection of neurodivergence and menopause presents unique challenges, yet it remains an underexplored topic. More research is needed to fully understand the long-term implications, and greater efforts must be made to ensure that healthcare and workplace policies are reflective of these diverse needs.
Menopause and Late Diagnosis of Neurodivergence
Historically, neurodivergent conditions have been underdiagnosed in women and individuals assigned female at birth (AFAB). Recent years have seen a surge in late diagnoses, particularly during midlife and menopause. Four key factors contribute to this trend:
The Gender Health Gap – ADHD and autism research has largely focused on male-presenting traits. Until the late 1990s and early 2000s, gender differences in neurodivergence were barely acknowledged. The first study linking autism and menopause was published only in 2020, with ADHD research following in 2021. The lack of data has contributed to significant delays in understanding and supporting neurodivergent women, leading many to struggle in silence.
Masking – Women and AFAB individuals are more likely to “mask” neurodivergent traits to fit social norms. This often leads to misdiagnosis of mental health conditions rather than neurodivergence. Menopause can make masking more difficult, leading individuals to recognize their neurodivergence for the first time. Unmasking can be a vulnerable and confusing experience, and without proper support, many women find themselves experiencing increased anxiety and self-doubt.
Hormone Sensitivity – Neurodivergent individuals often experience heightened sensitivity to hormonal fluctuations, exacerbating executive dysfunction*, anxiety, and emotional regulation difficulties. This can make menopause symptoms more intense and harder to manage. Traditional menopause treatments may not always be effective for neurodivergent individuals, meaning a more personalized approach to medical support is necessary.
*executive function refers to the cognitive processes that affect a person's ability to plan and prioritise tasks, organise thoughts, make decisions, remember, manage time and complete tasks.
Increased Information Seeking – As awareness of menopause grows, more individuals are reflecting on their lifelong experiences and recognizing their neurodivergence. The availability of online resources and personal narratives has also encouraged more people to seek formal or self-diagnosis. However, despite greater awareness, access to formal diagnosis and support services remains a significant barrier for many, due to long waiting lists and limited specialist knowledge about the overlap between neurodivergence and menopause.
The Impact of Hormonal Fluctuations on ADHD and Autism Traits
Hormonal fluctuations during menopause can significantly affect cognitive function, emotional and physical health. For neurodivergent individuals, these fluctuations can have further repercussions by affecting neurotransmitters (aka chemical messengers) that play key roles in executive function, emotional regulation, and sensory processing. See Figure 1. below:
Figure 1. Hormones that can impact menopause symptoms and neurodivergent traits
Key Hormone and Neurotransmitter Disruptions:
Oestrogen Decline → Reduces dopamine and serotonin activity, leading to brain fog, anxiety, and mood swings.
Progesterone Fluctuations → Decrease GABA levels, increasing sensory sensitivities, irritability, and sleep disturbances.
Cortisol Increase → Triggers stress responses, worsening emotional regulation and cognitive function.
Testosterone Decline → Reduces focus, energy, and mental processing speed.
Thyroid and Metabolic Changes → Contribute to fatigue, brain fog, and difficulty concentrating.
For neurodivergent individuals, these disruptions can mean difficulty with planning, organisation maintaining focus, worse sleep, feeling much less in control of their emotions and more vulnerable to stress. Heightened sensory experiences, such as those related to light, noise, and textures, may also become more pronounced, making day-to-day life and work increasingly challenging.
Overlapping Symptoms: A Double Burden
Menopause symptoms and neurodivergent traits share significant overlaps (see Figure 2), including:
Cognitive Challenges: Brain fog, forgetfulness, difficulty concentrating, and impaired decision-making.
Emotional Regulation Issues: Increased anxiety, mood swings, and heightened rejection sensitivity.
Sleep Disruptions: Insomnia and restless sleep, leading to increased fatigue and impaired executive function.
Physical Manifestations: Joint pain, digestive issues, migraines, and bladder sensitivity - conditions that disproportionately affect neurodivergent individuals.
Given the unpredictable nature of hormonal changes, symptoms can fluctuate daily, making it difficult for neurodivergent individuals to maintain routines and manage work responsibilities. This can have a profound impact on confidence and self-esteem, particularly in professional settings where performance expectations remain unchanged.
Moving Towards More Inclusive Support
Menopause workplace policies must be inclusive of neurodivergent experiences. Research suggests that while neurodivergent employees may continue to perform well at work, their self-perception and well-being may deteriorate undetected. This can lead to increased stress, burnout and, in some cases, decisions to leave work altogether.
While traditional accommodations such as flexible working and workwear policies are helpful, a more tailored approach is necessary.
Key Workplace Recommendations:
Raise Awareness – Educate HR teams and managers about the intersection of menopause and neurodivergence.
Provide Tailored Support – Support communication needs, offer accommodations and reasonable adjustments such as quiet workspaces, sensory-friendly tools / adaptations to reduce sensory input, and regular check-ins to review needs.
Encourage Open Conversations – Foster a culture where employees feel safe discussing their experiences without stigma.
Re-evaluate Performance Metrics – Recognise that fluctuating symptoms impact consistency and self perception. Allow for adaptive strategies.
Improve Access to Healthcare Resources – Ensure employees are signposted to menopause-friendly healthcare professionals who understand neurodivergence.
Conclusion: A Call for Change
The conversation around neurodivergence and menopause is still evolving, but workplaces have the power to lead the way in fostering inclusivity. Recognising difference as diversity - not deficit - is key to ensuring that all employees, regardless of their neurotype, can thrive during midlife and beyond.
By implementing policies that acknowledge and accommodate neurodivergent experiences, organisations can create environments where individuals feel understood, supported, and valued. The journey toward greater recognition of neurodivergence in menopause is just beginning - let’s continue to shine a light on this critical intersection.
Further Resources
For those seeking more information and support, the following resources may be helpful:
ADHD UK – Workplace adjustments for individuals with ADHD
National Autistic Society – Guide to reasonable workplace accommodations
The Late Discovered Club (Podcast) – Stories of late autism diagnosis in women
ADHD in menopausal women | Bev Thorogood | TEDxBrayfordPool
By acknowledging the unique challenges neurodivergent individuals face during menopause, we can build a future where inclusivity is not just a goal but a reality.
Mel x
Original blog written for Making Menopause Work