Neurodivergence and perimenopause

For anyone moving through perimenopause and menopause, it can be a heartbreakingly isolating experience.

It is under-researched and we’ve got a long, long way to go in supporting women and gender non-conforming people through what should be a meaningful (not shameful and negative) life chapter.

While it isn't my clinical specialty, when working with clients moving through any hormonal changes or challenges in their life, I never glaze over the impacts it can have on their life and relationships.

What I also know is that neurodivergent people can experience hormonal shifts far more significantly than neurotypical.

Your experience is probably more intense and there's a reason for that

Oestrogen has a meaningful relationship with both dopamine and serotonin — the neurotransmitters that play a central role in ADHD and autism. As oestrogen fluctuates and gradually declines during perimenopause, many neurodivergent people find that symptoms they had learned to manage — or had masked for years — suddenly become much harder to hold. Focus, emotional regulation, sensory sensitivity, sleep, and anxiety can all shift, sometimes dramatically.

This is often why neurodivergent women only receive their ADHD or autism diagnoses later in life.

Your coping strategies may stop working

You could be someone whose built carefully constructed systems for managing daily life — routines, compensatory strategies, ways of moving through the world that work just enough. Perimenopause can destabilise all of that. You suddenly feel like you've lost ground you worked hard to gain.

Communicating your needs

One of the hardest things about this period can be that your needs shift, sometimes week to week. Sensory needs, intimacy needs, emotional needs — they may feel inconsistent or hard to articulate. Communicating this to a partner can feel exhausting when you're already depleted. But naming what's happening, even imperfectly, tends to create more connection than withdrawing in silence.

If you’re the partner

If you’re not going through these hormonal changes but your partner is, from the outside they may seem more overwhelmed, more sensitive, more withdrawn, less like themselves. Just like any evolution any of us go through in life, your relationship will need to adapt to fit who you both are and are becoming - any stage in life. Also understanding that perimenopause interacts with neurodivergence in specific, intensified ways can help you move from feeling shut out to feeling like you're on the same team.

Consistency and low-demand support go a long way

During perimenopause, many neurodivergent people have a reduced capacity for the things that were already effortful — social demands, sensory input, emotional labour, unpredictability. You don't need to fix anything. Showing up consistently, reducing friction where you can, and not taking withdrawal personally are some of the most valuable things you can offer.

Ask, don't assume

What your partner needs may be different from what you'd need, and it may change. A gentle "what would be most helpful right now?" asked without pressure or expectation of a lengthy answer can open more space than trying to anticipate or solve. And when they tell you what they need, believing them is everything.

Your experience matters too

Supporting someone through perimenopause while also navigating changes in your relationship — including intimacy, communication, and connection — can feel hard and vulnerable. You're allowed to have feelings about it. Therapy, whether individually or as a couple, can be a space where both experiences are held without one overshadowing the other.

Perimenopause is a significant life transition. For neurodivergent people, it can feel like the ground shifting beneath systems that were already working hard. But with the right information, the right support, and a relationship where both people feel seen, it is absolutely navigable.

If you're looking for a space to make sense of what's happening, you’re welcome to book an introductory call with me and we can discuss how therapy may help.