When Hormones Meet Neurodivergence: ADHD, Autism and Midlife
If you’ve recently found yourself feeling foggy, irritable, or just not “on your game” the way you used to be—particularly at work—you’re not imagining things. For many midlife women, a new wave of symptoms begins to surface during perimenopause and menopause. But when those women are also neurodivergent, the impact can feel even more profound.
In fact, hormonal changes during midlife may be one of the most overlooked triggers for intensifying ADHD and autism-related challenges—especially for those who have spent years masking, coping, or compensating.
What’s Going On?
The culprit, for many, is oestrogen.
Oestrogen helps regulate dopamine, the neurotransmitter most closely associated with focus, motivation, mood, and executive function. If you already experience differences in dopamine processing—as is common in both ADHD and autism—the natural decline in oestrogen during perimenopause can magnify the difficulties you face.
Tasks that once felt effortless may now demand huge mental energy. You might find yourself forgetting appointments, zoning out in meetings, or struggling to complete projects that once came naturally. Emotional dysregulation can also spike, leading to overwhelm, irritability, and sensitivity to noise or social interaction.
What’s more, if you’re undiagnosed—or have been misdiagnosed in the past—this stage of life can bring deep confusion. Why now? Why does everything feel harder?
The Hidden Intersection
Although public awareness of ADHD in women is slowly improving, much of the research and clinical practice still focuses on children or younger adults. As a result, many midlife women report feeling invisible—or worse, dismissed—when they raise concerns about focus, memory, or mood.
But the science is starting to catch up.
A growing body of evidence highlights the hormonal link. One study published in Frontiers in Human Neuroscience notes that oestrogen plays a significant role in cognitive function and emotional regulation, particularly in those with pre-existing vulnerabilities¹. Another, published in The Journal of Women’s Health, emphasises that ADHD symptoms can worsen during menopause and are often misattributed to “normal ageing”².
This intersection—where neurodivergence meets hormonal transition—has real consequences for self-esteem, work performance, and mental health. And yet, it’s still not routinely addressed in most medical consultations.
Why This Matters
Without proper support or understanding, many women blame themselves.
They wonder if they’re “just not trying hard enough,” or if they’ve lost the drive they once had. Some even consider stepping back from careers or responsibilities they’ve thrived in for years.
But you’re not lazy. You’re not “losing it.” And you’re certainly not alone.
We’re only just beginning to understand how perimenopause and menopause interact with neurodivergent profiles—especially in women who may have gone undiagnosed for decades. These aren’t separate issues. They’re intertwined. And acknowledging that can be a powerful step toward healing.
What You Can Do
If this all resonates, here are three things to keep in mind:
1. Track your patterns
Start paying attention to when your symptoms are at their worst. Are there times of the month or particular triggers—like stress, poor sleep, or diet—that seem to make things harder? Noticing these patterns can give you insight and help build a case for further support.
2. Seek a neurodiversity-informed perspective
If you’re exploring whether ADHD or autism might be part of the picture, find a clinician who understands the unique ways these conditions present in midlife women. A diagnosis, if appropriate, can bring relief—not more pressure. It’s about clarity, not judgement.
3. Prioritise rest and nourishment
Burnout is common in midlife, but for neurodivergent women, it often arrives earlier and more intensely. Prioritise downtime. Choose rest over productivity when you can. And remember: real strength often looks like letting go, not pushing through.
A Final Thought
At the Autism ADHD Centre, we believe midlife should be a time of deeper understanding—not confusion. If you’ve spent years feeling like you were “almost managing” but never quite at ease, this stage of life might be the key to seeing yourself more clearly than ever before.
A diagnosis, if appropriate, can help make sense of things that never quite added up. But even without a label, you deserve to feel supported, seen, and validated—especially in moments of change.
This isn’t the end of your capacity. It might just be the beginning of your clarity.
References:
Jacobs, E. & D’Esposito, M. (2011). Estrogen shapes dopamine-dependent cognitive processes: Implications for women’s health. Frontiers in Human Neuroscience, 5(28).
Quinn, P. O. (2005). Treating ADHD in Women: Addressing the Unique Challenges. Journal of Women's Health, 14(4), 330–334.