ADHD and Perimenopause

I am a late-discovered AuDHD female.

I was diagnosed with both ADHD and Autism at the age of 49.

I’ve had a career, raised two boys, studied at university level, and led a full and busy life—yet I spent most of it wondering why I struggled with things that seemed easy for others.

The constant internal noise.

The overwhelm.

The confusion.

But it wasn’t until perimenopause hit that everything REALLY unravelled.

The brain fog, the exhaustion, the emotional dysregulation—it felt like my mind had short-circuited.

(DISCLAIMER: this is MY story and my experience. I’m not a medical professional and this post is not a substitute for professional medical advice, diagnosis or treatment. Always seek professional medical advice on the topics covered in this post)

Contents

1. Why Autism and ADHD in women often goes unnoticed

2. The ADHD and Perimenopause Collision

3. What is AuDHD?

4. The problem with 'High Functioning'

5. Why so many women are diagnosed around Menopause

6. My diagnosis on the UK National Health Service (NHS)

7. What's helped me so far

8. Frequenly Asked Questions (FAQs)

9. Finding what works for you

(And this post may contain affiliate links, meaning if you click on a product or service, and decide to purchase it, I may receive a small commission at no extra cost to you...but the recommended products and services are only based on my positive experience!)

Why Autism and ADHD in Women Often Goes Unnoticed

For most of my life, I thought I was “different”.

I was quiet and introspective.

I found social situations draining, and I always felt like I had to work harder to keep up.

Like many women with inattentive ADHD and Autism, I didn’t match the stereotypes—so I went undiagnosed.

We internalise our symptoms, mask our challenges and create coping mechanisms that hide the reality of how hard things really are.

This "masking" helps us survive—until it no longer does.

For many of us, the tipping point is perimenopause.

The ADHD and Perimenopause Collision

Oestrogen plays a crucial role in regulating dopamine, the neurotransmitter responsible for motivation, focus and executive function. 

So when oestrogen levels begin to fluctuate in perimenopause, dopamine dysregulation becomes more pronounced.

This can make previously manageable ADHD traits feel unbearable.

Brain fog increases.

Memory lapses happen more often.

Focus disappears.

Emotional regulation becomes harder than ever.

For some women, perimenopause is the moment their ADHD or Autism becomes impossible to ignore. It brings everything to the surface.

That’s what happened to me.

In late 2024, I received a dual diagnosis of ADHD and Autism (AuDHD). I was nearly 50 years old.

Like many late-diagnosed women, I’d masked my traits for decades.

I’d created a life built around coping strategies, structure, perfectionism, and pushing through.

I thought I was just highly sensitive, sometimes intense, sometimes chaotic—but always productive.

Until I wasn’t.

Perimenopause stripped away my ability to mask.

What had once looked like ‘high-functioning’ was now clearly burnout, sensory overload and executive dysfunction.

What is AuDHD?

AuDHD means having both Autism Spectrum Condition (ASD) and Attention Deficit Hyperactivity Disorder (ADHD).

They’re often misunderstood as opposites—autism is seen as rigid and routine-driven, ADHD as impulsive and chaotic—but for many of us, they coexist.

And they don’t cancel each other out. They complicate each other.

I crave structure and sameness, yet I get bored quickly.

I hyperfocus deeply, but I also forget to eat or respond to messages.

I’m sensitive to noise, light, and texture—but also impulsive, curious, and distractible.

It’s not a contradiction. It’s a neurotype.

The Problem With “High-Functioning”

Like many AuDHD women, I was considered ‘high-functioning’—a term that’s more damaging than helpful.

It meant I succeeded at work, masked well in social situations, and didn’t cause ‘problems.’

But it also meant I was never seen as someone who might be autistic. Or ADHD. Or struggling.

Behind the scenes, I lived in a constant state of internal panic.

I needed recovery time after every social event.

I overcompensated with perfectionism.

I obsessed over details most people wouldn’t notice.

I pushed myself to exhaustion, again and again.

And when perimenopause hit, the system broke down.

Why So Many Women Are Diagnosed Around Menopause

Perimenopause is often the tipping point for undiagnosed neurodivergent women.

Hormonal changes impact the brain’s ability to regulate mood, focus, and executive function—areas already vulnerable in ADHD and autism.

Estrogen plays a role in dopamine transmission, which is why ADHD symptoms often worsen when estrogen drops.

And for autistic women, sensory sensitivities, anxiety, and social exhaustion can all become more intense during menopause.

For me, the coping strategies I’d relied on for years suddenly stopped working.

And with the masks stripped away, I was forced to confront who I really was underneath.

Diagnosis on the UK National Health Service (NHS)

I was diagnosed through the NHS Right to Choose pathway.

I was relieved, validated and hopeful.

But the pathway ended after the diagnosis—there was no follow-up, no support, no medication review.

The provider recommended stimulant medication for ADHD, but my NHS doctor was unable to prescribe it as it is 'not an area of expertise in primary care'.

I was left in a no-man’s land: technically diagnosed, but not treated.

I’m still navigating what to do next. I'm on a new Right to Choose pathway now for the medication but this could take several years.

Part of me is cautious about stimulants anyway.

My autistic side worries about side effects and masking deeper needs.

My ADHD side is desperate for clarity and focus.

The internal conflict is real—and exhausting.

What's helped me so far

Hormone Replacement Therapy (HRT/MHT)

I'm a huge advocate for HRT and it has been extremely beneficial to me!

You can learn more about HRT on my blog where I share lots of information about all things menopause.

Supplements for ADHD brain health 

Certain supplements may support focus and dopamine regulation.

I love ‘Get Dopa’ which contain nutrients to support executive function, energy and cognitive performance.

They’re a scientifically-balanced food supplement with 16 amino acids, vitamins, minerals, probiotics and botanicals. Use my link above to get 10% off your purchase.

The government scheme Access to Work

I applied for an Access to Work grant, which provided funding for coaching and tools tailored to how my brain works.

It can help you get or stay in work if you have a physical or mental health condition or disability, including ADHD and Autism.

The support you get will depend on your needs. Through Access to Work, you can apply for:

• a grant to help pay for practical support with your work

• support with managing your mental health at work

• money to pay for communication support at job interviews

I follow the work of Dr Emma Ping

Dr Ping is a menopause doctor with a special interest in ADHD in women. She shares lots of valuable tips on her Instagram page.

My reading list

Books like “Unmasked” by Ellie Middleton and “ADHD an A to Z” by Leanne Maskell have helped me see how Autism and ADHD manifest in women.

There's also an incredible book “Rediscovered: A Compassionate and Courageous Guide for late discovered autistic women (and their allies) by Catherine Asta.

And 'Odd Girl Out' by Laura James has really helped me. Laura's story is so similar to my own.

Frequently Asked Questions - FAQS

Is ADHD worse during menopause?

Yes, ADHD symptoms can worsen during menopause due to fluctuating oestrogen levels, which impact dopamine production—a key neurotransmitter involved in focus and executive function. Many women find their usual coping strategies less effective, leading to increased forgetfulness, brain fog, and emotional dysregulation.

Does HRT help with ADHD?

Hormone replacement therapy (HRT) may help some women with ADHD during menopause by stabilising oestrogen levels, which can improve cognitive function and emotional regulation. However, the effects vary, and HRT is not a direct treatment for ADHD but may offer relief for related symptoms like brain fog and mood swings.

What are ADHD symptoms in women?

ADHD symptoms in women often include difficulty with focus, disorganisation, impulsivity, emotional sensitivity, and struggles with time management. Many women also experience chronic overwhelm, forgetfulness, and difficulties in maintaining routines, which can intensify during hormonal shifts like menopause.

What is ADHD masking in females?

ADHD masking refers to the unconscious effort women make to hide their symptoms by mimicking neurotypical behavior, overcompensating, or developing coping strategies that can be exhausting. This can lead to anxiety, burnout, and a delayed or missed diagnosis, as their struggles may be overlooked or mistaken for stress or emotional issues.

What makes ADHD worse?

ADHD symptoms can worsen due to stress, lack of sleep, poor diet, hormonal changes (such as menopause or menstrual cycles), and overstimulation. Lifestyle factors like excessive caffeine, high sugar intake, and inconsistent routines can also exacerbate difficulties with focus, memory and emotional regulation.

Finding What Works for You

Managing ADHD in midlife—especially when combined with perimenopause—can feel overwhelming but understanding the connection is the first step toward regaining control. 

The key is to experiment and find what works for you. 

ADHD and Autism aren’t one-size-fits-all, and neither are the solutions. 

Have you found a strategy that works for you? I’d love to hear about it! Drop a comment below.

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