The cyclical melody (or cacophony) of hormones that orchestrates the fertility of our physical and emotional selves is not simple at the best of times. With neurodivergence often adding heightened sensitivity, these fluctuations can lead to more intense and challenging experiences.
Neurodiversity is the naturally occurring range of humanity, in all its splendour, strife, and expression. It encompasses a range of variations in the human brain regarding communication, sociability, learning, attention, mood, and other functions, and may include conditions such as Autism Spectrum Disorder (ASD), Attention Deficit Hyperactivity Disorder (ADHD), Dyslexia and others.
The role and impact of hormones on neurodiversity is far from being understood. Most research doesn’t even acknowledge whether, let alone in what way, hormonal fluctuations affect the lived experience of neurodiverse women. However, voices are rising to acknowledge the intricacies of what people live with on a daily basis.
Fluctuations in hormones such as oestrogen and progesterone can affect mood, sensory processing, and executive functioning. For some, increased sensitivity to these shifts during different phases of their menstrual cycle can lead to sensory inputs or more pronounced emotional responses that can be almost unbearable.
One study reported that that while only 3% of non-autistic women experienced premenstrual dysphoric disorder (PMDD) – a technical term for premenstrual despair about yourself and the world in general - a significant 21% of autistic women found themselves regularly experiencing this nightmare.
Research focusing on ADHD in women has indicated that oestrogen’s modulating effects on dopamine and serotonin—neurotransmitters involved in ADHD symptomatology—can lead to noticeable fluctuations in attention, impulsivity, and emotional regulation across the menstrual cycle. A drop in oestrogen levels can lead to an exacerbation of symptoms after ovulation. A tailored approach to psychostimulant medication, whereby dose is calibrated around the menstrual cycle, specifically the lead up to the period, has shown promising results. It seems obvious, and hopefully will become more common.
What, then, about that grandmother of all oestrogen drops – menopause? One study found that neurodivergent women, those with autism, ADHD or both, tend to experience more intense menopausal symptoms. Symptoms such as hot flushes, insomnia, escalating anxiety, and troubles with concentration and memory - often tied to oestrogen levels - seem to hit harder in neurodivergent women. This could be due to a more pronounced hormonal imbalance or perhaps a heightened sensitivity to the physical shifts that accompany menopause, amplified by neurodivergent individuals’ increased sensory sensitivity.
So if any of this resonates, yes it is real. We are all unique, and this beautiful diversity makes life so much richer. Unfortunately society has a lot of catching up to do to support the constantly shifting kaleidoscope of hormones, emotions, and needs that are our natural state, and vary from person to person. Seek (and keep seeking!) support that is meaningful to you, be kind to yourself, and don’t expect things like work-rate to be the same throughout the cycle. We are not machines, rather daughters of the universe, and waxing and waning is our natural state. Minimise environmental stressors, use your chosen therapies to balance your hormones, be gentle, let things flow. They will change and we are here to be your biggest supporters.
Jenny x
References:
Ashley G. Eng, Urveesha Nirjar, Anjeli R. Elkins, Yancey J. Sizemore, Krystina N. Monticello, Madeline K. Petersen, Sarah A. Miller, Jordan Barone, Tory A. Eisenlohr-Moul, Michelle M. Martel. Attention-deficit/hyperactivity disorder and the menstrual cycle: Theory and evidence. Hormones and Behavior, Volume 158, 2024
de Jong M, Wynchank DSMR, van Andel E, Beekman ATF, Kooij JJS. Female-specific pharmacotherapy in ADHD: premenstrual adjustment of psychostimulant dosage. Front Psychiatry. 2023 Dec 13;14:1306194.
Groenman AP, Torenvliet C, Radhoe TA, Agelink van Rentergem JA, Geurts HM. Menstruation and menopause in autistic adults: Periods of importance? Autism. 2022 Aug;26(6):1563-1572.
Lever, A.G., Geurts, H.M. Psychiatric Co-occurring Symptoms and Disorders in Young, Middle-Aged, and Older Adults with Autism Spectrum Disorder. J Autism Dev Disord 46, 1916–1930 (2016).
Steward R, Crane L, Mairi Roy E, Remington A, Pellicano E. "Life is Much More Difficult to Manage During Periods": Autistic Experiences of Menstruation. J Autism Dev Disord. 2018 Dec;48(12):4287-4292
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