(Article co-written with myself and Nicola Green of Nicola Green Consultancy who provides practical advice on the menopause). This is my version from Inspire Coaching - Expert Neurodivergent Support, which has been slightly adapted for this Blog.
Nicola and I kept having a conversation about the similarities and connection between peri-menopause/menopause and how we both felt it an important subject area and wanted to raise some awareness in order to highlight this topic for you and provide you with some useful links for further insight.
Nicola took the time to delve into some research and to speak with me because I support many neurodivergent women with career coaching who are trying to manage their career and personal life during their peri-menopausal years.....and it's challenging!
A very alarming fact to start with…
ADHD in women was not recognised until 2014 and in 2021, 254,000 women took the ADHD test, which was an increase of 3200% from 2019.
The exact number of women with ADHD in the UK is unclear due to under-diagnosis and misdiagnosis. Women may display different symptoms than men and may mask to fit in with social expectations. Lack of awareness among healthcare professionals means many women may go unnoticed or receive a different diagnosis such as anxiety or depression.
Nicola asked me more about the connection between peri-menopause/menopause and ADHD and the struggles many of my clients face and this is what she learnt…
Attention deficit hyperactivity disorder (ADHD) is a common condition that affects millions of people worldwide. Some of the known positives of ADHD are many; creative & innovative, big picture thinker, notice everything, driver of change, strong sense of justice, however, it can also cause challenges which can impact various aspects of life, such as work, school, relationships and self-care. But the latest research appears to show that it has a greater impact for women & girls, during puberty, pregnancy, and their menstrual cycle right up to & including peri-menopause/menopause.
Unfortunately the symptoms that many peri-menopausal women will experience due to hormonal fluctuations are intensified even more for those women with ADHD and most likely this will include Autistic women. ADHD and Autism are often co-occurring conditions and often the symptoms these two groups experience are very similar.
We give more detail son the symptoms that may be experienced around the transitional time of perimenopause if you also have ADHD
As women enter this key stage of life many women may not realise they have ADHD or if they do know they don’t realise just how much peri-menopause can affect their ADHD symptoms.
Here are some of the similar symptoms of ADHD and peri-menopause and menopause to be aware of:
Difficulty concentrating/Lack of focus. Women with ADHD and menopause may have increased trouble paying attention, staying organised, finishing tasks and remembering things due to lower oestrogen levels, which affect dopamine and serotonin levels.
Brain fog. Heightened problems with memory, concentration or thinking due to lower oestrogen levels, which can affect cognitive function and brain health.
Mood changes. Low mood, anxiety, irritability, or mood swings can be greatly amplified due to hormonal fluctuations and the impact of their conditions on their physical and mental health.
Headaches & migraines. These may be worse than usual due to their ADHD, stress levels, lack of sleep, dehydration, or even certain foods. They may also be triggered by vasomotor symptoms such as hot flushes.
Many of my ADHD clients appear to be coping well externally, but internally they feel overwhelmed and out of control. Their mental health is suffering, relationships are more challenging, and their usual coping strategies are failing.
When they come for coaching, they usually don’t realise how much their hormones are to blame. They fear they are going crazy and will lose everything. By the time they seek support, they are anxious about their work performance and ability to handle stress and blame themselves for their current shortcomings.
My job is to not support them in navigating their careers and goals but also to help them better understand peri-menopause and their ADHD as this is something not usually considered straight away. We look at how this could be impacting them at work and in life and what support they might need from family, friends, and employers.
As always, there is a personal responsibility aspect and we need to seek support ourselves by researching. A couple of initial options are to research ADHD and seek a diagnosis if that is the best course of action and speak to a medical professional.
The consequences are that ADHD women could be experiencing heightened challenges at work, for example, anxiety around meeting deadlines, time and task management and many could find themselves over promising and underdelivering. However, these difficulties can be managed, if what is happening is understood and the conversation is made safe and comfortable.
Therefore, understanding and support are key and we would like to highlight a few simple steps that could be taken by you and your employer which could make an instant positive impact to your situation.
Take some time to research and learn about ADHD and menopause. There are many helpful resources available and I have listed a couple to get you started. And remember, you’re not alone and it’s not your fault that you’re experiencing hormonal changes.
1. Keep track of your symptoms in a log or journal and share your experiences with your partner and family. Being open and honest can help you feel supported and understood.
2. Speak to a menopause specialist at your GP, ideally one who also understands ADHD. Don’t be brushed off!
3. Making small changes to your diet and lifestyle can have a big impact. Try to get enough rest, cut back on sugar, caffeine, and alcohol, and eat more natural foods. Regular exercise can also help you feel better, gentle exercise like walking is great if you are feeling exhausted.
4. Explore different stress reduction techniques to find what works best for you. This could include therapy, walking in nature, mindfulness, yoga, Qi Gong, listening to calming music, taking a relaxing bath - anything that helps calm your nervous system can be really beneficial.
Although menopause is not a protected characteristic under the Equality Act 2010, many employers are taking steps to support staff affected by it. ADHD can be considered a disability under the Act if its impact is significant, and employers should provide reasonable adjustments to support employees with ADHD. It is not acceptable for an employer to do nothing to help a struggling staff member.
Of course not everyone going through perimenopause with ADHD will need extra support in the workplace, and those who do may need only small changes to enable them to work more effectively. Most of these will cost little or nothing to implement so there is no financial barrier.
Here are some useful reasonable adjustments that previous clients of mine with ADHD and peri-menopause have asked their company for and they have really made a positive difference:
Little or no financial cost...
Consider offering flexible working options to accommodate individual needs and schedules. For example, allowing some leeway with start times can help reduce stress levels for employees who may find it challenging to arrive at work precisely at 9am.
Be understanding and flexible when scheduling meetings and managing the time of your staff member. One client did her best work between 12-3am when her household was quiet and her firm supported her by ensuring there were no meetings in her diary between 9am-11am
Support your staff by avoiding any micromanagement and instead offer help with planning tasks and breaking down long assignments into manageable mini milestones.
Provide clear instructions in writing, helpful visual prompts, and handy checklists to make tasks easier.
Create a peaceful workspace or provide noise-cancelling headphones to minimise distractions and help your staff focus.
At maybe some cost
An Occupational Health referral and assessment can help your employer understand your needs and make reasonable adjustments for you at work. You can speak to your manager or HR department about arranging an assessment which should be at their cost.
If your employer refuses, or are being very slow to help, you can apply for a grant from Access to Work. They will conduct a free workplace needs assessment and your employer will be expected to make the recommended reasonable adjustments. Access to Work can provide a grant to pay for practical support in your work, including support for managing mental health, assistive technology and specialist equipment, and even the cost of engaging a coach who understands ADHD to help with planning, time and task management, goal setting, and organisation to highlight just a few areas.
The phrase, I have heard time and time again from client's is, “I thought I was going crazy!” and one which Nicola often hears after she has done one of her company talks on the menopause. So many women feel this way with their peri-menopausal symptoms when they are not understood, but this, again, can be a heightened comment from those also experiencing ADHD.
Neurotypical individuals will, of course, experience peri-menopausal symptoms and all in our own unique way, but this blog is to raise awareness that Neurodiverse individuals will experience the same, but potentially in an increased way.
In summary, many individuals who have masked their ADHD, or have never realised they have it, struggle to continue to do so when peri-menopause comes along.
We both have really only touched on the subject, but I do recommend reading the amazing booklet produced by Newson Health for a greater understanding:
Episode 18 of the The ADHD Adults podcast by James Brown and Alex Conner on Spotify is worth a listen to as Mrs ADHD gives her lived experience of ADHD and Menopause..
Here is also a link to self-report ADHD test: