Neurodiversity and Perimenopause: Why Some Women Stop Feeling Like Themselves

“I don’t feel like myself anymore.”

She was capable, intelligent and dependable.

For years, she had managed a demanding schedule, family responsibilities, work deadlines and the invisible mental load that often comes with being the person everyone relies on.

She had always needed structure.

Lists helped her remember. Routines helped her feel safe. Quiet time helped her recover after busy days, social situations or overwhelming environments.

She noticed details that other people missed. She felt things deeply. Sudden changes unsettled her, although she had become very skilled at appearing calm and organised.

Then perimenopause began.

The strategies that had supported her for years no longer seemed to work in the same way.

She started forgetting appointments.

She lost words halfway through sentences. Tasks that had once felt straightforward became harder to begin or complete.

Her sleep became unpredictable. Ordinary sounds felt louder. Clothing felt more irritating against her skin. Interruptions became more difficult to tolerate, and her emotions seemed much closer to the surface. Her body was changing too.

She experienced greater muscle tension, fatigue, headaches, joint discomfort, temperature fluctuations and periods when her nervous system felt permanently switched on.

And then there was something she felt embarrassed to mention.

Her body odour had changed. She tried different deodorants, soaps, fabrics and washing routines, yet nothing seemed to work as it once had.

It felt like one more unfamiliar change in a body she had known all her life.

She began asking herself:

Why can’t I cope the way I used to?

Am I becoming less capable?

Is this menopause, burnout, anxiety, ADHD, autism—or all of them interacting?

What is the connection between Neurodiversity and Perimenopause?

Neurodiversity describes the natural differences in how human brains process information, attention, emotion, sensory input and communication.

It can include experiences associated with ADHD, autism, dyslexia, dyspraxia and other neurological differences. Neurodivergence does not suddenly begin during perimenopause.

However, some women become more aware of lifelong neurodivergent traits during this stage of life. They may have spent decades compensating, masking or creating highly structured systems to meet expectations at work, at home and within relationships.

When perimenopause begins affecting sleep, energy, memory, concentration and emotional regulation, those existing coping systems may become harder to maintain.

The woman has not suddenly become lazy, careless or incapable.

She may simply have less physical and mental capacity available for constant compensation.

Can Perimenopause make ADHD symptoms feel worse?

Some women with ADHD report greater difficulty with:

• concentration

• working memory

• organisation

• task initiation

• emotional regulation

• motivation

• sleep

• managing interruptions

• recovering from stress

  
  

These difficulties can overlap with common perimenopause symptoms such as brain fog, fatigue, poor sleep and mood changes. This overlap can make it difficult for a woman to understand what is happening. She may wonder whether her ADHD has become worse, whether she is experiencing burnout or whether hormonal changes are affecting the strategies she previously relied upon.

Research into ADHD and female hormonal transitions is still developing. The evidence does not show that every woman with ADHD will experience more severe menopause symptoms.

However, hormonal fluctuations may influence attention, mood and executive functioning in some women. This is why personalised assessment matters.

How can Perimenopause affect Autistic women?

Some autistic women describe menopause as a time of increased:

• sensory sensitivity

• emotional intensity

• exhaustion

• difficulty identifying internal body signals

• disruption caused by changing routines

• reduced tolerance for social demands

• masking fatigue

• anxiety or low mood

• need for recovery time

  
  

Changes in temperature, sweating, sleep, body sensations and menstrual patterns may be especially unsettling for someone who already experiences sensory sensitivity or difficulty interpreting internal physical signals.

For a woman who has spent years masking discomfort, the menopause transition may become the point at which continuing to “push through” is no longer sustainable.

For some women, it may also lead to the first serious exploration of autism, ADHD or combined AuDHD. This does not mean menopause causes neurodivergence.

It may mean that hormonal, physical and social changes make previously hidden needs more visible.

Why can body odour change during Perimenopause?

Body odour can change when sweating patterns, temperature regulation and skin bacteria change.

Hot flushes and night sweats may increase perspiration, while hormonal changes may influence how sweat smells or how strongly a woman notices it.

For a neurodivergent woman with heightened sensory awareness, the change may feel particularly distressing. It may affect confidence, intimacy, clothing choices, social comfort and willingness to attend work or events. This symptom deserves compassion rather than shame. A persistent or sudden change in body odour should not automatically be attributed to menopause. Medication, infection, thyroid problems, diabetes, liver or kidney conditions and other health factors can also contribute.

A GP or qualified healthcare professional should be consulted when the change is significant, persistent or accompanied by other symptoms.

The emotional impact of not recognising Yourself

One of the hardest parts of perimenopause is not always the individual symptoms.

It is the loss of predictability.

A woman may no longer know how much energy she will have, how well she will sleep or whether she will be able to focus throughout the day. She may begin doubting her intelligence, competence or emotional stability. At work, she may fear being judged as unreliable. At home, she may feel guilty for needing more space, more quiet or more help.

Within relationships, she may struggle to explain why touch, noise, conversation or demands sometimes feel overwhelming. This can be especially painful for women who have built their identity around being capable, productive and available to everyone else.

She Is Not Failing—Her Needs Are Changing !

The answer is rarely to tell a woman to try harder, purchase another planner or simply accept that getting older is difficult.

She may need:

• a menopause-informed healthcare assessment

• a Neurodiversity-informed professional when appropriate

• support for sleep and mental wellbeing

• reduced sensory and social demands

• clearer boundaries

• realistic workplace adjustments

• more recovery time between commitments

• movement and bodywork adapted to her energy

• less masking and more honest communication

• permission to stop measuring her worth through productivity

  
  

Support should not become another performance target. The purpose is not to create a perfect wellness routine. It is to reduce unnecessary pressure and help the woman feel safer, more informed and more connected to her body.

How Holistic Bodywork may support women during Perimenopause

Massage does not diagnose or treat neurodivergence, and it is not a replacement for medical menopause care. However, appropriately adapted therapeutic bodywork may offer supportive space for women experiencing stress, muscular tension, poor sleep and physical overload.

A neurodiversity-aware session may include:

• clear communication before and during treatment

• reduced lighting or background noise

• choice around music and scent

• predictable explanations before touch

• pressure adjusted throughout the session

• additional support for temperature comfort

• permission to talk, remain quiet or pause

• a slower pace without unnecessary stimulation

  
  

For some women, the greatest benefit is not simply physical relaxation. It is having an hour in which they do not need to mask, perform, explain everything or look after anyone else.

When should a woman seek professional help?

Speak with a doctor, gynaecologist or qualified menopause professional when symptoms interfere with daily life, work, sleep, relationships or emotional wellbeing.

Medical support is particularly important when there is:

• persistent low mood or anxiety

• severe sleep disruption

• very heavy or unusual bleeding

• sudden or unexplained body-odour changes

• significant memory or cognitive changes

• heart palpitations, dizziness or fainting

• new or worsening pain

• thoughts of self-harm or feeling unable to cope

A woman does not need to wait until she is in crisis before asking for support with neurodiversity and perimenopause, menopause.

A different question for this stage of life

Perhaps the question is not:

“How can I become my old self again?”

Perhaps the more compassionate question is:

“What does this stage of my life need from me now?”

Perimenopause may reveal that the pace, expectations and coping strategies that once seemed manageable are no longer sustainable.

That is not weakness. It may be an invitation to create a life that respects the nervous system, the changing body and the person beneath years of adaptation.

Your experience is real.

Your needs are not inconvenient.

And you deserve to be heard rather than dismissed.

This article is educational and does not replace medical diagnosis, menopause care or mental-health support.

Love & Light, your therapist, Hajnalka