For many women, menopause is a period of profound change, physically, emotionally and psychologically. It is a time when hormonal fluctuations can exacerbate long-standing coping mechanisms, leaving them feeling unmoored. However, for a growing number of women, menopause is also the moment they first recognise that they are neurodivergent. This revelation is not the result of a new diagnosis, but rather the lifting of a lifelong mask that has kept their neurodivergence hidden, even from themselves.
The art of masking: a lifetime of adapting聽
Women are often socialised to adapt, to be flexible and to prioritise the comfort of others over their own needs. Neurodivergent women, whether autistic or living with ADHD or other neurodivergent traits, frequently develop sophisticated coping strategies from a young age.聽
They mirror social behaviours, over-prepare for interactions and meticulously structure their lives to compensate for difficulties in executive function, sensory sensitivities or emotional regulation.聽
Many of these women have excelled in their careers, built families, and navigated the world with what appears to be ease. But appearances can be deceptive. The energy required to maintain this level of adaptation is immense and, as menopause begins, the resources needed to sustain it are suddenly depleted.聽
When the mask slips: menopause as a turning point聽
As oestrogen levels decline, many neurodivergent women report that their executive functioning, emotional regulation and sensory processing challenges become overwhelming. They may experience:聽
- Increased sensory sensitivity. Lights, sounds and even clothing texture becoming unbearable.聽
- Emotional dysregulation. Stronger reactions to stress, difficulty controlling emotions and an increased likelihood of burnout.聽
- Executive dysfunction. Struggles with planning, remembering tasks and organising thoughts in ways they had previously managed.
- Social exhaustion. A newfound inability to keep up with social norms or expectations they once masked with ease.聽
For some, these changes trigger a profound realisation: they have been neurodivergent all along, and menopause has simply removed the mechanisms that kept their differences hidden. This can be both liberating and devastating.聽
Grieving the unseen self: the emotional toll of late realisation聽
The recognition of lifelong neurodivergence in midlife often brings with it a period of mourning. Women may look back on their lives and wonder how things might have been different had they known earlier. They may grieve:聽
- Missed opportunities and career paths that might have been different had they understood their needs and strengths.
- Relationships that felt strained, the exhaustion of masking in friendships, marriages, and family roles.
- The self they never fully understood, a lifetime of feeling different but never quite knowing why.聽
Therapists working with these women often find that this realisation reopens past wounds, bringing unresolved childhood trauma or lifelong struggles into sharp focus. The therapeutic space then becomes a crucial site for validation, exploration and healing.聽
Moving forward: embracing a neurodivergent identity聽
For many women, learning about their neurodivergence is ultimately empowering. It allows them to reframe their past experiences with self-compassion and move forward with a clearer understanding of their needs. Therapy can play a vital role in helping these women:聽
- Redefine self-worth beyond societal expectations of productivity and adaptability.
- Develop new coping strategies tailored to their neurodivergent minds rather than forcing themselves into neurotypical moulds.
- Advocate for their needs in the workplace, home, and social settings without guilt or shame.
- Foster self-acceptance, embracing their authentic selves without the exhausting effort of masking.聽
A rich area for therapeutic exploration聽
For therapists, the intersection of menopause and neurodivergence presents a unique and important area of exploration. How do we support these women through their grief and self-discovery? How can we help them unpick decades of learned behaviour and develop new ways of thriving?聽
The answers lie in a therapeutic approach that acknowledges both the losses and the gains of this newfound understanding. By providing space for validation, self-exploration and practical coping strategies, we can help women move from the shock of discovery to a place of empowerment and self-acceptance.聽
Conclusion: a new lens for understanding women鈥檚 experiences聽
As awareness grows around the late recognition of neurodivergence in menopausal women, it is crucial that both the therapeutic community and society at large adjust their perspectives. This is not about pathologising menopause or neurodivergence, it is about recognising the resilience of women who have navigated life with unseen differences and, finally, giving them the tools to embrace their true selves.聽
