Does menopause make autism and ADHD traits worse?

For many women, the menopause brings changes to sleep, mood, memory and concentration. For autistic women and women with ADHD, these changes can land on top of traits and coping strategies they have been managing, sometimes without realising it, for their whole lives. So, does menopause make autism and ADHD traits worse? The research is still young, but it is growing quickly, and it is starting to point in a clear direction.

Why women are often missed

Differences in how often autism and ADHD are diagnosed in males and females are well documented, with referral and diagnosis rates in males far outweighing those in females, especially in childhood (Gershon, 2002; Nøvik et al., 2006). This has been put down, at least in part, to a lack of recognition and referral bias for girls and women (Berry, Shaywitz & Shaywitz, 1985).

Research on how ADHD and autism show up in girls and women is growing, and studies suggest there are real differences between the sexes in how traits present (Young et al., 2020). Many women learn to mask or compensate for their difficulties, which means they may reach midlife without ever having been assessed.

Research is also beginning to look at how female sex hormones affect ADHD across the lifespan, including across the menstrual cycle, pregnancy and the menopause (Camara, Padoin & Bolea, 2022; Roberts, Eisenlohr-Moul & Martel, 2018).

ADHD and the menopause: what the research says

An early survey led by Dr Jeanette Wasserstein, a clinical neuropsychologist, collected responses from 2,653 women aged over 46 through readers of ADDitude magazine. Sixty-one percent said ADHD had the greatest impact on their lives between the ages of 40 and 59. Over half said difficulties such as poor time management, memory problems, overwhelm, putting things off, brain fog, distractibility and disorganisation had a ‘life-altering impact’ during their perimenopause or menopause (Wasserstein, Stefanatos & Solanto, 2023).

Since then, larger and more robust studies have started to appear. A 2025 population-based study from Iceland followed 5,392 women aged 35 to 55, including 535 with an ADHD diagnosis. Women with ADHD reported noticeably more severe perimenopausal symptoms overall. Severe psychological symptoms were reported by 58.6% of women with ADHD compared with 36% of women without, and severe physical symptoms by 30.4% compared with 13.9%. The biggest differences were seen in women aged 35 to 39, which suggests perimenopause may start to affect women with ADHD earlier than expected (Smári et al., 2025).

Not every study agrees. A 2025 UK survey of 656 women aged 45 to 60 found that women with ADHD did not report more menopausal complaints overall than women without ADHD, although ADHD symptoms and menopausal symptoms were linked across the whole group (Chapman et al., 2025). The authors suggest that women with ADHD may explain their symptoms differently, and that more long-term research is needed.

Autism and the menopause: what the research says

Research into autism and the menopause is even more limited, but what exists is striking. In one of the first studies on the topic, autistic women described the menopause as heightening existing difficulties and bringing new cognitive, social, emotional and sensory challenges. One participant described it as the point ‘when my autism broke’ (Moseley, Druce & Turner-Cobb, 2020).

A follow-up study with 17 autistic people found that awareness of the menopause was often low, and so was confidence in getting help from health professionals. Some participants described a marked decline in their ability to cope day to day, their mental health and their social lives. Many had only been diagnosed as autistic in adulthood (Moseley, Druce & Turner-Cobb, 2021).

Common themes across this research include:

• Masking becoming harder to keep up, sometimes bringing autistic traits to the surface for the first time
• Heightened sensory sensitivities, for example to noise, light, touch or temperature
• Disrupted sleep, and more frequent meltdowns or shutdowns
• Difficulty recognising and describing changes in the body (interoception), which can make symptoms harder to spot and explain to a GP

A 2026 review concluded that autistic women may experience the menopause more intensely than non-autistic women, and called for autism-informed health information, better training for health professionals and more research designed with autistic women (Badgett et al., 2026).

So, does menopause make autism and ADHD traits worse?

More research is needed, and not all findings point the same way. However, based on the growing evidence, the many accounts from women themselves, and what we know about how hormone changes during the menstrual cycle affect ADHD (Roberts et al., 2018), it is reasonable to say that yes, for many women, the menopause can make autism and ADHD traits more noticeable and harder to manage.

For some women, this is the first time they begin to wonder whether they might be autistic or have ADHD.

What might help

If you are concerned about the impact of the (peri)menopause alongside autism or ADHD, the following might be helpful to consider:

• If you have never been assessed, you may find it helpful to pursue an assessment to find out whether the difficulties or changes you are experiencing may be related to undiagnosed autism or ADHD.
• You may wish to speak to your GP about other things that might help, including psychological support or options such as hormone replacement therapy (HRT).
• It can help to track your symptoms over time to spot any patterns or changes. This can also make it easier to explain what is happening at appointments. Some useful apps for this are listed below.
• If you are autistic, think about what support would make appointments easier, such as writing things down beforehand or asking for a longer appointment.
• Eating a balanced diet, keeping active and protecting your sleep where you can are all important for keeping well.

Useful resources

Tracking your symptoms over time can help you spot patterns and give you something clear to share with your GP or clinician. Some apps that people find helpful include:

• Balance – a free app created by menopause specialist Dr Louise Newson. It lets you track (peri)menopause symptoms, periods and mood over time, and includes information about the menopause and treatment options. An optional paid upgrade (Balance+) is also available. Find out more about Balance. 
• Bearable – a symptom and mood tracker that many people with ADHD use. It lets you log symptoms, mood, sleep, medication and daily habits, and see how they link together over time. It is free to download, with optional paid features. Find out more about Bearable.

These apps are suggested for information only. The Autism Service is not affiliated with them and does not endorse any particular product.

Understanding yourself at any stage of life

If the menopause has left you feeling that you no longer recognise yourself, or that the strategies which used to work have stopped working, you are not alone. For some women, this is the moment they first start to wonder whether autism or ADHD might have been part of their story all along.

An assessment can help you make sense of this. It can give you a clearer picture of how your brain works, help explain difficulties you may have lived with for many years, and help you understand which changes may be linked to autism or ADHD and which may be linked to the menopause.

A diagnosis can also be a useful starting point. It can help you have more informed conversations with your GP, ask for reasonable adjustments at work, and find strategies that suit the way you think and feel. For many people, simply understanding themselves better, at any stage of life, brings a real sense of relief.

At The Autism Service, we offer autism and ADHD assessments, including combined assessments. If you would like to find out more, or talk through whether an assessment might be right for you, please get in touch.

References

Badgett, N.M., Taylor-Swanson, L., Quist, S., Price, J. & Villanueva, J. (2026). Experiences of autistic women in menopause: brief review and recommendations for practice and research. Frontiers in Reproductive Health, 8, 1762773.

Berry, C.A., Shaywitz, S.E. & Shaywitz, B.A. (1985). Girls with attention deficit disorder: a silent minority? A report on behavioral and cognitive characteristics. Pediatrics, 76, 801–809.

Camara, B., Padoin, C. & Bolea, B. (2022). Relationship between sex hormones, reproductive stages and ADHD: a systematic review. Archives of Women’s Mental Health, 25, 1–8.

Chapman, L., Gupta, K., Hunter, M.S. & Dommett, E.J. (2025). Examining the link between ADHD symptoms and menopausal experiences. Journal of Attention Disorders, 29(14), 1263–1277. doi:10.1177/10870547251355006

Gershon, J. (2002). A meta-analytic review of gender differences in ADHD. Journal of Attention Disorders, 5, 143–154.

Moseley, R.L., Druce, T. & Turner-Cobb, J.M. (2020). ‘When my autism broke’: a qualitative study spotlighting autistic voices on menopause. Autism, 24(6), 1423–1437. doi:10.1177/1362361319901184

Moseley, R.L., Druce, T. & Turner-Cobb, J.M. (2021). Autism research is ‘all about the blokes and the kids’: autistic women breaking the silence on menopause. British Journal of Health Psychology, 26(3), 709–726. doi:10.1111/bjhp.12477

Nøvik, T.S., Hervas, A., Ralston, S.J., Dalsgaard, S., Rodrigues Pereira, R., Lorenzo, M.J., et al. (2006). Influence of gender on attention-deficit/hyperactivity disorder in Europe – ADORE. European Child & Adolescent Psychiatry, 15(Suppl. 1), 1–24.

Roberts, B., Eisenlohr-Moul, T. & Martel, M. (2018). Reproductive steroids and ADHD symptoms across the menstrual cycle. Psychoneuroendocrinology, 88, 105–114.

Smári, U.J., Valdimarsdottir, U.A., Wynchank, D., de Jong, M., Aspelund, T., Hauksdottir, A., et al. (2025). Perimenopausal symptoms in women with and without ADHD: a population-based cohort study. European Psychiatry, 68(1), e133. doi:10.1192/j.eurpsy.2025.10101

Wasserstein, J., Stefanatos, G.A. & Solanto, M.V. (2023). Perimenopause, menopause and ADHD. Journal of the International Neuropsychological Society, 29(s1), 881. doi:10.1017/S1355617723010846

Young, S., Adamo, N., Ásgeirsdóttir, B.B., et al. (2020). Females with ADHD: an expert consensus statement taking a lifespan approach providing guidance for the identification and treatment of attention-deficit/hyperactivity disorder in girls and women. BMC Psychiatry, 20(1), 404. doi:10.1186/s12888-020-02707-9