When Menopause Unmasks Neurodivergence in Women by Julie Bjelland, LMFT

For many women, the years of perimenopause and menopause bring unexpected changes that go far beyond hot flashes or sleep disruption. Emotional intensity increases. Sensory overwhelm becomes harder to ignore. Coping strategies that once worked suddenly stop working. For some, there is a deep internal sense that something fundamental has shifted.

What many do not realize is that this life stage often coincides with the discovery of neurodivergence, particularly autism and ADHD. For countless women, this realization arrives not in childhood, but midlife. And when it does, it can feel both relieving and destabilizing at the same time.

A discovery that holds both relief and grief

Many women describe late neurodivergent discovery as a moment of profound clarity. Experiences that once felt confusing, shameful, or self-blaming suddenly make sense. A lifetime of feeling different now has a framework. There is often a deep sense of relief in realizing, “There was never something wrong with me.”

At the same time, this awareness can bring grief. Grief for the support that was never offered. Grief for the years spent pushing through exhaustion, masking traits, or believing the struggle was a personal failure. Both experiences can exist together. Relief and grief are not opposites. They are companions in this process.

This stage often opens the door to a new relationship with oneself, one grounded in self-understanding rather than self-criticism.

Why this often happens during perimenopause and menopause

There are several overlapping reasons neurodivergence becomes more visible during this time.

First, autistic and ADHD women have historically been underdiagnosed in childhood. Many learned early how to mask, compensate socially, and meet expectations by working twice as hard internally. These strategies were often praised rather than questioned, even when they came at a high cost.

Second, hormonal shifts play a significant role. Estrogen supports emotional regulation, sensory processing, executive functioning, and cognitive flexibility. As estrogen fluctuates and declines during perimenopause and menopause, the nervous system loses a key stabilizing factor. For neurodivergent women, this can amplify traits that were previously held in check through sheer effort.

Sensory sensitivities may intensify. Emotional regulation may feel more fragile. Brain fog, overwhelm, and shutdowns can become more frequent. Executive functioning challenges often become more noticeable. What once required effort may now feel nearly impossible.

Third, the cumulative load of decades of masking often catches up. Many women reach this stage already carrying burnout, trauma, or chronic stress. When the nervous system no longer has the same hormonal buffering, the cost of constant adaptation becomes unsustainable.

When symptoms are misunderstood

Because these changes often resemble anxiety, depression, or cognitive decline, many women are misdiagnosed or told they are simply not coping well with midlife stress. They may be offered treatments that focus on symptom suppression rather than understanding the underlying nervous system differences.

But what looks like anxiety is often sensory overload or nervous system dysregulation. What looks like depression may be autistic burnout. What looks like cognitive decline may be executive functioning under hormonal strain.

Understanding neurodivergence reframes these experiences. It shifts the narrative from pathology to context. The nervous system is not failing. It is responding to internal and external changes without the supports it needs.

A powerful beginning, not an ending

While menopause is often framed as loss, for many neurodivergent women it becomes a turning point. A moment of truth. A chance to stop forcing oneself into environments, roles, and expectations that were never sustainable.

With understanding comes permission. Permission to honor sensory needs. Permission to reduce masking. Permission to build a life that fits the nervous system rather than fighting it.

This stage of life can mark the beginning of a more authentic way of living. One rooted in self-acceptance, compassion, and nervous system support. Not because anything new is wrong, but because something essential has finally been named.

For many women, this is not the end of who they were. It is the beginning of becoming who they have always been.

If this resonates, you are not alone, and you do not have to figure this out by yourself.

Many women discover their neurodivergence during perimenopause or menopause, often after years of pushing through confusion, overwhelm, and exhaustion without answers. Understanding your nervous system can be deeply grounding and empowering.

If you are curious to explore this further, you are invited to take my free autism quiz for women, created specifically for highly sensitive, high-masking, and late-identified autistic women. I also offer in-depth neurodiversity-affirming autism assessments for women who want clarity, validation, and a compassionate understanding of their lived experience. You might also like to listen to my podcast episode, Women 35–55: Why You Might Feel Like You’re Falling Apart with Julie Bjelland, LMFT

You deserve answers that honor who you truly are.

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I’m Julie Bjelland, LMFT

A psychotherapist, author, and founder of Sensitive Empowerment. I specialize in high sensitivity and adult-discovered autism. My passion is helping you live with more self-love and self-compassion and flourish more fully in the world. I’ve developed tools to balance the sensitive nervous system and reduce challenges so you can reach your fullest potential. My global support hub includes online courses, the Sensitive Empowerment Community, a top-ranked podcast, articles, webinars, and more. I’m a proud neurodivergent and queer therapist, and my mission is to create a world where differences are embraced as strengths and celebrated. I look forward to supporting your journey. Learn more at JulieBjelland.com

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