Understanding Perimenopause, ADHD, Autism, and AuDHD: A Comprehensive Guide for Therapy

At Upward Behavioral Health, we understand the unique challenges faced by women navigating perimenopause, Attention-Deficit Hyperactivity Disorder (ADHD), autism, and AuDHD (co-occurring autism and ADHD). Providing tailored, evidence-based, results-focused therapy to perimenopausal women is one of our areas of expertise.

In this post, I will discuss the perimenopause and how it affects neurodivergent women, including examples of women (with names changed) we have had the pleasure of treating at Upward.

What is Perimenopause?

Perimenopause is the transitional phase leading up to menopause, typically occurring in women in their 40s. During this time, hormonal fluctuations can significantly impact mood, focus, physical health, and cognitive function. Symptoms can include hot flashes, sleep disturbances, and emotional changes, which can be particularly challenging for women with ADHD or autism.

As women enter perimenopause, their ovaries gradually produce less estrogen and progesterone. These hormones play critical roles in regulating mood and cognitive function. The decline in estrogen can lead to increased irritability, anxiety, and depressive symptoms, affecting overall mental health.

For instance, “Sarah”, a 45-year-old mother of two from Birmingham, Alabama, recently began experiencing symptoms of perimenopause. Balancing her job as a teacher with her family responsibilities and her diagnosis of ADHD made this transition even more difficult. She often felt overwhelmed and anxious, struggling to manage her symptoms. Through therapy at Upward Behavioral Health, Sarah learned coping strategies to navigate her perimenopausal symptoms while also addressing her ADHD.

The Intersection of ADHD and Perimenopause

Women with ADHD may experience heightened emotional responses during perimenopause. The hormonal changes can exacerbate ADHD symptoms, leading to increased impulsivity, anxiety, and mood swings. Understanding this intersection is crucial for effective therapy.

“Lisa”, a 48-year-old graphic designer from Nashville, Tennessee, had been diagnosed with ADHD in her 30s. As she approached perimenopause, she began to notice that her symptoms were worsening. The combination of hormonal changes and her ADHD led to increased forgetfulness and difficulty concentrating at work. The emotional turmoil she faced during this period made it challenging to maintain her usual routines. Through therapy, Lisa developed mindfulness techniques that helped her manage both her ADHD and perimenopausal symptoms, allowing her to thrive in her career.

Autism and Perimenopause: What to Know

Autistic women may experience perimenopause differently than their neurotypical peers. Sensory sensitivities, social challenges, and emotional regulation issues can be intensified during this phase. It’s essential for therapists to recognize these unique experiences to provide appropriate support.

“Emily”, a 50-year-old autistic woman from St. Louis, Missouri, found herself struggling with the changes brought on by perimenopause. Her heightened sensitivity to environmental stimuli made hot flashes and mood swings particularly challenging. In therapy, Emily learned to advocate for her needs and implement strategies to create a more comfortable environment at work and home. Solution-focused strategies helped her find ways to mitigate and manage her symptoms, enabling her to maintain a sense of control during this transitional period.

AuDHD: Navigating the Dual Diagnosis

“AuDHD” refers to the coexistence of autism and ADHD. Research indicates that between 50-70% of autistic individuals also meet the criteria for a diagnosis of ADHD. Women with this dual diagnosis may face compounded challenges during perimenopause. Understanding the interplay between these conditions can enhance therapeutic outcomes.

Hormonal fluctuations during perimenopause can affect attention, executive functioning, and emotional regulation for women with AuDHD. This can lead to increased feelings of frustration and overwhelm. “Karen,” a 46-year-old with AuDHD from Huntsville, Alabama, experienced significant challenges during her perimenopausal transition. She often felt confused and overwhelmed, struggling with focus and emotional control. Through her work with a therapist at Upward Behavioral Health, Karen learned to implement organizational tools and emotional regulation strategies that helped her navigate both her AuDHD and perimenopausal symptoms.

The Role of Neurotransmitters

In addition to hormonal changes, neurotransmitters such as serotonin and dopamine also play pivotal roles in mood regulation. Estrogen influences serotonin levels, which can affect mood and emotional stability. As estrogen levels decline during perimenopause, women may experience fluctuations in serotonin levels, leading to increased anxiety and depressive symptoms.

For women with ADHD, who may already struggle with emotional regulation and impulsivity, these changes can complicate their mental health further. The interplay between hormonal fluctuations and neurotransmitter levels can create a storm of emotional challenges that may feel unmanageable.

Evidence-Based Practices and Neurodiversity-Affirming Treatment Approaches

For women experiencing the challenges of perimenopause alongside ADHD and autism, seeking treatment from providers who specialize in neurodivergent conditions is essential. Evidence-based practices and neurodiversity-affirming approaches ensure that therapy is tailored to the unique experiences of neurodivergent women. These approaches recognize and celebrate neurodiversity, providing an empowering framework for treatment.

Cognitive Behavioral Therapy (CBT)

CBT is a widely recognized evidence-based approach that helps individuals identify and modify negative thought patterns. For women navigating perimenopause, ADHD, and autism, CBT can effectively address mood swings, anxiety, and other emotional challenges. By working with therapists knowledgeable in neurodivergence, women can receive tailored CBT strategies that resonate with their experiences.

Acceptance and Commitment Therapy (ACT)

ACT is another effective therapeutic approach that emphasizes acceptance of thoughts and feelings while committing to behavior change. This approach can be particularly beneficial for neurodivergent women facing the emotional and psychological challenges of perimenopause. ACT encourages women to embrace their identities while developing strategies to manage their symptoms and improve their overall well-being.

Executive Functioning Coaching

Executive functioning coaching specifically targets the skills needed for organization, planning, and time management. For women with ADHD and autism, these skills can be crucial during the hormonal changes of perimenopause. Therapists who understand neurodivergence can provide personalized strategies that align with each woman's unique cognitive profile, helping them navigate daily tasks and responsibilities more effectively.

Conclusion

At Upward Behavioral Health, we are committed to supporting women as they navigate the complexities of perimenopause, ADHD, autism, and AuDHD. By understanding the interconnectedness of these experiences and utilizing evidence-based, neurodiversity-affirming treatment approaches, we can provide tailored therapeutic strategies that promote healing and growth.

If you or someone you know is struggling with these issues, we encourage you to reach out to our practice for support.