Is Perimenopause Making You Feel Neurodivergent?

I see a lot of posts on social media about neurodivergence lately. Some highlight how neurodivergent brains process the world differently; others try to reframe neurodivergence away from a deficit model and highlight the unique superpowers it may bring. There’s discussions of sensory overload, masking and burnout. And of course, the ubiquitous “Spoon Quiz” which playfully highlights sensory preferences, comfort and decision making styles.

All of which is great, and very helpful, as neurodivergence – and in particular Autism Spectrum Disorder (“ASD”) and Attention-Deficit/Hyperactivity Disorder (“ADHD”) – affects several people I know and care about.

Looking at neurodivergent preferences and tendencies, I note that I deeply relate to both the preference for sensory comfort (quiet environments, dim lighting, fragrance free) as well as a tendency towards intense, highly focused engagement with specific hobbies and topics. Which always leads me to briefly question my neurotypical status.

But if an arts degree with a focus on psychology taught me nothing else, it’s that to meet a diagnostic threshold these traits must cause clinically significant impairment in social, occupational or daily functioning. Luckily, I’m only mildly inconvenienced by my periodic sensory overload and tangential tendencies. For the most part, I maintain my executive functioning even as I regularly dip my toes in the deep waters of divagation.

Although the line blurs noticeably in midlife. During perimenopause, severe fluctuations and eventual decline of estrogen and progesterone can mimic traits of neurodivergence. This might be what I’m noticing in myself. Could it be effecting you too?

Brief biology primer. Estrogen acts as a primary neuromodulator in the brain. It is directly responsible for stimulating dopamine synthesis, transport, and receptor sensitivity in the prefrontal cortex — the exact brain region responsible for working memory, focus, and impulse control. When estrogen drops during midlife, dopamine drops alongside it, triggering executive dysfunction that can feel identical to ADHD.

The primary perimenopausal symptoms that closely mimic neurodivergence include:

EXECUTIVE DYSFUNCTION (Mimics inattentive ADHD):

1. Brain Fog & Working Memory Failures: Forgetting why you walked into a room, losing keys, or misplacing items.
2. Word-Finding Difficulties: Struggling to retrieve common vocabulary words or losing your train of thought mid-sentence.
3. Task Paralysis & Procrastination: Experiencing a sudden, overwhelming inability to initiate multi-step tasks, organize schedules, or manage time effectively.

HEIGHTENED SENSORY SENSITIVITY (Mimics autism)

1. Decreased Sensory Filtering: Everyday background sounds (like a ticking clock or chewing), bright lights, or specific clothing textures suddenly feel intrusive, unsafe, or physically painful.
2. Misophonia Overdrive: The part of the brain that signals environmental safety quiets down during perimenopause, while the amygdala (the threat detector) becomes hyperactive, triggering a fight-or-flight response to common noises.
3. Temperature Rage: Hot flashes and night sweats do not just cause physical heat; they can cause intense, sudden claustrophobia and a feeling of being completely overwhelmed by your body.

EMOTIONAL DYSREGULATION (Mimics ADHD and autistic meltdown)

1. Rapid Mood Swings: Extreme, rapid fluctuations in mood, irritability, or low frustration tolerance that feel impossible to control.
2. Rejection Sensitivity & Anxiety: A heightened baseline of anxiety, feelings of impending doom, or an intense vulnerability to perceived social rejection.

OVERWHELM AND INABILITY TO MASK (Mimics Autistic Burnout):

1. Loss of “Scaffolding”: Many undiagnosed women spend decades relying on tight routines, calendar alerts, and sheer mental effort to hide their struggles (known as masking). When hormone levels crash, the energy required to maintain this scaffolding disappears, leading to sudden, debilitating burnout.
2. Social Withdrawal: Feeling too exhausted to perform standard social cues, leading to a deliberate avoidance of social situations.

Having experienced many of these symptoms recently (primarily: working memory failure, word finding failure, decreased sensory filtering and rapid mood swings), I find it fascinating that perimenopause should give me such hands on insight into neurodivergent realities. And of course I’ve come up with strategies to manage most of these annoyances; no need to suffer where it can be helped. But I’m also here for what they have to offer me: another perspective of the world.

Because better understanding that there are a number of valid perspectives on life (and experiencing some of them) fundamentally expands my empathy, enhances my communications and provides a more deeply textured life. But perhaps I’m just searching for a silver lining to this perimenopausal chaos? Ha! Can you blame me?