On October 21st, Send it to Alex is hosting a free virtual conversation about the cognitive shifts neurominority women face in their working lives—and how we can support them better.
Ahead of that live session, menopause and neurodiversity expert Jayne Woodman, offers some evergreen insights on how neurominority conditions and midlife cognitive shifts intersect, and what workplaces can do to be more neuroinclusive as team members navigate transitions…
Working Well with Perimenopause, ADHD and Autism
By Jayne Woodman, The Menopause Team
Perimenopause, the years leading up to menopause, is marked by significant hormonal change, particularly in oestrogen and progesterone. These hormones play vital roles in how the brain processes information, regulates mood, and maintains focus. When they fluctuate, it can affect how we think, remember, and function.
At this time, many affected describe “brain fog”: a temporary but real cognitive shift that may include:
- Forgetfulness or slower recall
- Difficulty concentrating or multitasking
- Reduced processing speed
- Fluctuating confidence and self-doubt
Neuroscientist Dr Lisa Mosconi (author of The Menopause Brain) demonstrates measurable changes in brain energy use and connectivity during perimenopause, explaining why even the most capable can feel temporarily challenged. Importantly, these changes are reversible; the brain adapts and re-stabilises once hormone levels settle.
Perimenopause can heighten existing neurodifferences
Neuroinclusivity acknowledges that people process information and experience the world in many ways. Those who are autistic, have ADHD, dyslexia or have other neuourminority conditions already navigate unique cognitive landscapes; the hormonal transitions of perimenopause can often heighten existing sensitivities, such as:
- Increased sensory overload and fatigue
- More noticeable executive-function difficulties (planning, organising, prioritising)
- Emotional dysregulation and anxiety
- Reduced tolerance for environmental or social stress
These challenges don’t reflect capability, but changing capacity.
What is usually familiar and easy can become challenging and difficult as neurodiversity and perimenopause collide. Masking strategies might become impossible.
Designing neuroinclusive menopause support at work
A neuroinclusive workplace values predictability, flexibility, and psychological safety, which also supports staff experiencing menopause-related changes.
Practical strategies include:
- Clear structure and written guidance – Provide step-by-step information, checklists, and priorities to reduce cognitive load.
- Flexible pacing – Allow for flexible hours, micro-breaks, or quieter work periods when symptoms peak.
- Predictable environments – Avoid unnecessary last-minute changes or multitasking demands.
- Quiet spaces – Offer sensory-friendly zones for focused work.
- Open conversations – Normalise discussion of menopause and cognitive wellbeing across all genders and roles.
Small design choices in workload planning, meeting culture, and communication style can make a profound difference in inclusion and retention of those experiencing perimenopause and menopause on top of neurodiversity.
Research insights: Understanding diverse experiences
Emerging evidence shows that menopause is not experienced uniformly. Autistic and ADHD women, for example, may experience stronger sensory changes or emotional swings.
Dr Aimee Grant, Associate Professor at Swansea University, has explored this. Her work emphasises that reproductive health must be understood through the lens of neurodiversity, that “one-size-fits-all” approaches exclude those whose experiences differ from what is perceived as the norm.
Both Grant and Mosconi remind us that menopause is not simply a private health matter but a public and organisational one — requiring knowledge, compassion, and structural change.
Towards menopause-inclusive and neuroinclusive workplaces
Cognitive shifts during peri/menopause are part of life’s natural cycle. For neurominority employees, these shifts can amplify existing challenges, yet they also highlight how adaptable, humane work design benefits everyone.
Steps organisations can take:
- Educate managers and teams – Deliver awareness training that connects menopause and neurodiversity.
- Encourage open dialogue – Create safe spaces for disclosure and conversation.
- Review workloads and expectations – Build flexibility into scheduling and performance targets.
- Offer reasonable adjustments – Provide temporary or longer-term accommodations as needed.
- Co-design policies – Involve staff with lived experience in shaping menopause and neuroinclusion strategies.
The perimenopausal transition can affect attention, memory, and mental clarity often made more challenging for those who experience autism, ADHD etc; with the right support, these changes are manageable and usually temporary.
By applying principles of neuroinclusion, organisations create environments where every employee can thrive, whatever their cognitive rhythm or life stage.
Jayne will join us on October 21st for our free Working Well with Perimenopause, ADHD and Autism virtual event. Other panelists include Powered by Diversity’s Cat Wildman, and Send it to Alex’s own Lillie Jamieson.
