As researchers increasingly link menopause and ADHD, employers are advised to recognise this intersection to support women at work better.
An employee’s concentration, memory and ability to manage competing demands can change during (peri)menopause. For women with ADHD, that may mean familiar coping strategies they’ve used all their life stop working. For those that have ADHD but it’s undiagnosed, that may mean symptoms are exacerbated.
But these women may fall between the cracks if an employer’s policies are too siloed.
For instance, an organisation may have a neurodiversity policy and a menopause policy, each with its own guidance, training and support – but a woman experiencing both may not fit neatly into either. That can mean that the policies can look good on paper but the complexity of the situation goes unrecognised.
When hormones and ADHD collide
The science is still developing, but researchers are increasingly investigating the link between menopause and ADHD. Some women with ADHD report changes in concentration, emotional regulation and their ability to manage everyday tasks as hormone levels fluctuate.
But this doesn’t mean that every woman with ADHD will experience a difficult menopause, or that hormonal changes explain every change in cognition or behaviour. Further research is still needed to clarify the link, however anecdotal evidence of it is compelling.
Dr Nikki Ramskill, a women’s health GP and founder of The Female Health Doctor, has run workshops exploring hormones, menopause and neurodivergence.
Implications can be significant
She says the implications of intersecting menopause and ADHD can be significant. Women in her workshops have talked of their frustration in this situation because the difficulty of what they were experiencing wasn’t recognised or understood.
”Women’s hormonal health and neurodevelopmental health has historically been under-recognised, and we need to do a much better job of joining those dots,” she says.
Ramskill knows how difficult navigating the workplace can be in this situation. She has ADHD and was diagnosed with premature ovarian insufficiency at 36. As professional and family responsibilities accumulated, she found the cognitive load increasingly difficult to manage. Hormonal changes brought additional challenges, including brain fog and fatigue, but the different factors were not necessarily easy to separate.
Her experience reinforced a crucial point: sometimes a person has not lost their ability but the systems that previously helped them perform are no longer enough.
”The most important thing employers can offer is flexibility,” she says. “Being forced into a very rigid working structure can make an already difficult situation significantly worse. Giving people some control over their working hours can make an enormous difference.”
The women who have been compensating for years
Some women reach midlife without a diagnosis, having spent years developing ways to manage challenges that other people may not see.
Trudi Roscouet, menopause coach and Founder of Vitality40Plus, believes masking can be part of that story.
“Symptoms can be masked. Women are renowned for masking,” she says. “We probably have masked for most of our lives in the corporate workspace, where I was; I had to fit that role.”
For Roscouet, menopause raises questions about how long women can continue to compensate for difficulties that remain invisible to colleagues and managers.
Researcher Dr Rachel Moseley, whose work explores autism, ADHD and menopause, describes many women now reaching menopause as part of a generation whose neurodivergence may have gone unrecognised earlier in life.
Two-way street
Moseley describes the interaction between neurodivergence and menopause as a two-way street. Existing difficulties with executive functioning, memory, sensory sensitivities or emotional regulation may become harder to manage during menopause. At the same time, being neurodivergent may shape how someone experiences and responds to menopausal symptoms.
For some women, the combination can feel like the final straw after years of working hard to keep up. Others experience a relatively straightforward transition. There is no single neurodivergent menopause experience, and the evidence base for what helps is still catching up with the questions being raised.
That uncertainty should not be an excuse for employers to do nothing. Moseley’s advice is to draw on what is already known about supporting neurodivergent employees, remain open to combining different adjustments and work with the individual to discover what helps:
“There are well-known reasonable adjustments that you can make related to menopause or autism or ADHD. But don’t be restricted by any one policy. Approach it like a ‘pick and mix’ and make sure it’s an ongoing trial-and-error collaborative process with the employee.”
Feeling frightened
This matters particularly for women who are newly exploring whether they may be neurodivergent. They may not have a diagnosis, or even know which adjustments would make a difference. They may simply know that the coping mechanisms they have relied on for years are now failing them.
“What our research has shown us is that a lot of autistic and ADHD women are going into menopause feeling quite frightened. What they’re experiencing doesn’t resemble a ‘normal’ menopause. They can’t just read a list of symptoms on the NHS website and recognise that it’s menopause. There’s a lot more complexity. In our surveys we often hear women say ‘I thought I was going mad’.”
Caroline Moore, an NHS advanced nurse practitioner, menopause workplace consultant and founder of Beyond the Fog, experienced this first-hand. Diagnosed with ADHD in July 2026, she had struggled with debilitating fatigue and brain fog when she entered perimenopause at 40.
Questioning staying in work
The strategies she had used to manage life and work began to fall away. At one point, she struggled to compose an email and questioned whether she could continue nursing.
“I began questioning myself and whether I could continue doing a job I had spent years building my career around,” she says.
Finally receiving her diagnosis in July 2026 helped her make sense of what had been happening to her.
“It wasn’t that I had suddenly become less capable. I was beginning to understand myself differently, realise my strengths and become more self-compassionate towards myself. I could find solutions to problems that fitted the way my brain worked and accommodate myself much more rather than ‘pushing through’.”
Understanding individuals
Caroline’s situation highlights the importance of understanding an employee’s experience, rather than making kneejerk assumptions about their capability or commitment.
For Moore, a menopause policy is a useful starting point, but what matters day to day is whether someone feels safe enough to explain what they are struggling with, and whether their manager listens without judgement.
So what can employers do to ensure that employees like Moore don’t fall through the policy gaps, and don’t leave because they haven’t got the right support to stay in work?
Not another policy
The answer is not to create an ever-growing collection of policies for every possible combination of circumstances. Roscouet warns that menopause action plans risk becoming a tick-box exercise if they don’t reflect women’s real experiences.
“Some companies are already just ticking the box and menopause action plans were never supposed to be about that. They were supposed to be about how women are affected and retaining them by addressing these issues.”
The answer isn’t to assume that menopause explains every difficulty experienced by a neurodivergent woman, either. It is to make sure existing policies work together, and that the people responsible for implementing them can look beyond a single label or tick box.
This is where embedding the wider workplace health and wellbeing agenda matters. HR, occupational health, line managers, DEI specialists and benefits professionals may each be able to see part of the picture. If they do not share knowledge or coordinate their response, important information can remain trapped in departmental silos.
Roscouet says, in her experience, the best way to retain staff experiencing this intersection is through management training and educating the workforce about what these women are going through.
As Moseley says, a single conversation followed by a referral to a policy document is unlikely to be enough. There is no ‘checklist’ for the ADHD-menopause intersection, and support may need to evolve as symptoms and circumstances change.
But while employers should be cautious about assuming a universal experience, they can act on what is already clear: people’s needs do not always arrive in the neat categories used by organisations to manage them.
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