On 5 February 2026, IP Ability and IPause co-hosted a webinar exploring the intersection between (peri)menopause and neurodiversity. The session focused on how the hormonal changes of perimenopause can significantly impact neurodivergent individuals, particularly in relation to cognitive functioning, emotional regulation and workplace experiences. The speaker, Sara-Louise Ackrill, spoke from both professional and personal perspectives, highlighting the challenges and practical strategies for support.
Sara-Louise’s organisations (Wired Differently and Start Differently) between them provide services to neurodivergent professionals and students, including therapy and coaching, learning and development, support and advocacy, virtual assistance and public speaking. Sara-Louise is perimenopausal and diagnosed with PMDD (Premenstrual Dysphoric Disorder). She is autistic with ADHD.
You can access a recording of the webinar here and a copy of the slides here. Read on for our summary of the highlights.
Neurodiversity and the Legal Sector
Neurodiversity refers to natural variations in how people think, process information, and experience the world. Sara-Louise noted that approximately 1 in 5 people are neurodivergent, encompassing conditions such as ADHD, autism, dyslexia, dyscalculia, dyspraxia, and sensory processing disorder. Neurodivergent individuals often develop coping mechanisms or “masking” strategies to navigate environments that are not designed with their needs in mind.
Sara-Louise spoke of the high numbers of neurodivergent individuals in the legal profession, and how despite this, it’s the sector where people are least likely to disclose their neurodivergence because of the perception that it’s risky to self-disclose. This reluctance to disclose can prevent individuals from accessing necessary support, exacerbating stress and potentially impacting performance and wellbeing.
The Impact of (Peri)menopause
Perimenopause – the transitional phase leading up to menopause – can last several years and is characterised by fluctuating hormone levels, particularly oestrogen and progesterone. It can bring a range of cognitive, emotional and physical symptoms.
For neurodivergent individuals, these hormonal shifts can significantly intensify existing traits or challenges, sometimes disrupting long-established coping strategies. Indeed, many individuals only discover they are neurodivergent during perimenopause as traits that were previously manageable become more pronounced, prompting individuals to seek explanations and, in some cases, diagnosis.
Neurodiversity Intensified
‘Executive function’ is the brain’s ‘management system’ – a set of cognitive processes used to plan, focus attention, regulate emotions and achieve goals. Core components include working memory, cognitive flexibility and impulse control. For many neurodivergent individuals, executive functioning takes more effort, intention, and support. And this is exacerbated by perimenopause, so that difficulties with organisation, emotional control, memory, and attention can become more severe, often disrupting both personal and professional life.
Masking and Cognitive Overload
Masking – the effort to hide or compensate for neurodivergent traits – was identified as particularly difficult during perimenopause. Many individuals who have spent years appearing “functional” or “coping” find that they no longer have the cognitive or emotional capacity to maintain these strategies.
This loss of masking ability can lead to increased visibility of neurodivergent traits, which may feel exposing and destabilising. It also contributes to significant cognitive overload, particularly when combined with common menopausal symptoms such as brain fog, fatigue and sensory sensitivity.
Trauma and Emotional Regulation
Sara-Louise suggested that many neurodivergent individuals carry unresolved complex trauma, which is often brought to the surface by perimenopause, with individuals experiencing disproportionately intense emotional reactions to seemingly minor triggers. Individuals are often unaware of complex trauma, which stems from unmet needs or lack of support earlier in life (as opposed to single-event trauma associated with experiencing a single, acute event).
For Sara-Louise, addressing complex trauma was a key step in improving her overall wellbeing, allowing her to regain ‘bandwidth’ to manage other challenges more effectively. Therapeutic approaches discussed included Brainspotting, EMDR (Eye Movement Desensitisation and Reprocessing) and hypnosis.
Health Risks and Coping Mechanisms
The webinar also addressed serious health risks associated with perimenopause, particularly for neurodivergent individuals. These include:
- Increased risk of alcohol dependency
- Higher susceptibility to addiction
- Elevated risk of suicidal ideation
Alcohol use was described as a form of self-medication or “desensitisation” after overwhelming days. This highlights the importance of healthier coping strategies and early support.
Practical Strategies for Support
Medical and self-advocacy:
- Track symptoms over several weeks/months (apps such as Flo or Zoe Menoscale may be helpful) and present findings to a GP.
- Be aware that conditions such as PMDD (Premenstrual Dysphoric Disorder) can develop at any stage.
- Consider private or self-testing options if needed.
- Consider (self-)hormone testing.
- Consider if medication will be helpful for you, such as HRT for perimenopause, or SSRIs for the luteal phase of your period for PMDD.
- Be kind to yourself – if weight-loss medication will help you feel better about yourself, then don’t judge yourself for taking it.
- Some neurodivergent individuals may be either hypersensitive or hyposensitive to medication, requiring careful and personalised approaches to treatment.
- Consider exploring the possibility of a neurodivergent diagnosis.
Lifestyle and wellbeing:
- Exercise is very helpful when you’re perimenopausal, but many people don’t find it easy for all sorts of reasons. It may be helpful to reframe exercise as “evacuation” – a release of the day’s accumulated stress and sensory input.
- Use supplements where appropriate.
- Connect with supportive communities who understand shared experiences.
Therapeutic support:
- Consider working with a neurodivergent therapist or seeking trauma-informed therapy.
Workplace Context and Challenges
The workplace was identified as a critical area for change. While menopause is not a specific protected characteristic under the UK Equality Act 2010, it is covered through existing protections regarding age, sex, and disability. Employers must not discriminate against, harass, or victimize employees experiencing menopause, and must make reasonable adjustments if symptoms constitute a disability, that is they have a “substantial” and “long-term” negative impact on daily life (irrespective of day-to-day variation). See our article from December 2024 on Menopause and the Workplace.
Inclusive Practices and Allyship
Creating inclusive workplaces requires both structural and cultural change. Key elements include:
- Reasonable adjustments tailored to individual needs.
- Recognition of intersecting identities and experiences.
- Strong allyship from colleagues and leadership.
- Embedding neurodiversity and menopause within Diversity, Equity, Inclusion and Belonging strategies.
- Ensuring psychological safety through appropriate language and communication.
Employee Assistance Programmes (EAPs) were also highlighted as a potential resource. These are chronically underused and may offer specific menopause support.
The role of supportive colleagues was also emphasised as important. Informal understanding and day-to-day empathy can make a significant difference in reducing stress and fostering inclusion.
Resources
Sara-Louise referred to a newly-published book:
- Autism and Menopause by Julie Gamble-Turner and Rachel Moseley (2026)
You may also be interested in our YouTube playlists which feature recordings of our webinars:
- IP Ability playlist on YouTube, which features recordings of all our webinars on neurodiversity, disability and chronic conditions,
- IPause playlist on YouTube, which features recording of all our menopause-related webinars,
- Our series of Menopause Stories on YouTube.
You can also check out our Menopause Resources and our IP Ability Resources.
PLEASE GET IN TOUCH
We would be delighted to hear from you! Contact us by email:
IP Ability – [email protected]
IPause – [email protected]
IP Inclusive – [email protected]