On this episode of Clinically Awkward, I sit down with Becca Block to talk about perimenopause and neurodivergence, and why this transition can feel especially chaotic for AFABs with ADHD and/or autism. We unpack what perimenopause actually is, how fluctuating hormones affect the brain, and why so many people start wondering if their ADHD symptoms are getting worse during perimenopause.

Becca shares her experience recognizing her autistic and ADHD traits later in life after her child was diagnosed, which led her to dive deep into research on neurodivergence, hormones, and executive functioning. We talk about the five-to-ten-year transition before menopause when estrogen, progesterone, and testosterone fluctuate, and how those hormonal shifts affect neurotransmitters like dopamine, serotonin, and acetylcholine, which influence focus, memory, motivation, mood, and sleep.

We explore why perimenopause symptoms are often missed or misdiagnosed, especially when they overlap with ADHD symptoms like executive dysfunction, forgetfulness, inconsistent energy, and burnout. We also talk about sensory sensitivities, chronic migraines, mood dysregulation, and masking burnout, along with the mixed experiences people have with hormone replacement therapy (HRT) and hormonal birth control.

We also discuss the psychological shift many people experience during midlife, including less anxiety about other people’s expectations and a growing DGAF (Don't Give A F*ck) mindset. The episode closes with a conversation about self-advocacy with doctors, radical acceptance, and practical supports for navigating perimenopause with a neurodivergent brain.

Becca Block works with neurodivergent adults on executive functioning, ADHD support, and sustainable productivity through her coaching practice. Learn more about her work at spicy-brains.com.

00:00 Perimenopause and Neurodivergence (Intro)
03:51 What Perimenopause Is and Why ADHD Symptoms Get Worse
06:21 Hormones, Dopamine, and the Neurodivergent Brain
10:44 Sensory Sensitivities, Autism, and Hormone Changes
18:22 Masking Burnout, Chronic Migraines, and Hormones
25:01 Perimenopause Rage, Mood Swings, and Emotional Dysregulation
30:22 Hot Flashes, Diet, and Perimenopause Symptom Hacks
34:36 Menopause as a Brain Reboot
42:27 Identity Shifts in Midlife and Neurodivergence
46:33 Self-Advocacy with Doctors During Perimenopause

Is Your ADHD Getting Worse? Perimenopause and the Neurodivergent Brain