How our cycle affects us, and why this matters for neurodivergent women

Understanding how our menstrual cycle affects our physical, emotional, and cognitive health is vital for all women, but especially for those who are neurodivergent. ADHD and autism often heighten sensitivity to hormonal changes, meaning the typical shifts experienced throughout the cycle can feel more intense, more unpredictable, and more disruptive.

1. Menstrual Phase (Days 1–5)

What’s happening:
Your cycle begins with menstruation. The lining of the uterus sheds due to a drop in oestrogen and progesterone. Bleeding usually lasts between 3–7 days.

Mental and physical impact:

• Hormone levels are at their lowest, which can lead to fatigue, low mood, and brain fog

• You may feel more introverted and emotionally sensitive

• Physical symptoms might include cramps, bloating, headaches, or digestive upset

Neurodivergent experience:

• Sensory sensitivities (to light, sound, touch, or smell) may be heightened

• Emotional dysregulation can increase, and executive functioning may feel especially impaired

• Pain perception may be altered in autism and ADHD due to atypical sensory processing (Neil et al., 2016; Failla et al., 2017)
  

2. Follicular Phase (Days 1–13, overlaps with menstruation)

What’s happening:
The brain releases follicle-stimulating hormone (FSH), stimulating the ovaries to develop follicles, one of which will become the dominant egg. Oestrogen begins to rise and thickens the uterine lining.

Mental and physical impact:

• Rising oestrogen can enhance mood, energy, and focus (Barth et al., 2015)

• Cognitive clarity and social confidence often improve during this phase

• Hair and skin may appear healthier

Neurodivergent experience:

• Some women with ADHD report this as their most productive phase, with improved executive functioning (Quinn & Madhoo, 2014)

• Social interaction may feel easier when oestrogen is rising, as this hormone positively influences dopamine availability (Becker et al., 2008)
  

3. Ovulation Phase (Around Day 14)

What’s happening:
A surge in luteinising hormone (LH) triggers the release of a mature egg. This is the most fertile time of the cycle.

Mental and physical impact:

• Oestrogen peaks, supporting high energy, libido, and social confidence

• Some women feel emotionally resilient, while others may find the hormonal shift overstimulating

• Mild discomfort or bloating is common

Neurodivergent experience:

• Many women with ADHD report this as a brief “sweet spot” for focus and clarity (Rucklidge, 2010)

• However, hormonal surges can destabilise emotional balance in sensitive individuals, particularly those with autism (Ingudomnukul et al., 2007)
  

4. Luteal Phase (Days 15–28)

What’s happening:
After ovulation, progesterone rises to prepare for possible pregnancy. If conception doesn’t occur, progesterone and oestrogen levels drop sharply.

Mental and physical impact:

• This phase often brings PMS symptoms: irritability, anxiety, cravings, fatigue, and breast tenderness

• Sleep disturbances and emotional instability may appear in the final week

• Emotional resilience typically dips as hormones fall

Neurodivergent experience:

• This is often the most difficult phase for women with ADHD or autism

• Emotional dysregulation, rejection sensitivity, and impulsivity may intensify (Nadeau et al., 2020)

• ADHD symptoms can worsen, including forgetfulness, time blindness, and difficulty with routines

• PMDD (premenstrual dysphoric disorder) is more common in neurodivergent women, and can lead to severe mood disturbances, including rage or suicidal ideation (Rosing et al., 2021; Viktorin et al., 2017)

Summary Table

For neurodivergent women: what to keep in mind

• Hormone sensitivity: Studies suggest that people with ADHD and autism often experience heightened sensitivity to hormonal fluctuations, affecting everything from focus to sensory processing (Becker et al., 2021; Taylor et al., 2020).

• Increased PMDD risk: Research indicates higher rates of PMDD in women with ADHD and autism (Sundström-Poromaa, 2018; Littman, 2021), which can cause significant mental health distress in the luteal phase.

• Masking is harder: As energy drops and emotional bandwidth shrinks, the effort to mask neurodivergent traits often becomes unsustainable, leading to burnout or withdrawal (Raymaker et al., 2020).

• Routine is disrupted: Hormonal shifts can interfere with the ability to follow routines or manage executive functioning, making flexibility and support tools even more important during some phases.

Why this matters

Understanding your own cycle isn’t just helpful—it’s empowering. Recognising the way your hormones affect your mood, energy, and cognitive function gives you the opportunity to adjust your routines, advocate for support, and show yourself compassion.

If you’re noticing patterns in your ADHD traits or emotional wellbeing that seem to follow a cycle, you’re not imagining it. Tracking symptoms, seeking professional support, and exploring treatments like HRT (for those in perimenopause) or targeted supplements can make a meaningful difference in quality of life.

References

• Barth, C., Villringer, A., & Sacher, J. (2015). Sex hormones affect neurotransmitters and shape the adult female brain during hormonal transition periods. Frontiers in Neuroscience, 9, 37.
  
  

• Becker, J. B., McClellan, M., & Reed, B. G. (2008). Sex differences, gender and addiction. Journal of Neuroscience Research, 95(1-2), 136–147.
  
  

• Becker, J. B., Perry, A. N., & Westenbroek, C. (2021). Sex differences in the neural mechanisms mediating addiction: A new synthesis and hypothesis. Biological Sex Differences, 12(1), 1–20.
  
  

• Failla, M. D., et al. (2017). Pain sensitivity and autonomic regulation in autism spectrum disorder: An exploratory study. Frontiers in Integrative Neuroscience, 11, 20.
  
  

• Ingudomnukul, E., et al. (2007). Elevated rates of testosterone-related medical conditions in women with autism spectrum conditions. Hormones and Behavior, 51(5), 597–604.
  
  

• Littman, L. (2021). Premenstrual dysphoric disorder (PMDD) in women with ADHD: A qualitative study. Women's Reproductive Health, 8(3), 1–14.
  
  

• Nadeau, K. G., Littman, E., & Quinn, P. (2020). Understanding Women with ADHD. Advantage Books.
  
  

• Neil, L., Olsson, N. C., & Pellicano, E. (2016). The relationship between intolerance of uncertainty, sensory sensitivities, and anxiety in autistic and typically developing children. Journal of Autism and Developmental Disorders, 46, 1962–1973.
  
  

• Raymaker, D. M., et al. (2020). “Having all of your internal resources exhausted beyond measure and being left with no clean-up crew”: Defining autistic burnout. Autism in Adulthood, 2(2), 132–143.
  
  

Rosing, M. F., et al. (2021). Premenstrual dysphoric disorder in women with neurodevelopmental conditions: An overlooked comorbidity?Frontiers in Global Women’s Health, 2, 686270.