Women on the Spectrum
Neurodiversity - particularly conditions such as Autism Spectrum Condition (ASC) and Attention Deficit Hyperactivity Disorder (ADHD) - presents very differently across genders, and for decades, diagnostic models and support systems have been heavily skewed toward male behaviours and traits. This has resulted in women and girls being significantly underdiagnosed, misdiagnosed, or misunderstood.
For example, while boys with ADHD may display more hyperactive and impulsive behaviours, girls often exhibit inattentiveness, internalised anxiety, and a strong desire to “mask” their struggles to fit in socially. Similarly, autistic girls are more likely to mimic peer behaviour, use learned scripts in social situations, and may not show the same outward signs of social difficulties typically associated with autism in boys. A 2018 study published in The Lancet Psychiatry confirmed that current diagnostic tools often miss autism in women due to this subtle presentation and high levels of social masking.
This mismatch has real-world consequences. Many women do not receive diagnoses until adulthood, often only after experiencing mental health problems, burnout, or misdiagnosis (e.g. anxiety, depression, borderline personality disorder). This diagnostic delay means that they often go through school, university, and the workplace unsupported, mislabelled as "lazy," "emotional," or "difficult." In contrast, boys are more likely to be identified earlier, leading to earlier interventions and tailored support.
Some Facts
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Research and anecdotal data suggest that autistic women may experience menopause differently, including:
- Later onset of menopause than the neurotypical average.
-Exacerbation of autistic traits during perimenopause due to hormonal shifts.
-Increased sensory sensitivities, emotional dysregulation, and social withdrawal during hormonal changes.
-Some women report experiencing menopause as a second "unmasking" - traits they previously learned to suppress resurface due to reduced cognitive or emotional bandwidth.A 2020 study published in Autism in Adulthood found that autistic women in menopause experienced heightened anxiety, executive dysfunction, and sensory issues, mirroring many puberty-related issues they’d experienced in adolescence.
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Many women report that hormonal fluctuations make ADHD symptoms (like focus, impulsivity, or mood regulation) significantly worse, yet this is rarely accounted for in treatment plans, especially in medication timing
-Delayed or irregular puberty is more common in autistic girls and those with ADHD.
-Hormonal changes can intensify sensory sensitivities or disrupt social coping mechanisms.
Girls with ADHD or autism may also struggle more with premenstrual symptoms (PMS) or PMDD (Premenstrual Dysphoric Disorder), a severe form of PMS that’s often misdiagnosed as mood or personality disorders. -
Higher Risk of Misdiagnosis in Physical Health
Women on the Spectrum are more likely to be:
-Dismissed by healthcare professionals (often due to "invisible" symptoms).
-Misdiagnosed with anxiety, fibromyalgia, chronic fatigue, or borderline personality disorder.
-Less likely to receive proper screenings for conditions like endometriosis, thyroid disorders, or PCOS, despite increased risk.
Hyper- and Hypo-sensitivities-Many autistic and ADHD women experience heightened sensitivity to pain, temperature, fabrics, smells, and touch.
-Conversely, some may under-register pain, leading to late diagnoses of physical conditions.
-Puberty and menopause can intensify these sensory responses, making everyday activities (e.g. wearing certain clothes, using hygiene products) difficult. -
The constant suppression of true behaviours or sensory discomforts contributes to burnout, chronic fatigue, and even autoimmune conditions.
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Studies show a high comorbidity between autism/ADHD and gastrointestinal conditions, particularly IBS and food intolerances, affecting mood and cognition.
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Especially in autistic girls, often due to sensory aversions or a need for control/routine, rather than appearance-related or self confidence concerns.
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Many women experience “racing thoughts” or perfectionism-driven productivity, which leads to undiagnosed ADHD being mislabelled as high-functioning anxiety.
How Spectrum Can Help
Understanding these nuanced intersections between neurodiversity, gender, and health is crucial for improving outcomes. At Spectrum, we are actively reshaping how neurodivergent women and girls are recognised and supported. We do this through:
Tailored wellbeing support.
Menopause and neurodiversity awareness workshops for workplaces and education leaders.
Research-backed content.
Neuro-Friendly training for everyone from medical students, educators, HR teams, families and more - so they can spot signs earlier, respond compassionately, and remove stigma around neurodivergent health issues.