Okay, so here’s the irony of this particular article – I know my estrogen is too low at the moment, because music is beginning to sound boring instead of giving me the yays, and also because I want to write a super informative and well-researched article on how there’s definitely something going on with hormones and neurodivergence… but my brain is a pile of brain-fogged goop.

So I’m just going to write my own concerns, and general observations. I think a lot of us in the Au/DHD community recognise that our hormones massively affect us, and not in the same way as neurotypicals. In my opinion, hormones can affect your autistic brain in such ways as increasing or decreasing sensory overwhelm, increasing or decreasing our threshold for having a meltdown, and from an ADHD persective can have you being the most productive person on the planet one week, and unable to do the simplest of tasks the following week (and leave you with a huge Laundry Pile of Doom for your troubles).

With this in mind, I worry a lot about late-diagnosed autistics and/or ADHDers who are hitting menopause and promptly flung on a standard dose of HRT without the practitioner even having any awareness of how hormones affect us differently to neurotypicals. Healthcare also has this neuronormative standard, and it’s infuriating. In fact healthcare has a normative standard full stop, and tends to treat everyone the same – same standard dosage, same standard treatment, when we’re all so different. It literally makes no sense to me.

Anyway, I digress. My own experience of HRT has been both amazing, and very difficult – and to be super clear, this is just my own experience. Firstly, not everyone may decide to go on HRT for whatever reason. It’s completely an individual decision and certainly not a one-size-fits-all thing. And not everyone Au/DHD will react the same way as me to estrogen and progesterone either, but the point is – just have in the back of your mind if you do decide to go on HRT, that you’re not alone in your experiences of a) hormones and their effects, and b) trying to figure it all out!

I discovered that estrogen helps improve my ADHD symptoms, which makes sense since estrogen is involved with dopamine production. And thus when ADHDers hit menopause and our estrogen levels decline, our ADHD literally goes into complete overdrive and we’re left going.. what in the actual f*** just happened? (And also we’re left sitting here, sometimes in a sweaty, brain-fogged heap, wondering who/what decided that neurodivergence wasn’t enough to be dealing with without this hormonal clusterf*** on top of it?). I discovered that if I have too much progesterone in my system, Ritalin will 100% stop working. And again I think this kind of tracks with the menstrual cycle, and how there’s literally thousands of discussions online about “why the fuck does my ADHD medication not work up to half the dang month?!”

Now I want to be really clear about this and I’ll say it again, I am just talking about my own experience here. And as I mentioned already, every body is different, literally. But here’s things I wish I’d known before starting HRT:

• Sometimes it’s not the hormone that’s making you feel extra Au/DHD, it’s the method of application. So if you feel off on lets say estrogen via a patch, try all the other methods of application available, because you might just find one that suits you better. For me, I tried different brands of patch, gel, and now I’m on a spray which is definitely absorbing better.
• I found it very, very difficult on synthetic hormones. They just didn’t suit me, AuDHD and otherwise – I’m now on bioidentical/body-identical hormones i.e. estrogen and progesterone that is the same/similar to what your own body produces, rather than synthetic hormones. I also found that synthetic hormones didn’t help with things like bladder pain and UTI’s that can hit you during meno, and sex was painful (yes, we talk about it all on here!). Being on bioidentical helped both those things massively.
• Fluctuations – for me personally, I found the less fluctuation of hormones I have, the calmer my AuDHD brain is. So I’ve really worked towards being able to take the same dose of HRT every day with no breaks (and therefore no withdrawal bleed). If you still have a womb, you need to be on progesterone if you’re on estrogen, else your womb lining keeps building and there’s no signal to your body to shed it = very, very bad. But progesterone is what I’ve struggled hugely with, and it has taken me a long time to find the best type, brand and method of application – but again, don’t give up, because when the balance is there, what a difference it makes!
• Timing – again my AuDHD brain is very sensitive to fluctuations, even small ones. For example, lets say you’re prescribed a dose of 4 sprays of estrogen, you may find it easier on your AuDHD brain to do 2 sprays in the AM and 2 sprays in the PM, or do the whole lot in one go in the evening or the morning… experiment on what works best for you.

I’ll also say don’t give up on HRT if you find it does things like affect your threshold for sensory overwhelm, makes you want to have an autistic meltdown more, makes you feel like your PMDD is back to haunt you (oy, PMDD needs to be a whole other article..!). Because when balanced, HRT can also help with these things, in my opinion. And it all really tracks, because how many times have we seen in discussions online that at various points in the menstrual cycle you feel less sensory overwhelm vs. more, like a complete energiser bunny that spring cleans their whole house in 3 hours (AND cancels all your unused subscriptions) vs. do I even have a brain?.

So the same situation happens if you decide to get onto HRT, however you have a bit more say in it. And you can do a fair bit of trial and error with dosages, types… and yes, some methods of HRT application are in of themselves a bit of a sensory hell – the smell of Lenzetto estrogen spray is FOUL, however it absorbs for me so much better than patches, that I just spray it on my arm and stick it out the window until it’s dry, and have a peppermint oil rollon under my nose until it does. So if you see a woman waving her arm out the window haphazardly somewhere in Dublin, it’s me – and now you know why…