Women, Hormones and Neurodiversity: What do we know?
Introduction
Neurodiversity encompasses a range of variations in the human brain regarding communication, sociability, learning, attention, mood, and other mental functions. It includes conditions such as Autism Spectrum Disorder (ASD), Attention Deficit Hyperactivity Disorder (ADHD), Dyslexia and others. Neurodivergent individuals often experience heightened sensitivities, difficulties with social cues, and unique patterns of focus and interest - but, it is important to remember that no two neurodivergent people are the same and may have wildly different experiences.
Recently, discussions about neurodivergence seem to have become divided: on one hand, there's a growing narrative that celebrates neurodiversity as a form of exceptional ability or "superpower." On the other, many emphasise the journey through neurodivergence as one marked by relentless challenges and obstacles. Recognising and respecting these diverse perspectives is crucial, especially in providing support to neurodivergent individuals. It is important to acknowledge that not everyone identifies their neurodivergence as a superpower, and sensitivity to individual experiences and views is key.
The Gender Gap in Neurodiversity
Traditionally, research and discussions around neurodiversity have centred on male experiences, leading to a significant gap in understanding how these conditions affect females. This gap is further complicated by the interplay between female hormones and neurodivergent conditions, making the experiences of neurodivergent women uniquely challenging.
Although there are more questions than answers at this stage, and a huge amount of research still to be done, what we do know is that neurodivergence presents differently in women than in men. Women with conditions like ASD or ADHD may exhibit less overt symptoms, often internalising their experiences rather than displaying the more stereotypical, externalised behaviours seen in males. This discrepancy has led to under-diagnosis or misdiagnosis of neurodivergent conditions in women, leaving many without the understanding or support they need - for decades, in many cases.
The Interplay of Hormones and Neurodivergence
Hormones play a crucial role in neurodivergent experiences, particularly for women. Fluctuations in hormones such as oestrogen and progesterone can impact mood, sensory processing, and executive functioning. For example, some neurodivergent women report increased sensitivity to sensory inputs or more pronounced emotional responses during different phases of their menstrual cycle.Several studies have started to explore the connection between hormonal changes throughout the menstrual cycle and variations in the symptoms of neurodivergent conditions like Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD).
For instance, a pivotal study published in the Journal of Autism and Developmental Disorders highlighted that some women with ASD experience a worsening of symptoms such as sensory sensitivities and social difficulties during specific phases of their menstrual cycle, particularly during the premenstrual period. This suggests a link between oestrogen levels and symptom severity in ASD.This supported earlier observations by Lever and Gertz (2016) who discovered that while only 3% of non-autistic women grappled with premenstrual dysphoric disorder (PMDD), a significant 21% of autistic women found themselves wrestling with this condition.
Similarly, research focusing on ADHD in women has indicated that oestrogen's modulating effects on dopamine and serotonin, neurotransmitters involved in ADHD symptomatology, can lead to noticeable fluctuations in attention, impulsivity, and emotional regulation across the menstrual cycle. A study in Hormones and Behaviour found that some women with ADHD report an exacerbation of symptoms in the luteal phase of the menstrual cycle, when oestrogen levels drop.
The quest for solutions has led to innovative approaches like cyclical dosing, a method explored in a 2023 study by de Jong and colleagues. The team investigated the impact of premenstrual adjustment of psychostimulant dosage in women with ADHD, which showed promising results. With the increase in medication dosage before menstruation, all nine women reported enhancements in their ADHD symptoms and mood, with minimal negative side effects. There was a notable improvement in premenstrual focus, irritability, and energy levels, making these symptoms more akin to those experienced during the rest of the month. Consequently, all women chose to maintain the higher medication dosage during their premenstrual phase.
Experiences of Menopause
In a deep dive into the intersection of menopause and neurodivergence, research by Moseley and their team in 2020 shed light on the unique struggles faced by autistic individuals navigating menopause. Their study with seven participants between the ages of 49 and 63 unveiled key issues: a widespread lack of professional awareness and understanding, a noticeable increase in autistic traits including heightened anxiety and social challenges, and significant barriers to accessing needed support and care.
Further exploring this area, Groenman and colleagues (2022) found that neurodivergent women, those with autism, ADHD, or both, tend to experience more intense menopausal symptoms. The list includes troubling hot flashes, sleepless nights, escalating anxiety, and troubles with concentration and memory. These symptoms, often tied to the ups and downs of oestrogen levels, appear to hit harder in neurodivergent women. This could be due to a more pronounced hormonal imbalance or perhaps a heightened sensitivity to the physical shifts that accompany menopause, amplified by neurodivergent individuals' increased sensory sensitivity.
These findings highlight the complex and amplified nature of menopausal symptoms within the neurodivergent community.
Challenges and Future Directions in Understanding Hormones and Neurodivergence
The journey into understanding the interplay between hormones and neurodivergence, particularly among women, has only just begun. While recent studies have shed light on this complex relationship, they often rely on small sample sizes or are limited to observational methods. This foundational work lays the groundwork, yet it highlights the critical need for more expansive and in-depth research to navigate the intricacies of hormonal effects on neurodivergent experiences.One of the primary challenges in this field is the variability of neurodivergent conditions and hormonal influences across different individuals. This diversity necessitates a broader approach to research, one that encompasses larger population sizes to capture a wide range of experiences and outcomes. Moreover, the existing body of research has predominantly focused on white, cisgender women, leaving a significant gap in our understanding of intersectional experiences and differences.
To move forward, research must aim to untangle the specific mechanisms through which hormones influence neurodivergent traits and symptoms. This entails not only identifying the hormonal fluctuations that correlate with changes in neurodivergent symptoms but also understanding how these hormones interact with the brain and nervous system to produce such effects. Investigating the potential for hormonal interventions offers another promising avenue for research. Hormone-based therapies could provide relief for some neurodivergent individuals, but their efficacy, safety, and long-term impacts need thorough examination.In conclusion, addressing these challenges and pushing the boundaries of current research will not only enhance our understanding of the intersection between hormones and neurodivergence but also lead to more personalised and effective support strategies.
By embracing the complexity of these interactions and the diversity of the neurodivergent community, we can pave the way for a future where all neurodivergent individuals receive the understanding and specialist support they need to thrive.
Further Information and Support
Below we've provided a list of organisations offering a range of resources, support, and advocacy for individuals with ASD, ADHD, Dyscalculia, Dyslexia, and Developmental Coordination Disorder. They can provide valuable information, support networks, and assistance in navigating educational and life challenges associated with these conditions.
UK
National Autistic Society:https://www.autism.org.uk
ADHD Foundation:https://www.adhdfoundation.org.uk
British Dyslexia Association: https://www.bdadyslexia.org.uk
Dyspraxia Foundation: https://dyspraxiafoundation.org.uk
The Dyscalculia Association: http://www.dyscalculia.me.uk
Contact Us
Don't hesitate to reach out if there is anything we can do to support you, or you'd like to share your own experience with our community. Get in touch by emailing us at hello@seeherthrive.com.