When perimenopause and neurodivergence collide in the workplace

Perimenopause and neurodivergence collide in ways most PR workplaces still ignore. The result is a significant yet preventable loss of capability in experienced practitioners. Because PR and comms prides itself on being fast, resilient and always on, it quickly becomes apparent that continuing to build an industry on that basis is a serious strategic mistake.

Perimenopause is not just about hot flushes and “a bit of brain fog”. It is a neurological transition that affects concentration, memory, sleep, mood and sensory processing. In the UK, it is estimated that around 13 million people are currently peri‑ or menopausal, roughly a third of the female population, and changes can persist for several years. CIPD research suggests that 73 per cent of working women aged 40 to 60 have experienced menopause‑related symptoms, and two‑thirds say that they have had a mostly negative effect at work, with psychological impact such as anxiety, low mood, loss of confidence, memory problems and reduced concentration the most frequently reported.

Neurodivergence is not marginal either. A PRCA survey found that one in five UK PR professionals identify as neurodivergent, with ADHD, autism and dyslexia the most common conditions. CIPD’s work with Uptimize shows a similar pattern across sectors where 20 per cent of neurodivergent employees surveyed had experienced harassment or discrimination at work because of their neurodivergence or neurotype and only about half felt their organisation had an open, supportive climate. 

Professor Amanda Kirby’s work on neurodivergence and menopause estimates that around 7.5 per cent of women in England are neurodivergent. When applied to the peri/menopausal age band, that is roughly 700,000 women likely to be both neurodivergent and in peri/menopause. Many autistic and ADHD women are still diagnosed late, often in their thirties and forties after years of being mislabelled or missed, which means a substantial number encounter this intersection for the first time in the middle of demanding careers.

The central question then is straightforward: who was the prevailing idea of high performance built for, and what happens when mid‑career bodies need something else?

The intersection

Perimenopause is above all a neurological transition, not just a hormonal one. Neurodivergence shapes how information, energy and social dynamics are processed, often long before any diagnosis. Together, they create a predictable pattern of change that can easily be misread as individuals ‘losing it’ when the underlying issue is cumulative load.

A cross‑sectional study of over 400 employees found that the symptoms most likely to affect work for women over 50 were fatigue, difficulty sleeping, poor concentration and poor memory. Sixty‑five per cent said menopausal symptoms negatively affected their work performance and nearly one in five had taken sick leave as a result. CIPD’s survey echoes that the psychological and cognitive impacts, such as mood fluctuations, anxiety, memory problems and loss of confidence, were reported by two‑thirds of respondents and were the most common workplace effect.

Perimenopause disturbs sleep and recovery, disrupts working memory and word‑finding, lowers tolerance for stress and sensory overload and makes mood and energy less predictable. Neurodivergence often brings exactly the pattern recognition, creativity and critical thinking prized in crisis comms and strategy, but it can also mean differences in executive functioning, sensory processing and social‑cognitive load. For many women in professional roles, those differences have been managed for years through masking, rigid self‑management and over‑preparation.

When perimenopause lands on top of that level of constant self‑management, the margin disappears. Sleep loss hits an already stretched executive system, hormonal shifts amplify sensory and emotional load and masking that was costly but doable becomes unsustainable. The performance dip is real, but what is being observed is a system hitting its design limits, not a sudden collapse in individual capability.

The problem with high performance

Read the culture back to itself and the implicit spec for high performance in PR and comms looks like this: always reachable, endlessly responsive, comfortable in noisy environments, able to absorb other people’s anxiety without showing one’s own and capable of delivering the same output regardless of life stage or cognitive profile.

None of this is inherently malicious. It is simply tuned to a particular kind of body and brain where hormones do not significantly alter focus, sleep or mood, a nervous system with high sensory tolerance and executive functioning that is broadly consistent from week to week. Midlife, perimenopausal, neurodivergent women sit well outside that unspoken spec. Not because they are less capable, but because the job has been calibrated for different humans.

This matters because menopausal women are not a niche workforce segment. They are the fastest‑growing segment of the UK workforce. In 2023, 62.3 per cent of women aged 55 to 64 were participating in the labour force, which is a substantial workforce reality.

ADHD coach and writer Kate Moryoussef works with late‑diagnosed women whose careers look successful on paper but are privately held together with masking, self‑doubt and exhaustion. Her premise is simple: work must be designed with the actual brain in mind and attempting to live as if one had a neurotypical nervous system is a reliable route to collapse.

That reframes what is often dismissed as ‘stepping back’ or ‘not quite cutting it anymore’ as rational risk management. The question for PR and comms is how many mid‑career neurodivergent women are being misread in this way while the industry quietly benefits from years of over‑extension.

A competence issue

In the mismatch between bodies and prevailing performance standards, the dominant outcomes are simple: mask harder and burn out, or step sideways, then out. This is a preventable loss of expertise, relationships and context that another awareness day will not fix. 

We must treat perimenopause and neurodivergence as standard, not edge, cases. That means redesigning roles, timelines and communication around cognitive and sensory load. It also means changing what is rewarded so sustainable delivery and boundary‑setting carry real weight in the workplace.

The legal risk is crucial too. Under the Equality Act 2010, successful discrimination claims can result in declarations, compensation and recommendations. It is also worth noting that compensation for discrimination is uncapped. If performance standards and working practices systematically disadvantage midlife women while ignoring the predictable impact of perimenopause, that moves beyond poor culture and towards indirect sex discrimination.

Neurodivergent practitioners often bring exactly the pattern recognition, creativity and constructive challenge the profession claims to prize. Mid‑career women carry knowledge and networks that cannot be replaced by hiring another junior or plugging in some AI. An idea of high performance that quietly filters out anyone whose body stops aligning with the original spec is not evidence of a tough industry. It is evidence of expensive selection bias.

Bodies will continue to do what bodies do. Brains will continue to be different. The real test for PR and comms is whether the profession is prepared to redesign for that reality or keep writing off the fallout as individual failure and calling it business as usual.

Dannie-Lu Carr is an ILM Level 7 executive coach, senior training consultant and executive speaker coach specialising in personal impact, high-stakes communication and creativity under pressure. With 18+ years in leadership development and behavioural change, she helps senior and board-level leaders sharpen their presence, influence and message when it matters most.

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