Perimenopause: Or, How My Autism Suddenly Turned the Volume to 11

Perimenopause: Or, How My Autism Suddenly Turned the Volume to 11

I used to think I was coping reasonably well with life.

Sure, I was autistic (unknowingly at the time), exhausted, chronically overwhelmed, and holding myself together with routines, pretending, and sheer force of will—but from the outside, I was functional. Productive. Employed. Wearing a bra with intention.

Then perimenopause - reverse puberty, showed up like an uninvited houseguest, rearranged my furniture, ate all my snacks, and set the smoke alarm off for no reason.

Looking back, I’m fairly certain perimenopause played a starring role in the complete collapse of my coping mechanisms. 

At the time, I hadn’t yet been diagnosed as autistic. I was working in health care during a global pandemic (0/10, do not recommend), my sensory tolerance evaporated, my executive functioning packed its bags and left, and my nervous system entered what I can only describe as permanent red alert.

Naturally, I assumed I was just “failing at being a human.”

As one does.

Around the same time, I also developed a constellation of physical symptoms that eventually led to the diagnosis of a second autoimmune disease—because apparently my immune system, like my hormones, had decided to freestyle.

Now, can I definitively say which specific symptoms were caused by autistic burnout, perimenopause, pandemic stress, autoimmune disease, or the crushing weight of existence?

Absolutely not.

But I strongly suspect perimenopause poured gasoline on a brain that was already running hot.

And here’s the thing nobody tells neurodivergent women: this is extremely common. Hormonal shifts can dramatically exacerbate autistic traits—sensory sensitivities, emotional regulation, executive function, fatigue, anxiety. Somebody really needs to put that information on a billboard, or at least a pamphlet we can lose immediately.

I am still very much in perimenopause. I have not “bounced back.” If anything, I have gently rolled into a new version of myself who sometimes stares into space trying to remember why she entered a room.

The brain fog can be next level.

Just the other day, I forgot the word umbrella and confidently referred to it as a “rain thingy.”

This is my life now.

Also—and this feels important—I have a beard.

Not a full beard. Yet. But enough chin hairs that I now have to add “groom beard to avoid looking like a lumberjack” to my mental to-do list, which is already overwhelmed and frankly not accepting new tasks at this time.

I have not sought medical help for my perimenopause symptoms. I probably should. But for now, I’m managing with copious amounts of caffeine, industrial-strength tweezers, and stuffing cold packs into my bra during hot flashes.

Is it elegant? No.
Is it effective? Surprisingly, yes.

I am also seriously considering patenting a weighted vest with built-in cold-pack pockets specifically for autistic women going through perimenopause. Deep pressure and temperature regulation? Take my money. I would like five. One for the house, one for the car, one for emergencies, one for emotional support, and one I forget I own.

If there’s a moral to this story, it’s this: if you are a neurodivergent woman and suddenly find that everything you used to manage has become unbearable, you are not broken. You are not weak. You are not “losing it.”

You might just be perimenopausal.

And honestly? That explanation deserves way more airtime—and possibly its own line of cooling, weighted, chin-hair-inclusive merch.

Until then, I’ll be over here with my rain thingy, my tweezers, and my bra full of cold packs, doing my best.