This post is part of our 4-part series discussing ‘Neurodiversity and Hormones’ by Dr Alice Siberry.
What if support was less reactive, and more rhythmic?
By now, if you’ve read the other blogs in this series, you’ll recognise that hormonal fluctuations can profoundly shape the way neurodivergent people experience the world, from executive functioning and sensory regulation, to mood, motivation and energy. But most systems, like our workplaces, schools and healthcare systems are not set up to accommodate these natural rhythms. Rooted in a history set up for males, whose hormonal cycles reset every 24 hours (unlike females who reset between 28 and 36 days!) our systems expect consistency, linear progress and predictability. One begins to question, is it finally time to rethink what good support looks like?
Beyond the typical “reasonable adjustment” checklist
In many cases, support looks like:
- Noise cancelling headphones
- Clear communication
- Agendas, questions and meeting notes in advance
These are absolutely helpful, yes, but they are often designed to meet static needs – for certain roles, certain tasks and certain environments. What happens when people need more adjustments at certain times, but less at others? When someone who is usually communicative becomes shut down for a few days each month? When their sensory needs fluctuate? When burnout spikes suddenly after weeks of “coping”? The interaction between hormones and neurodivergence can lead to all of these things and therefore support needs to by dynamic.
The myth of “inconsistency”
One of the most common (and frustrating) challenges faced by neurodivergent people is being perceived as “inconsistent”. But what if it’s not inconsistency at all, what if it’s cyclical?
Particularly during the luteal phase (the one just before menstruation), most people will experience challenges, but neurodivergent people are likely to have:
- Increased focus and memory challenges
- Increased sensory sensitivities
- Increased social tolerance
- Challenges with emotional regulation
- Changes in energy levels
- Changes in communication style
Not to mention the fact that we have not yet developed systems for the inevitability that is menopause – anyone who menstruates will experience this, and as a society, we are severely behind in the support provided for this natural progression. What we label as “up and down” behaviour or mood might actually be deeply patterned and if we understood that better, we could build systems that work with people’s hormonal cycles, not against them.
What needs-led, hormonal-aware support can look like
The following are only a few ideas as to the flexibility and dynamic nature of support that could be provided for all, not just neurodivergent people who experience such hormonal fluctuations.
- Check-ins that ask the right questions: Instead of ‘are you ok?’, try ‘is this one of your lower energy weeks?’, or ‘is anything feeling more intense right now?’
- Adaptable, co-created support plans, built in conversation with the person, and reviewed regularly as patterns emerge.
- Normalising fluctuation, don’t pathologise every shift in behaviour or mood. Look at ways to build a culture where it’s OK to share that you are in a different phase right now and trust that people know what they need.
- Training and awareness for staff, and this training should not just be about neurodivergence, but about the impact that hormones can have on everyone, including neurodivergent and otherwise disabled people.
- Finally allow for autonomy and permission, give people the space to opt out or adjust how they engage during more difficult phases, without guilt or fear of being judged.
Furthermore, there are a huge amount of self-support strategies that can be implemented to support people experience hormonal-based challenges:
- Prepare – prepare young people for their first period, prepare for post-pregnancy changes, prepare for menopause, or simple prepare for the luteal phase each month. Build a toolkit and adapt existing coping strategies to ensure that they are fit for purpose.
- Keep a record or tracker of your cycle, there’s lots of free apps that can assist. When you understand how your body works and reacts to changes in hormones, you can use this to your advantage.
- Though the healthcare system is not super up to scratch with hormones and hormonal changes, not to mention the impact these have on neurodivergence, sometimes medical intervention might be the only option. This should always be discussed with a professional.
Reframing our rhythm
As we come to the end of this blog series, it is important to highlight that being hormone-aware is simply just a biological fact. It does not mean medicalising neurodivergence or reducing people only to such biology, but it means acknowledging the complexity and impact of how minds and bodies interact. It means honouring internal rhythms, letting go of rigid expectations, trusting people to know their bodies and designing systems that flex, not force. When we invite people into conversations about support, we don’t just create better outcomes, we create more human ones.
Resources for support:
- CIPD (2023) Menstruation and support at work
- The Fawcett Report (2022)
- Balance Menopause and ADHD report
- ADDitude magazine
- National Autistic Society
- The work of Dr Sandra Kooij
Get in touch with us about how we can support you explore the impact of hormones and neurodivergence: