AuDHD (Autistic + ADHD) Menopause, Food & Health
You're holding a plastic bag, inside, dripping green slime. Could it be radioactive?
The bag used to represent hope and a plan. And now, guilt. You had every intention of making a salad; you've had the same desk lunch for weeks.
Hello and welcome to the perimenopause AuDHD collision course.
I believe that the AuDHD profile (autism + ADHD) is its own third thing, not necessarily a perfect Venn diagram. If it helps to have this complex profile explained by a duck, then here you go.
If we haven’t met yet, Hi!, I’m Melinda Staehling. I’m an Oregon-based Certified Nutrition Specialist and Menopause Society Certified Practitioner. I’m also a highly perimenopausal, late-diagnosed AuDHDer.
This post is a little different than my usual style. I’m sharing some current thoughts about what makes an AuDHD menopause particularly challenging in hopes of helping you to feel more informed and to be able to release any shame you’re carrying. This makes room for finding flexible systems that support, not strangle, you.
The salad might not be happening for lunch on this day, but I’m of the mindset that we can scaffold in support systems (like dead-simple snacks) for when things inevitably don’t go to plan.
Bottled shake and peanut butter toast to the rescue.
What does Menopausal AuDHD (Autistic + ADHD) Look and Feel Like?
With profiles of both ADHD and autism, our lives exhibit what Dr. Megan Anna Neff calls the "push-pull AuDHD tension.”
If you watched the reel with the duck above, you can feel some of that dynamic at play in that video.
On one hand, the autistic part of you craves routine, predictability, and sameness. You want to eat the same lunch every day because it's safe and known. Then the ADHD part swoops in, needing novelty, stimulation, and variety. That same lunch becomes unbearably boring after three days, but a suitable replacement has yet to appear.
This tension shows up everywhere: You want structure but also spontaneity. Your brain serves up generative ideas, but you lack the energy to follow through. You want to focus on singular, deep work while also exploring every possible rabbit trail.
Autistic parts might prefer eating the same foods in the same order at the same time. ADHD might forget to eat entirely or impulsively order takeout because cooking feels impossible.
Now, let’s add menopause to this already complex dance.
Menopause: When Hormones Are a Roller Coaster
With the menopause transition, there's an overall decline in estrogen. There are other hormone shifts involved throughout peri to postmenopause, but let’s stick with estrogen for now.
It’s crucial to remember two things:
A. This decline is not linear. Perimenopause looks like a roller coaster when we track it. Some days, estrogen is relatively high; other days, it plummets. This unpredictability is the opposite of what many AuDHD nervous systems crave.
B. There are estrogen receptors in nearly every body system. This means that for people with uterine-ovarian systems, the changes go far beyond periods getting erratic. The hypothalamus, the part of the brain responsible for temperature regulation, begins to behave differently in response to temperature changes (hello, hot flashes and night sweats). The brain itself goes through a years-long remodeling process, which affects cognition and memory.
C. The body changes, too. Body weight and shape shift, often in ways that feel unfamiliar and distressing, especially when you've spent years developing a specific relationship with your body and its sensory needs.
For AuDHD, this hormonal chaos compounds existing challenges with emotional regulation, sensory processing, and executive function. The predictability you might have carefully constructed? Gone. The coping strategies that worked for decades are suddenly ineffective.
AuDHD Late Diagnosis & Menopause: We Need More Awareness & Education
Many AuDHDers who are currently in perimenopause receive their diagnoses later in life, often in their 30s, 40s, or 50s. For women and people AFAB (assigned female at birth), neurodivergence was not on the radar in our earlier years.
Sometimes a diagnosis or self-discovery might come during perimenopause itself, when the hormonal changes strip away masking abilities and coping mechanisms that had been (sort of) working for years.
What does it mean to be neurodivergent and going through a process of discovery, grief, understanding, and identity formation, all at the same time as perimenopause? It's a double reframing of your life experience.
You're simultaneously processing:
❤️🔥"Oh, this is why I've always struggled with xyz."
❤️🔥"Wait, I'm not a broken human, I'm AuDHD/autistic/ADHD."
❤️🔥"My brain and body are also changing because of menopause."
❤️🔥"Which symptoms are neurodivergent and which are hormonal? What about my chronic health conditions?"
This happens while you're navigating less access to good information due to medical trauma, lack of knowledgeable providers, communication mismatches with medical systems, complex health concerns being siloed out, and insurance barriers.
What’s the Menopause Sandwich Generation?
Let's talk about timing. Perimenopause typically hits during the "life stressor sandwich years", ages 40-55. This is a TOUGH season.
During this time, many people are:
🌋 Raising children or supporting young adults
🌋 Managing careers at demanding stages
🌋 Caring for aging or ill parents
🌋 Navigating their own relationship changes
🌋 Processing trauma history that may surface
🌋 Navigating their own chronic or emerging health issues
For AuDHD folks, these stressors are extra intense because:
🥪 Social demands are at an all-time high
🥪 Masking requirements are exhausting
🥪 Executive function needs exceed capacity
🥪 Sensory overwhelm is constant
🥪 Recovery time is nonexistent
Add hormonal chaos, and you have a perfect storm.
Alexithymia: When Emotions in AuDHD Menopause Are Hard to Name
This post requires mentioning alexithymia, which is the difficulty in identifying and describing emotions. This is more common in neurodivergent people and can make the emotional volatility of perimenopause confusing.
When you can't identify what you're feeling, how do you know if you're:
🥹Anxious, or having a hot flash?
🥹 Sad or experiencing a hormonal dip?
🥹 Hungry or dysregulated?
🥹 Tired or depressed?
Especially in perimenopause, the answers aren’t always clear.
This difficulty with interoception (sensing internal body states) compounds the challenge of responding to your body's needs, including nutritional needs. You might not realize you're hungry until you feel shaky from low blood sugar.
READ MORE: How ARFID Confuses Interoception
Brain Changes in the Menopause Transition
The research on menopause and the brain is still in its nascent stages. We know that brain fog increases during the perimenopausal years, to the point where many people experience distress, embarrassment, and lots of general oopsies around missed language, appointments, and the like.
This is compounded by the AuDHD experience of language, memory, and focus. Shifts in cognition for a person who likely thrives on predictability can feel super unsettling.
I was in my Master's program in 2021 and remember not having the grasp or attention I previously relied on, especially for tasks and assignments that didn't light me up. I flat-out missed appointments that I knew were on the calendar just hours before. There was also a global pandemic, which I think factors into the current menopause/neurodivergent cohort. That's an essay for another day.
ADHD: Attention and Controlling Attention
With ADHD, attention is either everywhere or nowhere. You can either:
🔍 Focus on everything (overwhelm, distractibility).
🔍 Focus on nothing (unable to engage).
🔍 Focus on one thing so intensely you forget the world exists (hyperfocus).
During perimenopause, the hormonal fluctuations make this even less predictable. Tasks that used to be manageable feel impossible.
Autism: Monotropic Attention
Autistic attention tends to be monotropic—intense and focused on a limited number of interests or tasks at a time. When you're in flow with something that interests you, everything else disappears. Including basic needs like eating, drinking, or using the bathroom.
This is one reason why the salad rots. You get pulled into a brand new project (dopamine! special interest! flow state!), and suddenly it's been days since you circled back to the salad-for-lunch -plan. The routine you set up? Abandoned in favor of the current hyperfocus. ADHD is a piece of this, too. That tension between the two, again.
Menopause, brain fog, and cognitive changes disrupt this monotropic flow, making it harder to access those deep focus states while making task-switching even more difficult.
Why AuDHD Menopause Creates a Complex Relationship with Food
Here's where it all comes together with relationship with food. Food is one of our most important relationships in that even if we don’t always want to pay it much attention, we need to interact with it often to be at our best.
👽 The magic space alien pill that my clients often crave to replace this relationship and necessity hasn’t been invented yet, so here we are.
Food can be a connection point, nourishment, social, sensory, and memory.
And, food is complex when you're navigating:
Intense Sensory Experiences
👃🏽 Food textures that feel intolerable
👃🏽 Taste changes during menopause - safe foods cycling so often they aren't safe anymore
👃🏽 Temperature sensitivities (hot flashes make hot food unbearable)
👃🏽 Smells that only you perceive that trigger nausea or overwhelm
👃🏽 The clank of dishes has me reaching for earplugs
Interoception Challenges
💦 Not noticing hunger until you're shaky
💦 Confusing thirst, hunger, and emotional needs
💦 Difficulty identifying fullness cues
💦 Not connecting how food affects your body
Executive Function Barriers
🎧 Planning meals requires multiple steps
🎧 Grocery shopping is sensory hell
🎧 Making decisions about what to eat is exhausting (WTF do we have to eat dinner every. single. night)
🎧 Food prep requires sustained attention
🎧 Keeping track of what's in the fridge feels impossible
Performing Health
I call this Performing Health because often, these measures don’t necessarily move the needle, but it’s distressing to think of moving away from the behaviors and ideas because of societal expectation.
🥨 Internalized messages about "eating healthy" or being “picky”
🥨 Shame around safe foods being "childish" or "unhealthy,." even though Uncrustables are the only thing that feels remotely tolerable to eat right now
🥨 Pressure to meal plan and prep like everyone else
🥨 Comparison to wellness culture standards
🥨 Guilt about that rotting produce
Body Image and Changes
❤️🔥Body shape shifting during menopause
❤️🔥 Weight changes that feel out of control
❤️🔥 Sensory needs around clothing
❤️🔥 Diet culture trauma resurfacing
❤️🔥 Difficulty accepting a body that feels unpredictable, which makes so much sense
I share the above lists not to make you more overwhelmed, but rather to help you understand that you’re not alone and that things feel hard because they ARE hard, not because you’re failing in any way, shape, or form.
Understanding what’s really going on is how we find solutions and systems that are actually helpful.
AuDHD Menopause Physical Health Hurricane
Where menopause, midlife, and the AuDHD health experience converge, we see challenging physical health profiles:
Sleep
Sleep disruption is common in both ADHD and menopause. Night sweats wake you up. Racing thoughts keep you awake. You can't fall asleep without the right sensory conditions, but hot flashes make your usual sleep setup intolerable.
Co-occurring Conditions
Many AuDHD people experience:
More complex PMS and/or PMDD
MCAS (Mast Cell Activation Syndrome): Food sensitivities that seem to multiply
Dysautonomia/POTS: Dizziness, fatigue, temperature regulation issues
HSD: Many of my clients with hypermobility spectrum disorders received their first hypermobility diagnosis around the time of midlife/menopause. Again, something that has been present for the lifetime, but that we had little experience with, and didn’t have an actual name, or treatment.
Migraine: Often worsened by hormonal fluctuations.
These conditions further complicate food choices and nutritional needs.
Metabolic Health Changes
The usual physical health challenges of getting older affect everyone, and they require a lot of maintenanace which can be harder to manage with executive function challenges:
Blood pressure monitoring and medication adherence
Blood sugar regulation (especially with erratic eating patterns)
Cholesterol management and limited food lists
Bone density concerns
Support Digestion
Both menopause, midlife, and AuDHD create digestive challenges:
Stress affects gut function
Food sensitivities are more likely
Eating patterns are irregular
Hydration is a challenge
READ: What Works for Perimenopause Bloating & Constipation
READ: How to Stop Perimenopause Diarrhea
What Actually Helps in the AuDHD Menopause Transition
Given all this complexity, what actually helps?
Think of the ideas below like a buffet. Nobody is going to like everything on the tables, and that spinach with strawberries salad is highly polarizing.
Also known as, take what you like and leave the rest.
Learn About Menopause
📖 In the recent book Autistic Menopause, learning about menopause is one of the top suggestions for making it through the transition intact, and I could not agree more. When perimenopause hit, I was clueless and without a map. If you didn’t start learning about what menopause is when you were’re 35, now is the next best time.
The first rule is to stop following people who love to poke at the frustration, changes, and distress by selling snake oil supplements and weird meno-branded exercise plans. If you like to learn about menopause and get your info from a book, I suggest this one -
📖 What Fresh Hell is This - Heather Corrinna’s book is weight-inclusive and offers a straightforward, brutal, often hilarious approach that I appreciate when we’re talking about menopause.
And a few more of my blog posts:
READ: Signs & Symptoms of the 10 Stages of Menopause
READ: Perimenopause Nutrition from a Weight-Inclusive Approach
Learn About AuDHD
Podcasts:
Resources:
💭 Field Notes Friday Series: AuDHD Push/Pull
Develop Flexible Routines That Can Adapt
This is where I push back against rigid routines that tend to break entirely when you have a bad day, and instead shift toward flexible frameworks that can scale up or down based on available energy:
🥄🥄🥄 Higher energy days: Full meals and/or parts and pieces of meal prep, trying a recipe or a new food
🥄🥄 Medium energy days: Simple assembly meals, safe foods, consistent snacking
🥄 Low energy days: Whatever you can manage with what is on your current safe food list, using your support systems
READ: ARFID Safe Food List Blog
Create Visual Systems for Food
Executive function thrives on external supports. Here are some examples of visual tools that may make your life feel simpler in this season:
🍽️ Photos of meals you like and can make
🍽️ Visual lists of foods sorted by energy level required
🍽️ Meal components laid out visually in your fridge (protein options, veggie options, carb options)
🍽️ Pictures inside cabinets showing what's there
🍽️ Transparent containers in the fridge
Find Your Healthcare Team
Whether that's:
🕸️ Menopausal hormone therapy (MHT)
🕸️ Working with medical providers who understand neurodivergence
🕸️ Asking for accommodations like virtual appointments or more detailed follow-up notes
🕸️ Creating a web of integrative supports like therapy, PT, and OT
Remember that what works is individual, and it's okay to advocate for what your body needs.
Support Physical Health (Without Perfectionism)
💤 Movement that feels good and is actually sustainable
💤 Sleep support (darkness, temperature, sensory tools)
💤 Supplements, when warranted, and finding a structure to take them
💤 A gentle reminder that 95% of us aren’t really nailing the basics here—don't feel bad if it's you too.
Going Against Traditional Ideas of Productivity
This might be the most important one and also the hardest to put into place. The collision of AuDHD and menopause is asking you to release:
✔️ Perfectionism
✔️ Constant productivity
✔️ Comparison to others
✔️ Shame about doing things "differently"
✔️ The idea that there's one "right" way to be healthy
Your version of health might look like:
⏳ Eating the same three safe meals on repeat
⏳ Taking supplements only when you see them
⏳ Moving your body in ways that feel good, not "optimal"
⏳ Resting when you need to, not when you "should"
⏳ Asking for accommodations without apology
The collision of AuDHD and menopause is real and challenging, and it's wildly underrepresented in both menopause and neurodivergent spaces. You're not failing. Your greens might rot, your routines might crumble, and your brain might feel like it's betraying you.
You're navigating a genuinely complex intersection of biology, psychology, and social factors that most people don't understand. Give yourself credit for showing up in whatever way you can.
And maybe consider buying pre-washed salad instead of lettuce heads. Or frozen vegetables. Or accepting the veggies might not happen some weeks, and that's okay, too.
As a Certified Nutrition Specialist and Menopause Society Certified Practitioner, I’m here to help you navigate neurodivergent perimenopause while looking out for your relationship with food and your body.
If you’re feeling overwhelmed by it all and would like a helping hand to guide you through some options, let’s chat. Please reach out here to book a free Introductory call.
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