Divergent Menopause (previously The Autistic Perimenopause)

For anyone who’s ever silently lost their s**t at doctors, hormones, or Ken: this is your AuDHD Barbie, finally done pretending. Originally titled. "Introducing AuDHD Barbie".Hello and welcome to Divergent Menopause, previously known as The Autistic Perimenopause: A Temporary Regression.I am Sam Galloway (she/her), an autistic ADHDer, and I have recently had a hysterectomy. As a neurodivergent perimenopause and PMDD survivor, I offer peer support and share knowledge on how to make it through the hard times.Thanks for joining me on this wild midlife ride! 🎢This is a snapshot in time of Barbie in midlife, who is late diagnosed Autistic, with co-occuring ADHD (AuDHD), in the throes of hormonal flux and she does not have enough f***s left to give.In this spoof piece, let me take you into Barbie’s messy Dream House where our protagonist can safely self-regulate and drop her social mask…AuDHD Barbie - or just “Barbie” to her friends - ignored her ringing phone, as Ken came through to her voicemail message: “Hi, it’s Barbie. Please do not leave a message. Text me, but only if it is important. Bye.”“For f**k’s sake, Ken”, Barbie muttered under her breath finally picking up as Ken rang through yet again. “This had better be important”, Barbie seethed down the line. “No, I don’t want to go to the beach party. I already told you! None of my clothes fit me anymore and my stupid period just started. How can I be bleeding again? It is only sixteen days since my last - hello? Ken?!”The dead phone line was the most soothing sound Barbie had heard all day.Barbie high fived herself. Period talk always made Ken cut his conversations short. Barbie believed that sand was cursed, and a cold shiver coursed through her body at the thought of ever having to go to another beach party again. This gave some light relief to her otherwise 24/7 hot flush. It was all right for Ken to go, he wasn’t experiencing hormonal mania making him rapidly lose muscle mass, bone density and his entire sense of self.Yes, things were just fine for Ken as always. Whilst he grinningly pumped iron and mainlined a creatine and protein powder blend on the daily, Barbie was forgetting to eat. Her only exercise was to burn calories through hanger-induced meltdowns. Her lifelong body dysmorphia was now at its peak.Looking down at her bloated meno belly, Barbie felt that she was retaining more water these days than there was in the entire ocean. ‘Calorie deficit diets’ were no longer working for her. Nor was intermittent fasting, the 5-2, Mediterranean, Paleo, Keto, Whole30, low FODMAP, low histamine, or eating only even numbered quantities of beige foods during even numbered hours of the day.Barbie collapsed into her sensory swing, kicked off her high heels and threw them across the room. They had been digging into her cankles, and she applied an ice pack to the ankle she had badly rolled earlier that day. Not for the first time, she dry heaved at the sight of the thick dark hairs growing at right angles out of her once dainty feet and toes.What is wrong with me? she wondered to herself. I used to love beach parties and hanging out with Ken. Now I just want to kill him every time he comes near me! God, he is such a dick.Barbie excavated the teetering mountain of hot pink dirty laundry to find the remote control for her cooling fan, trying not to disturb her sleeping cats. Turning her fan on to the max helped redistribute the air flow, which was currently carrying the unmistakable odour of the cat s**t in the nearby litter box.For f**k’s sake, Ken! Barbie thought to herself again, as rage filled every fibre of her being faster than any number of mindful deep breaths could diffuse. Scooping the cats’ s**t is a blue job. Why haven’t you f*****g done it?Even if she had wanted to, Barbie couldn’t scoop the litter boxes; not with her tennis elbow, frozen shoulder and splinted hypermobile wrist that her doctor had said in no uncertain terms were not symptoms of perimenopause.“Well, Ms AuDHD Barbie, you are in the prime of your life”, the doctor had told her earlier that day, whilst attempting to look both up her itchy short skirt and down her scratchy scoop neck top. Barbie could feel hives emerging across her chest, but she resisted agitating them with her brittle nails. She would wait until she got home, and then rub them raw until they bled. Bliss!“Allow me to assure you that you are too young to be experiencing menopause symptoms”, her doctor went on. “And, might I add, that you do not look autistic, and you are far too successful to have ADHD. Your lab results are fine. Your estradiol is at normal levels. You are still a very fertile young woman.”His lack of eye contact was now vexing her, ironic given that her own reported discomfort at holding a gaze was flagged in her recent autism assessment. Yes, for decades she had masked endlessly, with her iconic plastic moulded smile rouged to constant perfection. But now she felt ready to tear off the mask and stamp on it right there and then in the doctor’s office.“Look,” the doctor had gone on, “I will note your concerns but, for the record, I am of the professional opinion that you have nothing at all to worry about. You are seeking diagnoses unnecessarily. There is no cure nor treatment for neurodivergence or perimenopause anyway. This trend of over diagnosing autism and ADHD is getting out of hand! We all know that males are 1,000,000 times more likely to be neurodivergent than females. Not to mention the fact that women cope with it. Why would a woman of your standing want a diagnosis when you have managed fine all your life until now?”Barbie was mute. Situationally, not selectively. Despite scripting the discussion in advance over and over in her head, she could feel her neck and face burning, hot tears pricked her eyes. She sniffed them back. A thousand retorts would fire around her mind like pinballs in the hours and days that would follow, yet for now she froze in despair and panic. Her ever saggier face remained static, fixed with a wry smile. Barbie’s now unfocused eyes were blurring off into the distance, as she wished she could be anywhere else.“This is all in your pretty little head. How does Ken feel about all of this?”, the doctor went on. “I can increase your SSRI dose but I cannot offer you hormonal therapy because the significant risks are not worth the supposed benefits. You are fine. Keep doing what you are doing. I am here any time you need to see me for support and advice.”Barbie was already so f*****g sick of being objectified and patronised, but medical gaslighting was a new one on her. She decided not to tell this professional pervert all the other worries she had noted down to prompt the consultation. Bleeding gums. Loose teeth. Itchy ears. Cognitive decline. Urinary incontinence. Insomnia. Losing all her stuff. Suicidal thoughts. And that the sight of Ken in all his so-called glory did nothing for her anymore, and that she was feeling dead inside. Particularly ‘downstairs’. Her vagina was rapidly becoming nothing short of warped, and some prolific Googling of the mind-blowing symptoms of perimenopause had led to a self-diagnoses of vaginal atrophy and pelvic organ prolapse.If Ken only knew that my vag feels like someone has taken a cheese grater to it, and that my kamikaze uterus is doing it’s best to sacrifice itself, Barbie thought, he might stop calling me all the time and let me live in peace.No. Despite feeling broken, Barbie hadn’t mentioned her more sensitive gynaecological ailments to this doctor, and instead made a mental note to find a neuro-affirming menopause specialist doctor, and develop her self-advocacy skills.Back in the sensory sanctuary of her Dream House, Barbie slipped into something a little more comfortable to see her through her impending shutdown. A black hoodie, compression tights that covered her multitude of coffee table bruises, and her noise cancelling earbuds. She zoned out listening to a perimenopause podcast to help her feel sane, informed and less alone.Barbie took off her shiny sleek blonde wig to free her own matted, unwashed hair, doused her hair in dry shampoo then tied it back out of her face. The regular intrusive thought of shaving her head returned, and she blinked and cleared her throat ten times whilst humming to try to make it stop, whilst pulling out tangled clumps of fallen hair from between her fingers. Barbie was alarmed at the amount of hair she was losing, and her male pattern hair loss and receding hair line made her cry in secret most days. The wig was just easier now than dealing with her own hair, and facing questions about it.Until she found a better doctor, she didn’t have the right answers anyway.🩷 How are you feeling about Mattel’s announcement of the new Autistic Barbie? 🩷Let me know in the comments!Cheers,andThanks for reading Divergent Menopause. Paid subscribers make this work possible. 💕🐈 Get full access to Divergent Menopause at samgallowayaudhd.substack.com/subscribe

Hello and welcome to Divergent Menopause, previously known as The Autistic Perimenopause: A Temporary Regression.I’m Sam Galloway (she/her) and I am an AuDHD woman four months into surgical menopause (hysterectomy and oopherectomy).If you are interested about why I needed the surgery, you can read more here.Thanks for joining me on this wild midlife ride! 🎢Thank you to everyone who tuned into my live video with Sonia Voldseth, the creator of Menopause & Misogyny! TL;DR * This advocacy-focused conversation documents real harm caused by estrogen patch failures and loss of choice in Aotearoa New Zealand. * When menopausal and neurodivergent women aren’t believed, symptoms escalate into cognitive, emotional, and physical crises. * Menopause care is essential healthcare. It is not optional, not cosmetic, and not something women should have to fight this hard to access.Sonia and I are both fortunate enough to live in Aotearoa New Zealand. Sonia, originally from the United States, lives surrounded by mountains in Queenstown on the South Island, and I, London Irish in origin, enjoy beachside life on the Kāpiti Coast near the bottom of the North Island.Unfortunately Sonia and I have both been affected by the ongoing oestrogen patch debacle. In 2024, we saw a global shortage of oestrogen patches, which I wrote about here. Currently there is laboratory testing underway in response to many people reporting that their menopause symptoms have returned despite staying on the same dose and brand. This has coincided with a new formulation of this vital hormone therapy treatment. My fellow pedants may notice that today I can’t decide whether to spell it “oestrogen” (UK and NZ) or “estrogen” (US), but please know that I am referring to the same hormone, regardless of the spelling used.Remarkably, the sedatives and general anaesthetic still have lasting effects on my capacity to write articulately, now four months after my total hysterectomy with bilateral salpingo oopherectomy (cervix, uterus, ovaries and Fallopian tubes removed). Surgical menopause has been life saving to my mental health, energy capacity and general functioning, so I am not complaining. But, rather than feeling able to summarise our discussion myself, instead I include ChatGPT’s offering below.As ever, for accessibility, you have the options to watch the video (with or without closed captions), listen to the audio and/or read the transcript. AI-Generated Timestamped Summary00:00 — Why this conversation matters02:31 — Progress made… then undone05:31 — Estrogen patch shortages & loss of choice (NZ)09:01 — Symptoms returning on the same dose12:01 — Collective patterns, individual gaslighting15:31 — Neurodivergent risk & mental health impacts18:31 — Estrogen as a brain hormone22:01 — Why “just switch to gel” isn’t simple25:31 — Sleep collapse as the red flag28:31 — Admin, advocacy & exhaustion32:57 — Suspected formulation change (mid-2025)34:31 — Medsafe reporting & deflection36:05 — User-error narratives & systemic gaslighting37:42 — Absorption differences & dosing reality39:58 — Brain fog, language loss & regression41:25 — Estrogen receptor saturation explained44:19 — Menopause is serious, not “just hot flushes”45:37 — Generational harm & WHI fallout47:03 — Surgical menopause & compounded harm48:37 — Aging with quality of life49:30 — Vaginal estrogen, bladder health & prolapse prevention52:35 — Prolapse, gatekeeping & specialist care54:38 — Medical training gaps (global)55:10 — Vaginal estrogen & cancer-risk reassurance56:07 — Solidarity over infighting56:56 — Closing reflections, access & hopeThank you to fellow AuDHDer and PMDD survivor Kim Pitts for chatting with us in the comments about her personal experience of menopause and medical misogyny. Kim and I have previously chatted live (link below) and here is Kim’s Auti Peri Q&A.Cheers,SamThis work exists through collective care. A paid subscription is a meaningful way to support Divergent Menopause in 2026. Thank you! 💕 Get full access to Divergent Menopause at samgallowayaudhd.substack.com/subscribe

Hello and welcome to Divergent Menopause, previously known as The Autistic Perimenopause: A Temporary Regression.I’m Sam Galloway (she/her) and I am an AuDHD woman four months into surgical menopause (hysterectomy and oopherectomy).If you are interested about why I needed the surgery, you can read more here.Thanks for joining me on this wild midlife ride! 🎢Hello and Happy New Year to you!And just like that we are in 2026. Hooray, we made it! Ageing is a privilege, but it isn’t easy. All we can do some days is take one step at a time, one breath at a time, and keep on keeping on. And that is more than enough. Around this time last year I wrote an article about Anti-Goals, and it is still being read and shared daily! It is by far my most popular post so far, and it captures the spirit of those of us who reject and repel the January conventions of self-improvement.Demand avoidance is running high in my life and I have long been wanting to write a follow up article. My brain has forbidden it though, so I have compromised with myself and recorded this follow up video on the topic for now instead. As always, the video is optional and is accompanied by an audio only podcast alternative, and/or a transcript. For accessibility’s sake, I also include below a timestamped summary provided by ChatGPT. What’s helping you get through right now?What do you wish you had more support with?If you want to share in the comments, you’re welcome to.One word or an emoji is more than enough.⏱️ AI-Generated Timestamped Breakdown00:00 – New Year’s resolutions are nonsense (for many of us)Why January pressure is unrealistic, especially during hormonal flux, and why time is a social construct anyway.00:01 – Why goal-setting can fail demand-avoidant brainsIntroducing anti-goals and why avoiding harm can be more useful than striving for achievement.00:02 – When survival becomes the goalWhat anti-goals looked like at my lowest point: reducing pain, anxiety, depression, and suicidal ideation.00:03 – You can’t reverse a spiral aloneWhy support and a plan matter — and why “starting from scratch” isn’t possible when you’re already overwhelmed.00:04 – Different baselines, different needsWhy comparing yourself to people “optimising” their lives is harmful when you’re just trying to get through the day.00:05 – Redefining success at homeFrom magazine-perfect homes to hygienic and safe: using tools (like a robot vacuum) to reduce energy drain.00:06 – Pain management over fitness goalsWhy “I don’t want to be in pain” is a valid goal — and how medical support, warmth, medication, and pacing mattered more than exercise plans.00:08 – Addressing the root causeHow hormonal instability drove pain, mood changes, and loss of self-care capacity — and why treating that came first.00:09 – Hormonal treatment and surgeryMy path through HRT, chemical menopause, and ultimately hysterectomy/oophorectomy — and how stability changed everything.00:11 – Survival before self-improvementWhy health span matters more than optimisation, and why there is still no clear medical model for neurodivergent menopause.00:12 – Don’t waste energy on unachievable goalsChoosing meds, blood tests, and basic care over gyms, meal prep, or “doing it properly”.00:14 – Accepting support is not failureWhy masking through struggle is dangerous — and how getting help allows us to later help others.00:15 – Hormones as a buffer, not a cureMedication, therapy, cleaners, junk food, respite — whatever helps you get through now is valid.00:16 – Incremental change, not January transformationsWhy progress is slow, nonlinear, and includes regression — and why that’s not shameful.00:18 – Spending energy and money wiselyLooking at root-cause support (pelvic physio, hormone care, surgery pathways) rather than short-term coping fixes.00:19 – What do you need right now?An invitation to reflect, share in the comments, and focus on getting through 2026 and beyond.💛 Key TakeawayIf you are neurodivergent and navigating perimenopause or menopause, your job is not to optimise yourself.Your job is to stay alive, reduce suffering, and be kind to yourself while you transition through this phase.Everything else can wait.That’s all for now. It is bedtime here and I am delighted to report that my menopausal sleep is phenomenally better than my perimenopausal sleep was this time last year! I hope that whatever you have planned for today, that you can afford yourself some peaceful time to rest. Cheers,SamIf this post helped you feel a little less alone, a paid subscription is how you support this work and help keep it going. No pressure! Just here if and when it feels right. 😊 Get full access to Divergent Menopause at samgallowayaudhd.substack.com/subscribe

Hello and welcome to Divergent Menopause, previously known as The Autistic Perimenopause: A Temporary Regression.I am Sam Galloway (she/her), an autistic ADHDer, and I have recently had a hysterectomy. As a neurodivergent perimenopause and PMDD survivor, I offer peer support and share knowledge on how to make it through the hard times.Thanks for joining me on this wild midlife ride! 🎢I am delighted to be joined again by Allegra Chapman (she/her) from Creative Fix in the final episode of Divergent Creativity in Menopause!Together Allegra and I have created this four part mini series on the importance of creativity during the menopause transition and beyond. 🎧 1) What is creativity is and why does it matter?🎧 2) How can creativity fit your needs?🎧 3) Can you be creative by accident?🎧 4) Can your creativity change as you change?In this fourth and final part we talked about: 💕 Creativity shifts as our needs change throughout fluctuating capacity in neurodivergent perimenopause and beyond. Our creative practices can adapt and may become slower, smaller, or look entirely different.💕 Creativity is a tool for unmasking and self-understanding. It helps us process our emotions (even when alexithymia makes them hard to name), recognise our needs, and navigate a world not built for neurodivergent, disabled or midlife women.💕 There is no “right way” to be creative. We don’t need to follow neurotypical or traditionally masculine productivity advice. Creativity can look like writing novels or doodling, resting, or simply daydreaming. Whatever works for you is the right way. Writing an autism adapted suicide safety planis creative because you’re thinking about what are your triggers,what do you need, and what needs to be on hand. And then also about havinga toolkit you know to keep you regulated, regulate your nervoussystem and then that that’s also creative to meet your needs. You don’t alwayshave to be doing something.Sam Galloway Further reading and resourcesAllegra’s inspiring book ‘Creativity is your self-care: 52 creative therapy exercises exercises to support your emotional wellbeing all year round’ is available to buy here!If you would like to immerse deeper into Allegra’s creative wisdom, you can sign up to her course, Divergent Creatives.The online programme to enable neurodivergent or disabled people to build a sustainable and joyful creative practice. If you’re a writer or artist who has more ideas than you know what to do with, but you struggle to finish things, or even to get started, then this course is going to help you get sh*t done!A group of autistic menopause researchers based in the UK and Canada invited creative submissions reflecting people’s lived experience of this often challenging life transition. They wrote a paper on the submissions called ‘Stepping into who I fully am: A creative exploration of Autistic menopause.’Creative exploration of Autistic menopause encouraged emotional catharsis, self-understanding, and activism/artivism. Autistic Community Researchers noted transcendent, almost “magical” dimensions of connecting with other Autistic people’s lived experiences. Our creative emancipatory approach enabled Autistic, multimedia responses which traditional research methods would not have elicited…… Traditional research methods have limitations in capturing lived experiences of the Autistic menopausal transition. In this study creative, multimodal, arts-based approaches enhanced understanding by capturing nuanced interpretations and meanings.The ability to communicate through creative submissions facilitated participants’ self-expression and they recognised the potential therapeutic value of the creative process, as a “remedy” for Autistic menopause related difficulties.This study adopted a novel approach to data analysis in which Autistic community researchers used creative, reflexive approaches to respond to arts-based submissions rather than relying on traditional academic methods.For both Autistic research participants and Autistic researchers, creative methods had the potential to act as a catalyst for activism, artivism, and self-actualisation, encouraging personal transformation and magical transcendence through a process of (to paraphrase one of our participants) “stepping into” who we fully are.Stepping into Who I Fully Am: A Creative Exploration of Autistic MenopauseAuthor(s): Mx Rose Matthews , Christine A. Jenkins , Margaret Janse van Rensburg, Miranda J. Brady, Rachel L. Moseley, Julie M. Gamble-TurnerPublication date (Electronic, pub): 27 June 2025This concludes our series, and we hope you have enjoyed it! Thanks so much again to Allegra for recording this great chat with me, and thanks also to you for reading and listening! Cheers,If Divergent Menopause has helped you feel seen, understood, or a little less alone, please consider becoming a paid subscriber. Your support helps me keep this space accessible, and funds time to create more honest writing, Q&As, and resources for our neurodivergent menopause community. Get full access to Divergent Menopause at samgallowayaudhd.substack.com/subscribe

Hello and welcome to Divergent Menopause, previously known as The Autistic Perimenopause: A Temporary Regression.I am Sam Galloway (she/her), an autistic ADHDer, and I have recently had a hysterectomy. As a neurodivergent perimenopause and PMDD survivor, I offer peer support and share knowledge on how to make it through the hard times.Thanks for joining me on this wild midlife ride! 🎢I am delighted to be joined again by Allegra Chapman (she/her) from Creative Fix in the third episode of Divergent Creativity in Menopause!Together Allegra and I have created this four part mini series on the importance of creativity during the menopause transition and beyond. 🎧 1) What is creativity is and why does it matter?🎧 2) How can creativity fit your needs?🎧 3) Can you be creative by accident?🎧 4) Can your creativity change as you change?In this third part we talked about: 💕 Taking natural seasonal items home to curate our own arrangements.💕 Finding beauty in dried flowers over fresh flowers these days as my skin and body become increasingly dry in menopause!💕 Noting down your accidental creativity using the downloadable sheet in this post from Allegra. It’s time to reclaim your creative nature and take note of just how much creativity you bring to the world without even realising it. Then, hopefully, you can give yourself permission to explore your creativity further, with more intention, and see where else it wants to take you!Allegra ChapmanWhat natural treasures can you find where you live?🍁🐚🌸Further reading and resourcesAllegra’s inspiring book ‘Creativity is your self-care: 52 creative therapy exercises exercises to support your emotional wellbeing all year round’ is available to buy here!If you would like to immerse deeper into Allegra’s creative wisdom, you can sign up to her course, Divergent Creatives.The online programme to enable neurodivergent or disabled people to build a sustainable and joyful creative practice. If you’re a writer or artist who has more ideas than you know what to do with, but you struggle to finish things, or even to get started, then this course is going to help you get sh*t done!A group of autistic menopause researchers based in the UK and Canada invited creative submissions reflecting people’s lived experience of this often challenging life transition. They wrote a paper on the submissions called ‘Stepping into who I fully am: A creative exploration of Autistic menopause.’Creative exploration of Autistic menopause encouraged emotional catharsis, self-understanding, and activism/artivism. Autistic Community Researchers noted transcendent, almost “magical” dimensions of connecting with other Autistic people’s lived experiences. Our creative emancipatory approach enabled Autistic, multimedia responses which traditional research methods would not have elicited…… Traditional research methods have limitations in capturing lived experiences of the Autistic menopausal transition. In this study creative, multimodal, arts-based approaches enhanced understanding by capturing nuanced interpretations and meanings.The ability to communicate through creative submissions facilitated participants’ self-expression and they recognised the potential therapeutic value of the creative process, as a “remedy” for Autistic menopause related difficulties.This study adopted a novel approach to data analysis in which Autistic community researchers used creative, reflexive approaches to respond to arts-based submissions rather than relying on traditional academic methods.For both Autistic research participants and Autistic researchers, creative methods had the potential to act as a catalyst for activism, artivism, and self-actualisation, encouraging personal transformation and magical transcendence through a process of (to paraphrase one of our participants) “stepping into” who we fully are.Stepping into Who I Fully Am: A Creative Exploration of Autistic MenopauseAuthor(s): Mx Rose Matthews , Christine A. Jenkins , Margaret Janse van Rensburg, Miranda J. Brady, Rachel L. Moseley, Julie M. Gamble-TurnerPublication date (Electronic, pub): 27 June 2025Next week Allegra and I will be sharing the fourth and final part of our podcast mini series with you. Have a great week!Cheers,Enjoying Divergent Menopause? Become a paid subscriber to support independent writing on neurodivergent midlife and menopause. Get full access to Divergent Menopause at samgallowayaudhd.substack.com/subscribe

Hello and welcome to Divergent Menopause, previously known as The Autistic Perimenopause: A Temporary Regression.I am Sam Galloway (she/her), an autistic ADHDer, and I have recently had a hysterectomy. As a neurodivergent perimenopause and PMDD survivor, I offer peer support and share knowledge on how to make it through the hard times.Thanks for joining me on this wild midlife ride! 🎢“Care for your needs as a priority, rather than leaving them at the bottom of the list.”I am delighted to be joined again by Allegra Chapman (she/her) from Creative Fix in the second episode of Divergent Creativity in Menopause!Together Allegra and I have created this four part mini series on the importance of creativity during the menopause transition and beyond. 🎧 1) What is creativity is and why does it matter?🎧 2) How can creativity fit your needs?🎧 3) Can you be creative by accident?🎧 4) Can your creativity change as you change?In this second part we talked about: 💕 how societal expectations and internalised ableism combine to make us de-prioritise our creativity💕 giving ourselves permission to meet our needs, and pacing our creative endeavours around our menstrual cycles/menopause stage 💕 being unable to do our best creative work if we are in neurodivergent burnout.Everyday creativity can be free, low key and take place both in the home and out and about.Resources and further readingAllegra’s inspiring book ‘Creativity is your self-care: 52 creative therapy exercises exercises to support your emotional wellbeing all year round’ is available to buy here!If you would like to immerse deeper into Allegra’s creative wisdom, you can sign up to her course, Divergent CreativesThe online programme to enable neurodivergent or disabled people to build a sustainable and joyful creative practice. If you’re a writer or artist who has more ideas than you know what to do with, but you struggle to finish things, or even to get started, then this course is going to help you get sh*t done!Dr Samantha Newman AKA Female GP Monthly Cycling “Your menstrual cycle is a natural process made up of four key stages: Menstruation, Follicular, Ovulation, and Luteal. Knowing how these stages work helps you better understand your body and mind.”Kate Codrington Menopause facilitator, speaker and author (Moon and Menopause tracking)Red School Menstrual cycle and menopause awarenessA group of autistic menopause researchers based in the UK and Canada invited creative submissions reflecting people’s lived experience of this often challenging life transition. They wrote a paper on the submissions called ‘Stepping into who I fully am: A creative exploration of Autistic menopause.’Creative exploration of Autistic menopause encouraged emotional catharsis, self-understanding, and activism/artivism. Autistic Community Researchers noted transcendent, almost “magical” dimensions of connecting with other Autistic people’s lived experiences. Our creative emancipatory approach enabled Autistic, multimedia responses which traditional research methods would not have elicited…… Traditional research methods have limitations in capturing lived experiences of the Autistic menopausal transition. In this study creative, multimodal, arts-based approaches enhanced understanding by capturing nuanced interpretations and meanings.The ability to communicate through creative submissions facilitated participants’ self-expression and they recognised the potential therapeutic value of the creative process, as a “remedy” for Autistic menopause related difficulties.This study adopted a novel approach to data analysis in which Autistic community researchers used creative, reflexive approaches to respond to arts-based submissions rather than relying on traditional academic methods.For both Autistic research participants and Autistic researchers, creative methods had the potential to act as a catalyst for activism, artivism, and self-actualisation, encouraging personal transformation and magical transcendence through a process of (to paraphrase one of our participants) “stepping into” who we fully are.Stepping into Who I Fully Am: A Creative Exploration of Autistic MenopauseAuthor(s): Mx Rose Matthews , Christine A. Jenkins , Margaret Janse van Rensburg, Miranda J. Brady , Rachel L. Moseley , Julie M. Gamble-TurnerPublication date (Electronic, pub): 27 June 2025It is a pleasure to continue sharing my conversation with Allegra with you. I hope you are enjoying it, and that you are able to fit some crucial creativity around your current needs and within your fluctuating capacity. Cheers,If you enjoy these posts and want to fuel more of them, think of a paid subscription like buying me a coffee each month. It’s a small gesture that makes a big difference to keeping Divergent Menopause going strong. Get full access to Divergent Menopause at samgallowayaudhd.substack.com/subscribe

Hello and welcome to Divergent Menopause, previously known as The Autistic Perimenopause: A Temporary Regression.I’m Sam Galloway (she/her) and I am an AuDHD woman ten weeks into surgical menopause (hysterectomy).If you are interested about why I needed the surgery, you can read more here.Thanks for joining me on this wild midlife ride! 🎢October was World ADHD Awareness Month and World Menopause Awareness MonthAs you are here, chances are that you are already aware of both Attention Deficit Hyperactivity Disorder (ADHD) and menopause. I wish I had known about them sooner… but better late than never. We still don’t know enough about how the two intersect, but early research suggests that hormonal flux in neurodivergent brains and bodies may be suboptimal for our mental and physical health. To say that perimenopause sent me absolutely batshit cray cray would be a gross understatement. Why is awareness still the goal in 2025? Acceptance and gold standards of care should be where we are already at. Yet awareness it must be, since many of us have friends, family members and even healthcare teams who are not yet aware of the potential for volatility during the neurodivergent menopause transition. Why is ADHD affected by hormonal flux? Well, we don’t know yet. But Behrman and Crockett explain in their 2024 research paper, Severe mental illness and the perimenopause, that:Executive dysfunction and other cognitive problems are commonly reported during the perimenopause; these which can appear very similar to the constellation of symptoms seen in attention-deficit hyperactivity disorder (ADHD)32 and, like ADHD, can respond to stimulants.33 It is unclear whether this is an unmasking of underlying pre-existing ADHD or entirely de novo symptoms. Given the overlap, it can be hypothesised that those with pre-existing ADHD may experience a worsening of their ADHD symptoms with perimenopause, and it has been shown that people with comorbid ADHD are also more vulnerable to perimenopause-associated psychological symptoms.34There is much hypothesising in the field, whilst those of us deep in the trenches are falling daily on the battlefield. We may not know why menopause is such a challenging transition for many neurodivergent people, but we need to be alert to the risks. This is not a “Yay for ADHD !” article. Yes, there are advantages to having this condition, as there are also disadvantages. My ADHD wasn’t diagnosed until I was 39 - two years after my later in life autism diagnosis. I thought naively that by 40 I had all the answers, and would be able to live my best years going forward. I could not have been more wrong!I was only too glad to finally be aware of my neurotype, yet awareness is only the beginning. Forty five minutes into my hour long Zoom consult with an Auckland-based psychiatrist, my ADHD assessment was over and it was a done deal. He diagnosed me with ADD (which is an out of date diagnosis now, but whatevs). He hung up and spent the remainder of my allocated session writing up notes for my diagnostic report and filing the pharmaceutical admin to process the special authority number required for me to trial controlled stimulant drugs. Meanwhile, I sat alone in floods of tears weeping for Little Sam who had never stood a chance. Tears are welling up now (or trying to) in my menopausally dry eyes just from thinking back on it.As an AuDHDer (autistic and ADHD), I have learnt the long and hard way that the impact ADHD can have on our menopause transition can be catastrophic, isolating and feel deeply shameful.1 in 4 ADHD women have attempted suicide. Things are already hard for us during times of hormonal flux but we often make exceptions for people’s hormonal changes in puberty, pregnancy, postpartum and during menstrual periods and premenstrual dysphoria disorder (PMDD). Menopausal people also need accommodations and support. Knowing what to expect is crucial in then dealing with it. You aren’t broken and you don’t need to be fixed. You are enough and not too much. You deserve acceptance not awareness.To save you the time and energy on obsessively compulsively meticulously researching characteristics of adult ADHD, and the implications perimenopause has on ADHD, I am here to share the low highlights in no particular order:* It’s not called ADD (attention deficit disorder) anymore. ADD is no longer diagnosable. There are three types of ADHD: hyperactive, inattentive, and combined type. Combined means you are both hyperactive and inattentive.* Lagging skills versus inability. Neurodevelopment is slower for us. Immature behaviour and executive dysfunction do not determine intellect, regardless of our age. Remember that you have strengths. Play to them when and where you can. * You might see ADHD in your kids - especially boys - first, because their external hyperactive symptoms can manifest as “disruptive” in the classroom, and the teachers want to shut them down support them. * Your energy is exceptional and feels abundant, but you can crash hormonally. We can’t run on empty. Those of us who are exceptionally sensitive to hormonal flux will know all too well that we have had “good weeks” and “bad weeks” in our menstruating years. When those changes are catastrophic, it may indicate that we have premenstrual dysphoria disorder (PMDD). Previous patterns of mental health implications caused hormonally such as during menses, menstruation, pregnancy, postpartum, during IVF treatment etc. are indicators of future challenges during perimenopause. * Hyperactivity can be cerebral, not always physical. Overthinking, anxiety, rumination, sleep issues, scripting phone calls, imagining other worlds and embarking on new and illicit relationships in your head are allways it can manifest. We create these elaborate situations in our minds because our physical surroundings are understimulating or triggering. What’s more interesting than deciding what to cook for dinner yet again? Alternative lives, sliding doors, reimagined reality. When we are externally presenting as inattentive often it’s accompanied by internal hyperactivity which means that we are often combined type, even when diagnosed ADD, as I was. * Inattentiveness can be painful and shameful. We aren’t mishearing and daydreaming on purpose to annoy others - although they rarely see it that way. Part of the assessment process for ADHD includes presenting our old school reports to inform the diagnostic process. Proof that we have always been considered not good enough. Annually and without fail my end of year reports read, “Must try harder. Could do better. Not reaching potential.” Yet nobody in a classroom is trying as hard as a girl/AFAB who is endlessly having to suppress her rich and stimulating inner world and pass for normal.* People will tell you you’re wrong about ADHD, especially those with the least amount of experience or knowledge about it. They won’t want you to talk about it with them so, unless it is imperative to the safety of yourself or someone else, don’t waste your finite energy. Find your neurotribe, because they may want to talk about nothing else, and we can all geek out together on the wonders of being neuromagnificent! ⭐️* We see ADHD in others, usually long before they wish to accept it. They refuse the label, as if you are branding them like cattle, or trying to insult them. Bide your time, realisations can take a while and denial is real. Try to protect your own rejection sensitivity dysphoria (RSD) being triggered when they seem supportive of you being ADHD, yet when it comes to their own identity they are appalled at the suggestion. * RSD is painful and overwhelming. Rejection sensitivity occurs when we have been rejected, insulted, gaslit, dismissed or any manor of things by someone, whether they did so intentionally or not. We can really stew on it, and then be consumed by it. It feeds our negativity bias and need for cerebral stimulation until we have broken ourselves. I have found the best way to manage this is to recognise it, and stop myself from spiralling. Do what you can to stop building on the idea that you have been slighted. Even if they meant to upset you, screw them. Instead you can: stim, listen to a favourite song that uplifts you and takes you to another time or place, journal it then burn the page, get outside. As I was writing this around Halloween, you may also like to curse them and/or make a voodoo doll and inflict pain on them. Whatever you do, keep it short then move on. If it comes up in your head again, tell yourself you have already dealt with it, and that it is just the hungry RSD looking for your attention. * Boredom is our kryptonite and our brains will do anything to avoid it.* Hyperfocus can be productive or not, and it is hard to channel it. Unless it is harming someone, once you get into flow, lean into it. Hyperfocus is a beautiful process and don’t feel bad if you don’t end up with a completed project at the end. Just go to the toilet, drink some water and have something to eat, because you are likely to have forgotten that the concept of time exists, and that you live in human bodily form. * So-called hard things are easy for us: entrepreneurship; picking up and dropping new hobbies and interests as though our lives depend on it; changing careers; earning multiple degrees; pulling all nighters; spotting neurodivergence in others. These are not superpowers though, and we should not be made to excel beyond our capacity to meet other people’s expectations. Exploiting neurodivergent people’s strengths whilst ignoring our struggles puts us at risk of burnout and abuse.* So-called easy things are hard for us: sensing the passage of time, and thus punctuality; booking appointments; small talk; meal planning; remembering to take the meds that help us do all of the above. Basically anything requiring executive functioning can become increasingly difficult in perimenopause, not helped by increasing midlife demands

I am delighted to be joined by Allegra Chapman (she/her) from Creative Fix!Together Allegra and I have created this four part mini series on the importance of creativity during the menopause transition and beyond.1) What creativity is and why it matters,2) How to fit it in around needs and what activities work for different needs3) Special interests and “accidental” creativity and stuff that’s creative that you don’t think about4) How your creative practice changes as your needs change... or how creativity can help with unmaskingResources:https://www.scienceopen.com/hosted-document?doi=10.13169/intljofdissocjus.5.1.0004Allegra’s bookAllegra’s coursePrevious articles by Allegra? Get full access to Divergent Menopause at samgallowayaudhd.substack.com/subscribe

Content warning: Discussion of suicidal ideation.Themes 💕Hormonal literacy | Mental health | Neurodivergent self-advocacy | Medical gaslighting | Access inequality | Post-surgical recovery | PMDD symptom improvement“When I try to raise awareness — what IAPMD does — their mission is awareness and education.And I think that’s really where any woman or uterus owner should begin: with knowing.I know that’s hard — it’s executive function all over the place — but truly, information is everything.I’ll never forget reading The New Menopause; in it, she says ‘Information is your foot in the door.’And we just — we have to be able to get that foot in the door.Whether you do that through peer support or whatever means you can, that’s one of the only ways right now to really start the conversation.It’s unfortunate, and so tragically unfair.But just know that there’s always a conversation that can be had.We just have to — unfortunately — sometimes be the ones to start it, which is such b******t.But still, there’s always a way to begin.”Kim PittsIf this conversation helps you feel seen, please share or comment below. Your story could help someone else survive their PMDD too.Kim and I have been planning to discuss PMDD and our resulting hysterectomies for a while now, and we finally figured out the timezones between her location of Oregon, US and mine in Wellington, Aotearoa New Zealand.Links to all the resources and further reading we discussed are at the end of this post.Our chat is available in multiple formats for accessibility:* Video with subtitles/closed captions available* Podcast/audio only* Transcription* Plain timestamped summary table** Substack-formatted timestamped summary** Generated by ChatGPT as an executive functioning tool on my part. Sorry, Kim! I know you gave AI the finger during our chat!🩸 PMDD, Hysterectomy & Neurodivergent MenopauseA Conversation with Kim Pitts⏱️ 00:00 – 02:00 | IntroductionsSam (Aotearoa NZ) and Kim (US) open the chat.Both are neurodivergent women who chose surgical menopause (hysterectomy) to stop PMDD symptoms and save their mental health.This is peer support, not medical advice.🩺 02:00 – 04:00 | Surgery StoriesKim shares how her US doctor fought for her right to a hysterectomy despite insurance barriers.Sam reflects on recovery, her four laparoscopic scars, and the strange post-op moment of thinking, “Where’s the baby? Oh wait — no more uterus!”💊 06:00 – 10:00 | Progesterone IntoleranceSam explains how progesterone caused bloating, digestive pain, and depression.Kim agrees—progesterone can be lifesaving or intolerable depending on the body.They unpack the delicate HRT balancing act and how mental health depends on getting the right dose and delivery.🧠 10:00 – 13:00 | Medical GatekeepingSam details the challenge of navigating public vs. private healthcare, using index cards to remember key points at appointments.They talk about executive dysfunction, prescription chaos, and how neurodivergence complicates healthcare admin.💬 13:00 – 17:00 | What Is PMDD?Kim defines Premenstrual Dysphoric Disorder (PMDD) — a neuroendocrine disorder where hormonal fluctuations trigger severe mood symptoms.Often mistaken for PMS, it requires careful tracking, but that’s hard for ADHD and autistic women.📝 17:00 – 22:00 | Hormones, Neurodivergence & TrackingThey discuss multiple hormone sensitivity theory, links between ADHD/autism and PMDD, and why symptom tracking is often impossible.Kim used old text messages as evidence to identify her cycles.⚖️ 22:00 – 27:00 | Self-Advocacy & Self-GaslightingSam shares how she doubted her own symptoms right up to surgery.Both reflect on medical gaslighting, the exhaustion of self-advocacy, and the relief of being believed.Finding the right doctor = survival.⚠️ 25:00 – 33:00 | Suicidality & SurvivalContent warning: Discussion of suicidal ideation.They discuss how PMDD, autism, and ADHD overlap with high suicide rates for midlife women (ages 44-58).They stress the need for hormonal treatment first, not just SSRIs, and for open peer conversation.🫀 36:00 – 40:00 | Hysterectomy Research & HRT MythsKim explains how outdated studies scared women — early hysterectomy patients weren’t given HRT, so they suffered bone and heart issues.Modern practice should include immediate hormone replacement for safety and quality of life.💸 43:00 – 46:00 | Funding BarriersKim shares how she accessed surgery through a hospital financial-assistance program in the US.The approval felt like “relief and disbelief.”They dream aloud of a nonprofit fund to help others afford lifesaving PMDD surgeries.🔄 47:00 – 52:00 | Before Surgery: Life in CyclesSam recalls living between inertia, shutdown, and rage, with shrinking windows of good days.After constant bleeding and progesterone crashes, surgery brought instant hormonal stability and mental clarity.🩺 52:00 – End | Takeaways & Solidarity* Blood tests are a snapshot, not the full story.* Lived experience matters more than lab numbers.* Peer advocacy can bridge dangerous medical gaps.* Both women close with gratitude — for surviving, for community, and for being heard.Resources and Further Reading* International Association for Premenstrual Disorders (IAPMD) website* PMDD Symptom tracker from IAPMD website (above)* The New Menopause - Navigating Your Path Through Hormonal Change with Purpose, Power and the Facts book by Dr Mary Claire Haver* Your Periods, ADHD & the Multiple Hormone Sensitivity Theory Dr Nighat Arif video* MENO-D A rating scale to detect depression in menopause by Professor Jayashari Kulkarni* Progesterone intolerance Dr Loiuse Newson articlePlease take good care of yourself.Want to support me? The best way to support my advocacy and peer support work at Divergent Menopause is to become a paid subscriber. Thank you again for your support! It means the world to me. 💕P.S.: That was intense, so here’s a photo of Harry! I have invested my paid subscriber contributions on some equipment to make my desk more ergonomically accessible post-hysterectomy. Huge thanks to my paid subscribers for making this possible! Get full access to Divergent Menopause at samgallowayaudhd.substack.com/subscribe

Hello and welcome to Divergent Menopause, previously known as The Autistic Perimenopause: A Temporary Regression.I am Sam Galloway (she/her) and I am an AuDHD woman seven weeks into surgical menopause (hysterectomy).If you are interested, you can read more on why I needed the surgery here.Thanks for joining me on this wild midlife ride! 🎢October 18th marks the annual event that is World Menopause Awareness Day! In this video and podcast episode, I take you through the advice (see the six posters below and here) provided by the World Menopause Society for 2025’s theme of Lifestyle Medicine in Menopausal Health!Closed captions and transcript available too.🎥 Prepare yourself for much brain fog, sarcasm and despair as I explore the multiply astonishing ways in which this mainstream advice is, at best, inaccessible and, at worst, detrimental to neurodivergent people going through this life transition. 🎧Here is last year’s World Menopause Day post from me.Some resources referenced in the video/podcast today:I wrote this article on Blue Zones earlier in the year, because I have always been obsessed with longevity research. However, I am now extremely scornful on the topic as you will find out if you read this, or listen to the podcast episode link in the following post:This is a great read on the narrow minded push for Mediterranean style diets:The six (!) International Menopause Society posters I share in the video, brimming with unreachable targets for so many of us who don’t and can’t conform to neuro-normative expectations:Below is my viral 2024 post, which shows that our way of being in the world is totally valid and important. Maybe we need anti-goals for menopause lifestyle advice. What would yours be? I would love to know in the comments.Take good care of yourself. 💐And be realistic about it, the above International Menopause Society goals were not written with neurodivergence, chronic illness and disability in mind.Cheers,Divergent Menopause is a labour of love. Each article takes hours to research, write and edit. If you have found my ongoing advocacy work valuable, please consider becoming a paid subscriber if you are able to. Thank you 💕 Get full access to Divergent Menopause at samgallowayaudhd.substack.com/subscribe

Hello and welcome to Divergent Menopause, previously known as The Autistic Perimenopause: A Temporary Regression. I am Sam Galloway (she/her) and I am an AuDHD woman four weeks into surgical menopause (hysterectomy). If you are interested, there is more on why I needed the surgery here. Thanks for joining me on this wild midlife ride! 🎢Hi All, Welcome to the final video of the mini series with Amanda Hanna from SomaPsych. I hope you have enjoyed it! Please let me know in the comments whether you like this format, and what topics you would to see covered in future mini series. This episode requires a content warning for suicidal ideation and actions, panic attacks, mental health crises and feelings of hopelessness. So many helpful techniques offered, and I would love to know which, if any, you find most effective. Please let us know in the poll, and feel free to expand in the comments. In case you missed the previous videos, the first offers techniques to use in the margins of our day to regulate our nervous systems and feel rested. In the second video Amanda suggests how to stop anxiety spiralling at night and (hopefully!) get back to sleep. The third video covers how to manage chronic pain flares and reduce recovery times.Why do we need S.O.S. techniques for de-escalating sudden panic, suicidal ideation and feelings of hopelessness?In my experience of pre-menstrual dysphoric disorder (PMDD), pregnancies, postpartum, puberty and perimenopause (not listed here in chronological order), states of hormonal flux trigger extremes of mood and personal safety concerns.Now that I am in a state of surgical post-menopause by hysterectomy, and in the fresh absence of my ovaries, my hormone production has now flatlined. That was the intention of my highly medicalised menopausal treatment plan, in order to eliminate all risk to myself from my own hormonal fluctuations.Some people may have lovely menstrual cycles and manage their perimenopause with minimal medical interventions. I am genuinely happy for those people, and wish we could all be like that. But we can’t. Some of us experience sudden moods that are so inextricably linked to our extreme hormonal highs and lows, that we cannot understand why we think we would be better off dead before we have had time to challenge that thought. For autistic women, our suicide risk is 13 times higher than that of neurotypicals during midlife. 1 in 4 ADHD women have attempted suicide. Perhaps, like me, you are an AuDHDer. I don’t have the stats on us, but I expect they are bleak. I don't tell you those statistics to shock or frighten you. My intention is to make you aware that you may be at increased risk, but that you have the ability to mitigate that risk by being aware of your emotional states throughout times of hormonal flux. We can be extremely impulsive, which may have been great when we were younger, but we have so much more at stake in midlife. If your highly sensitive brain tricks you into thinking your rage is shameful and your family would be better off without you, please know that that is a common thought. We just don't live in a society where it is acceptable to share these thoughts with someone else. I get DMs from people frequently who are feeling this way.Our thoughts are not facts, they can’t objectively dictate to us. Thoughts come, and then they go, and new ones take their place. Please share with others if you are experiencing thoughts of suicide, self-harm or causing harm to others. Ruminating on these thoughts isn’t unusual, and just because certain thoughts persist and/or recur doesn’t make them any more substantial or credible. You matter to me, to this community and to all the people who love you. Sometimes it doesn't feel like this, I know. During perimenopause I too experienced intrusive thoughts that put my family and I at risk. Thoughts that I should stop my car on the train tracks and wait for a freight train to stop my pain and functioning regressions. My kids were in the back of the car! And it was a recurrent thought.Often I wasn’t even experiencing suicidal ideation until I reached a railway crossing, and that would trigger the thought. I would hum, stim, flap all whilst driving; trying to hush and force away the thought, consciously accelerating across the tracks and willing myself to stay in motion on the road. It took all of my limited energy to just get my kids and I home safely, at which point I would need to crash (excuse the pun) out on the sofa. Often autistic inertia followed. It would take me 24 hours to process the thoughts, which had come and gone in the fraction of a second, and to tell my husband and/or my doctor what had happened. I don't wish that pain on you. It can be common in neurodivergent menopause, but please, let’s not normalise it. It is a signal that you need more support, more rest, more mental health interventions - and those aren’t bad things. As late diagnosed neurodivergent, we have stuffed down our feelings for decades. This is the time to unmask, to reach out, to prioritise yourself. For me, this looked like surgical intervention to stop the problem at its root cause - by cutting out my ovaries the surgeons have stopped my hormonal flux. Yes, it is drastic, but not as drastic as the potential headline “Local woman, 44, and two sons killed on impact by freight train”. Please, take your thoughts to someone else if and when they are bothering you. I am not saying a hysterectomy is the answer for you, but I know for sure that suicide definitely isn’t. Please don't underestimate the power of a safety plan! Contrary to popular belief, talking about suicide does not lead to suicide. If you are experiencing suicidal ideation, self-injurious thoughts or behaviours, and/or fear for your own or someone else’s safety, please tell someone you trust. Although overwhelmingly intense, these feelings do pass. Get help now to protect your future self. Zoom AI has provided the following summary of the conversation:SummaryManaging Panic and Suicidal IdeationSam and Amanda discussed techniques for managing panic, anxiety, and suicidal ideation, particularly in the context of neurodivergence and hormonal fluctuations. Amanda emphasized the importance of recognising patterns and creating a "rescue kit" with soothing objects and practical items like water and medication to help manage overwhelming moments. They also highlighted the need to remember that these experiences are temporary and to practice self-compassion during difficult times.Safety Planning for Panic ManagementAmanda and Sam discussed strategies for managing panic attacks and creating safety plans. Amanda shared her methods of using post-it notes and voice recordings as reminders during overwhelming moments. Sam mentioned a video she created on writing autism-adapted suicide safety plans, emphasising the importance of considering professionals' availability and boundaries. They both stressed the value of evolving safety plans and having prearranged signals with supportive contacts for distraction or reassurance.Mindfulness Tools for OverwhelmAmanda discussed the challenges of managing overwhelming situations without proper safety resources, explaining how the brain can become hyper vigilant or fixated on past or future concerns. She described various personal tools people use to ground themselves in the present moment, such as physical sensations or specific activities, and emphasised that finding an effective tool requires personal discovery. Amanda concluded that these tools serve as circuit breakers to help individuals regain focus and presence.Neurodivergent Emotional Management StrategiesAmanda and Sam discussed strategies for managing intense emotional states, particularly focusing on post-panic attacks and suicidal ideation. Sam shared her experience of having suicidal thoughts while driving, particularly during hormonal fluctuations, and emphasised the importance of having a plan for dealing with such moments. They agreed that it's crucial to recognise these feelings as part of their neurodivergent experiences and to consider the impact on loved ones, rather than acting impulsively. Amanda highlighted the need for more open conversations about these experiences, especially in neurodivergent and hormonal contexts.Emotional Regulation Techniques DiscussionAmanda and Sam discussed tools for managing discomfort and panic attacks, with Amanda introducing "riding the wave" as a technique for observing and navigating emotional states without immediate action. Sam shared personal experiences with ADHD and autism, highlighting how pattern recognition can both help and hinder understanding of emotional responses. They agreed that building nervous system regulation capacity through regular practice, even when feeling well, is crucial for better managing challenging moments.* Toolkit: Warning Signs of Suicide for Autistic People: An autism-specific resource based on research findings and expert consensusPlease take good care of yourself. Cheers, If you find my work valuable, why not become a paid subscriber to The Autistic Perimenopause: A Temporary Regression? (This is not a rhetorical question.) Get full access to Divergent Menopause at samgallowayaudhd.substack.com/subscribe

Hi Team Auti Peri, Welcome to the third video in the series with Amanda Hanna from SomaPsych. In this episode we explore how to:* identify our individual patterns of current or recurrent pain flares* be present at times of reduced pain or “good moments”* encourage the nervous system to imprint soothing and regulating patterns in our bodies.How does the nervous system get to know what is painful? What is uncomfortable? What’s tension versus tightness? Please share in the poll which techniques discussed in this video that you have tried. I suspect this work needs to be done consistently and regularly to see longer term benefits. The poll has been set to stay open “Forever” (which feels like more time than we need), so feel free to come back to this episode in the future and let us know in the poll and the comments what benefits you have noticed over time. In case you missed the previous videos, the first offers techniques to use in the margins of our day to regulate our nervous systems and feel rested. And in the second video Amanda suggests how to stop anxiety spiralling at night and (hopefully!) get back to sleep.Amanda discusses the work of Addie deHilster (she/her), Founder of Moved To Meditate. Addie is a Mindful Movement specialist who offers “Mindfulness practices for all the moving parts of your life”. To explore her work into meditating and moving with pain, you may like to listen to these podcast episodes:We'll cover:* the discomfort that is a normal part of the meditation process* meditating when the pain is more serious or ongoing* what the research says about mindfulness and pain* how the practice might need to be adjusted to accomodate painWhat you’ll hear about chronic pain and yoga:* defining chronic pain and what makes it so complex* how Yin Yoga practice can help you unwire habits and beliefs that perpetuate pain* using Somatic exercises and Yin poses to build back confidence in movement, and decrease fear* how Yin Yoga contributes to restoring your body image if it has been distorted by prolonged pain experiences.You’ll hear about:* addressing social anxiety and sensory issues that can come up for neurodiverse meditation students in a class setting* the importance of offering multiple ways to practice a technique like Mindfulness of Breathing or Loving-Kindness Meditation* stacking anchors to help students connect with the kinesthetic, visual, or auditory aspects of meditation, on their own terms* being aware of how different verbal instructions may (or may not) work for everyone* how Sue and Jan approach mindful movement or walking meditation for neurodiverse groups.In this video we are lucky enough to have a star cameo from Amanda’s puppy, Layla! ⭐️ 🎥 🐕‍🦺 Zoom AI has provided the following summary of the conversation:Conversational Discussion on Puppy FascinationSam and Amanda engaged in a casual conversation, discussing a puppy named Layla who was under the desk and seemed fascinated by a light. They briefly talked about taking notes and the appearance of a quill, before Sam prepared to record a video.Chronic Pain Management StrategiesSam and Amanda discussed strategies for managing chronic pain flares and reducing recovery times, particularly for neurodivergent individuals. Amanda shared insights from Addie deHilster's work on chronic pain management, including the concept of pendulating between neutral and painful sensations to help the nervous system reframe pain experiences. They explored techniques such as using opposite sensations (e.g., cold for hot pain) and planning ahead to mitigate predictable pain triggers. Sam emphasised the importance of explicit instruction for neurodivergent individuals, who may not naturally associate physical sensations with emotions.Shoulder Pain and Hypermobility JourneySam discussed her experience with shoulder pain and her journey to understand its root cause, which she suspects may be related to hypermobility and potentially Ehlers-Danlos syndrome. She explained that traditional medical approaches, like physiotherapy, might not address the underlying issue and highlighted her self-discovery process about "coat hanger pain," a term she learned that describes a specific pain region.Chronic Pain Management StrategiesSam and Amanda discussed strategies for managing chronic pain, focusing on balancing periods of pain and wellness. Amanda emphasised the importance of being present during "good" moments to help the nervous system better process and remember these feelings, which can help reduce the perception of pain over time. They also touched on how certain hormones and neurotransmitters, such as dopamine and serotonin, play a role in regulating pain and mood. I hope you have enjoyed this episode, and the series so far. The next episode concludes this mini series on nervous system regulation.Wishing you a regulated week!Cheers,The Autistic Perimenopause: A Temporary Regression is a reader-supported publication. Subscribe so you don’t miss a post, and please consider supporting the ongoing advocacy for neurodivergent menopause by becoming a paid subscriber. Thanks! Get full access to Divergent Menopause at samgallowayaudhd.substack.com/subscribe

📣 Great news! The Autistic Perimenopause: A Temporary Regression has been renamed Divergent Menopause. Yay!! 💕It’s less of a mouthful, for sure. Only the name has changed, it is still me - Sam Galloway (she/her) and my faithful ragdoll cats Harry and Toby - steering the good ship Divergent Menopause. TL;DRWhy “Divergent”? Inclusivity.Why “Menopause”? Verb, not noun. To cover the entire menopause transition and beyond. Why the rename? For the sake of inclusivity for all our differently wired neurokin.Most autistic people have other co-occuring neurodivergent conditions, such as ADHD, sensory processing disorder, dyslexia, dyspraxia etc. Although we may not be aware of them all yet… Not all neurodivergent people will identify as autistic, but they may be having a scary old menopause transition, sharing most, if not all, of the same struggles and challenges. Let’s build each other up! We all know that the academic research is unable to keep up in real time with what we are uncovering daily about the ways our menopause experiences diverge from “the norm”. I believe that research will soon catch up and uncover that all of us differently wired legends share similar strengths, vulnerabilities, support needs, cognitive regressions and so on. I also believe that in time rigorous academic research will show that neurodivergent people are more likely than neurotypicals to have hormonally sensitive bodies and minds, and that we are collapsing under the weight of extreme hormonal flux.While they are piecing it all together, running research projects and publishing evidence that will take even longer to disseminate into supporting the everyday challenges faced by neurodivergent people, we are already gathering here. Our stories matter. Every time you leave a comment, reply to someone else or generously share your story in the Auti Peri Q&A (yet to be renamed…) feature, you are helping to compile the anecdotal evidence of what it means to move through the menopause transition neurodivergently. I could not do this work without you. We are trail blazers! This is urgent now. Autistic midlife women are 13 times more likely to attempt suicide than non-autistics. 1 in 4 ADHD women have attempted suicide. Compounding a lifetime of high masking neurodivergence with menopausal hormonal flux exacerbates our vulnerability. We already have lower than average life expectancy. The sooner we understand the risks our differences can present, the sooner we can engage appropriate support systems and maintain our safety. As neurodivergent people, I believe that we need to group together rather than being siloed by our different diagnoses. We have more in common than we have differences. Also, and I know I am not the only one, I am BOTH autistic AND have ADHD. An AuDHDer.Additionally, I have diagnosed anxiety, undiagnosed hypermobility/connective tissue disorder, dyspraxia, dyscalculia, and other neurodivergences that I can’t even recall right now thanks to my major menopausal and post-general anaesthetic brain fog…In my pre-peri life, I was likely gifted which is a yet another form of neurodivergence, but my cognitive regressions have raged on and on regardless of management of other symptoms. I hope it’s reversible as I age…Although my ADHD and autism have both been late diagnosed, when I look back over my life I can see eras where one reigned over the other. Often it was the ADHD that ramped up in times of pre-peri hormonal flux, such as during puberty. Then something about being a mother made me present more autistically overall. Yet I was multi-neurodivergent all along.Separating my neurodivergences is fruitless, I can no longer pretend to be more one than another. They all contribute to create the mess the person who is writing these words to you right now. It feels increasingly inauthentic to present my writing purely from an autistic perspective, when I am an AuDHDer, with astonishing levels of executive dysfunction to prove it. I don’t want to be down on my autism, my ADHD, or on any of the other complexities that make me me who I am. And so in renaming this community Divergent Menopause I hope that we continue growing in numbers, diversity and momentum. There are so many things I need to iron out, but I can’t right now because my brain is mush. Three weeks post-hysterectomy feels like an entire lifetime and a fleeting moment. I have been told by the surgeon and my primary care doctors that the recovery time is 6 to 8 weeks, and also that the general anaesthetic may take 3 months to wear off entirely. That means I am hopeful to be pain-free, fully mobile and have clarity of mind just in time for Christmas, which will be a gift. 🎄The reason I am calling this move a “rename” rather than a “rebrand” is because Canva looked at my efforts for a new logo and told me to stop wasting both our time. Here are some examples *cringe*And why have I changed the name from Perimenopause to Menopause?Simply because I have transitioned from a perimenopausal state to a surgically induced post-menopausal state in the slice of a scalpel (well, several, I have four incisions…).I am fully aware that the word ‘menopause’ is generally used as a noun, with the dictionary meaning of being the day that is exactly one year after a person’s final menstrual bleed. Yet menopause does not often fit into tidy little boxes. I haven’t had a menstrual cycle since I had a Mirena IUD inserted two years ago this month, and that was only advised because I was having a constant uncontrollable bleed that lasted months. I wouldn't call that a “period”, but we don’t have words for that either. The bleeds I have had since have been short, isolated emotional bodily trauma responses. One occured at my Dad’s deathbed, the other when my Mum’s visit to stay with my family in Aotearoa New Zealand ended and she went back to the UK. My GP advised me to anticipate another bleed in the event of any future little-t trauma. Hormones impact our emotions. Emotions impact our hormones. We are not as straightforward as medical science would like us to be, hence decades of gross negligence into avoiding research on women’s health. I am your classically annoying correct autistic pedant. I know that the language around the menopause transition is deliberately blurred. We descend from generations of women who were not supposed to talk about their menstrual bleeds, nor their cessation. We may never have heard from our sisters, cousins, aunties, mothers and grandmothers on the subject of hormones and menopause, and we were socialised to be “good girls” by not asking questions. The language of menopause, even our own anatomy, has been denied us. Our neurodivergent ways of communicating go chronically misunderstood and silenced. When we have questions in midlife, medical science does not yet offer answers to our predicaments. None of this is our fault though, and Divergent Menopause will continue to be a safe space for us to chat about our lived experiences. This remains a community that welcomes all forms of diversity. For all these reasons, my use of the latter word in the new name Divergent Menopause will be intended as a verb, rather than a noun. “Menopause” as an occurrence, a state of being, a transitional time in our lives. As for the Auti Peri Q&A, I still welcome people to please forward their responses to me if they would like to feature in the series! 🙏The Auti Peri Q&AI will soon be adapting the Q&A questions to open it up to all neurodivergent people who would like to share their experience of the menopause transition. I have other grand plans: to start a proper podcast, to rebrand Divergent Menopause with Autumnal tones, and perhaps to one day train as a menopause doula.But that is all going to have to wait until my brain is fully functioning again.🤞I thought I would have moved on from that stage in three weeks, but I suppose major surgery is major surgery… It is reminiscent of how I was feeling whilst still in hospital. ⬇️As I type this, my homemade hysterectomy pillow is lying across my tummy and under my arms giving me oodles of support, as I hoped it would. My laptop is balancing precariously on top of it. I have also been building this amazing LEGO set I was gifted to build whilst recovering from surgery. The wooden tray has also been balanced precariously on the pillow during the extensive build!I hope the name change isn’t too much of a shock. I hate surprises and change, and even I am cringing at the new name, despite it being a change I have been intending to make for many months now. It would be great if you could please share Divergent Menopause within your networks to help us get more visibility, have a wider reach, and, in so doing, support more people to feel less alone and lost in the haze of this challenging yet unavoidable life transition. I think it’s time for another nap…I hope you have a restful weekend ahead. Take good care of yourself.Cheers,Divergent Menopause (formerly known as The Autistic Perimenopause: A Temporary Regression) is a reader-supported publication. Paid subscriptions are on a patron model. If you find my work supportive and informative, and you value advocacy work, please consider becoming a paid subscriber. Thank you! 💕 Get full access to Divergent Menopause at samgallowayaudhd.substack.com/subscribe

Hello to you, Welcome to the second part of this four part video series with Amanda Hanna from SomaPsych. You can watch Part 1 here. In the first video we discussed techniques to use in the margins of our day to regulate our nervous systems and feel restedThis time we focus on sleep, which can be so elusive to neurodivergent people in times of hormonal flux. Let’s face it, sleep can be hard for us throughout our lifespan. As children, we may have formed negative associations with sleep depending on how gently - or not - our own times of sleeplessness were managed. This can impact us as we age. I know I can’t be the only midlife neurodivergent parent having to co-sleep with a child to give the whole family a better chance of refreshing sleep. This comes at a cost to me though, as flailing limbs of pre-teens does nothing to help with night sweats and hormonal insomnia…Resting during the daytime can be a challenge for us too, as high anxiety coupled with executive dysfunction can make everyday tasks take ten times longer - if we can do them at all. Writing “Take a nap” on our to-do lists rarely leads to action (or inaction in the case of napping?).But don't despair! Amanda is back with more neuro-affirming gems to help us learn to soothe our nervous systems, increasing our chance of improving our sleep overnight rest opportunities (sometimes calling it “sleep” just adds too much pressure).In Part 2, Amanda encourages us to ask ourselves:“Are there restful things I could do in the moments when sleep is not happening?”So many helpful techniques offered, and I would love to know which, if any, you find most effective. Please let us know in the poll, and feel free to expand in the comments. Let’s collectively workshop sleep for everyone’s benefit!As always, the transcript and closed captions are available to ensure the video content is as accessible to you as possible. If you prefer audio only content, you can listen to our chat as a podcast episode. 🎧Zoom AI has provided the following summary of the conversation:SummarySleep and Anxiety Management StrategiesSam and Amanda discussed strategies to manage anxiety and improve sleep, particularly for neurodivergent individuals and those experiencing hormonal shifts like perimenopause. Amanda emphasised the importance of reducing cortisol levels to allow melatonin to work effectively for sleep. She suggested techniques such as journaling, soothing activities, and setting restful associations through lighting cues. Sam shared personal experiences with sleep disruptions, including urinary incontinence and mast cell activation syndrome, and highlighted the importance of understanding body signals to manage waking up at night.Open Monitoring and Brain RestAmanda discussed the concept of open monitoring, which involves allowing the brain to daydream and wander, particularly during moments of low external stimuli. She explained how the hippocampus, often compared to a librarian, processes and files away memories when the brain is not actively engaged. Amanda emphasised the importance of giving the hippocampus time to clean up and organize memories, contrasting this with the constant demand for productivity and attention in modern society. Sam acknowledged her difficulty in allowing for such moments of mental rest.Short Meditation Practices DiscussionAmanda and Sam discussed incorporating short meditation practices into daily routines, such as 30-second mindfulness moments and a figure-8 eye movement exercise for sensory stimulation. Amanda explained that these techniques can help reduce stress and improve sleep, while Sam expressed interest in trying the eye exercise that night. I hope you enjoyed the second part of this mini series. We are already halfway through. I can’t wait to share the next two instalments with you!Cheers, The Autistic Perimenopause: A Temporary Regression takes extra effort to write and curate whilst recovering from major surgery. Show your support by beco ming a paid subscriber, so you can glow inside knowing that you are a patron of neuro-legendary menopause advocacy! 🌟 Get full access to Divergent Menopause at samgallowayaudhd.substack.com/subscribe

Hi Team Auti Peri!Well, here it is! The first part of four in this series on nervous system regulation, yay! I would like to take this opportunity to once again thank the lovely Amanda Hanna of SomaPsych for sharing her time and expertise with our community. At SomaPsych, we empower resilience and transformation through trauma-informed care and somatic practices - from individual restoration to collective social change.Amanda weaves science with embodied wisdom, crafting spaces where curiosity thrives and empowerment takes root. Her approach is nervous system focused, polyvagal informed, collectively-minded and grounded in a deep reverence for all things ecosomatic and alive.I am still lying flat on my back in bed after my hysterectomy last week, so I have included the Zoom AI meeting summary below (demarcated in block text) as the main body of the article. At the time of recording I had fully intended to write up a lovely summary for you, but now I am unable to even sit up unaided. Plus my painkillers make it rather difficult for me to convey much coherence!I know AI usage is contentious, but needs must. I need my recovery to be as smooth as possible as I have regressed so far within the bowels of my neurodivergent perimenopause, and now I need to cut myself some slack.Please be assured that the video conversation is real though, ha ha! You will be able to tell that from my inability to cut out the first three seconds. Oh I had such grand plans of making this mini series look slick and professional. Sigh..!As always, the transcript and closed captions are available to ensure the video content is as accessible to you as possible. If you prefer audio only content, you can listen to our chat as a podcast episode. 🎧After you have watched the video, please come back and let us know in the poll which technique is helping you the most. Quick recapSam and Amanda explored nervous system regulation challenges, particularly for neurodivergent individuals, and shared strategies for managing mood fluctuations and emotional responses. The conversation concluded with Amanda providing coaching on managing difficult thoughts and building a relationship with the amygdala, with plans to continue their discussion in future recordings.Neurodivergent Nervous System Regulation ChallengesSam and Amanda discussed nervous system regulation, particularly for neurodivergent individuals who have spent their lives masking and managing their emotions. Amanda explained that nervous system regulation involves understanding both internal and external sensations, and recognising when one is in a "green zone" of relative calm versus experiencing dysregulation. They agreed that the constant pressure to maintain regulation can be particularly challenging for neurodivergent people during menopause, when control may feel even more elusive.Enhancing Well-Being Through Daily ToolsAmanda and Sam discussed strategies to manage nervous system regulation and mood fluctuations, focusing on integrating simple tools and techniques into daily routines to enhance well-being. Amanda emphasized the importance of "stacking" these tools during everyday activities, such as filling a water bottle or making tea, to create moments of calm and downregulation. She explained the concept of physiological sighing as a natural technique to shift brain chemistry and reduce stress. Sam shared personal experiences with mood stabilising medication and expressed a desire to rely more on self-regulation techniques. Amanda concluded by demonstrating a physiological sigh, highlighting its effectiveness in promoting relaxation.Self-Regulation Techniques for Emotional ControlAmanda and Sam discussed self-regulation techniques, focusing on both public and private methods for managing emotional responses. Amanda explained that she uses both overt and covert strategies, including physical gestures like palm massage, to maintain control in different situations. She emphasised the importance of having both visible and hidden coping mechanisms, allowing her to manage her emotions without always needing to explain herself to others.Amygdala Regulation and Thought ManagementAmanda provided coaching to Sam about managing nervous system regulation and dealing with difficult thoughts, explaining that the amygdala's role is to keep us safe and suggesting that building a relationship with it can make challenges easier over time. They discussed how rumination can lead to hyper-focusing on negative thoughts, and agreed to end the current session with plans to continue in the next recording. I hope you enjoyed the first part of this mini series. I can’t wait to share the next three instalments with you!Cheers, If you find my work valuable, why not become a paid subscriber to The Autistic Perimenopause: A Temporary Regression? (This is not a rhetorical question.) Get full access to Divergent Menopause at samgallowayaudhd.substack.com/subscribe

Dear Team Auti Peri, Thanks for being here, your presence means the world to me!Contents summary* Why I am taking August off* Things you might like to do to contribute at The Autistic Perimenopause* Exciting plans for September on nervous system regulation in neurodivergent hormonal flux with sneak preview!* Recap of the Autism Adapted Suicide Safety Plan with links to the Newcastle University document, and my previous video and audio step-by-step guide* Bonus content only in this audio recording: A real life cat fight between Harry and Toby when my son accidentally let them into the recording room to tell me that Harry had knocked over a plant pot in the kitchen. With cat squeals and inaudible flying fluff! Note to self: go and clean up the plant pot mess. With any luck, the cats won’t have peed on the soil/carpet… 🪴 🙄🐈 🐈‍⬛ 🐈 🐈‍⬛ 🐈 🐈‍⬛ 🐈With reluctance, I have decided that I need to take some time off to focus on my own health and wellbeing. It won’t be for long! A few weeks ought to do it. My little family is in desperate need of a holiday (vacation/break/total reset), and I haven’t taken any time off from The Autistic Perimenopause: A Temporary Regression since it launched in April 2024. So I am planning on taking off all of August for a personal mental health break. This is a one woman show, and this one woman is at risk of cracking up entirely. I fear if I breakdown completely this time, I may be unable to piece myself back together. If you are familiar with my work, you will know that I am adamant that a neurodivergent menopausal transition can be a distressing and prolonged time for many of us. I don’t know about you, but every single time I spiral further downwards at an alarming rate, I wonder if I ever will be able to reverse these regressions. I want so badly to make sense of my own menopause in the way aspirational writers do: the ones who tell us that this is an opportunity to live the second half of our lives with joy and purpose. They say, once we become empty nesters, we can invest our newfound time entirely in ourselves. This theory of the menopause in no way aligns with my lived experience. Those of us who suddenly find ourselves in neurodivergent perimenopause, often only uncover our neurological differences alongside our children’s diagnoses. Our midlives are lived outside the norm.We may not have an empty nest to look forward to. We are often devoted parent carers: we prepare different meals for everyone in the home to ensure safe foods are always available; we monitor and despair at our kids’ ever increasing screen time (just me?); many of us choose to homeschool - due to the failure of the mainstream schooling system, or from personal preference. For those of us who have neurodivergent kids in schools, we may find ourselves constantly meeting with teachers and special education needs coordinators (SENCOs), feeling belittled and blamed when our children naturally react to the school systems’ inability to accommodate them all of the time. And what about when our differently wired children grow up? With their spiky profiles and asynchronous development, they may not be equipped to leave home at the same time as their non-disabled, neurotypical peers. Yes, we strive for them to be independent. We see their pure brilliance. We want them to be happy, and preferably not gaming into their 30s in our basements, needing regular reminders to clean their rooms of dirty dishes and even dirtier laundry. And - for goodness sake - can’t they just take a shower AND apply deodorant without being verbally badgered to do so? Our families are often on a different trajectory entirely from regular families, which is why it cuts so deep when others have no awareness of the extra effort we put into helping our offspring assimilate into this world that does not have their best interests at heart, to say the very least. To be told that we are pandering, enabling and just plain parenting wrong is insulting. And it most often comes from those we love, rarely from the psychiatrists, therapists and support workers who are privy to the most intimate details of our volatile and tender day to day lives. Well, I don’t know where that came from, because I went completely off topic. How cathartic though, ha ha! Anyway, yes, I suppose I do need a break because of all the stressors above - perhaps you do too? - and also: * Down here in Aotearoa New Zealand we are months into the depths of Winter, and my body hurts from the cold. It is hard to motivate myself to get outside and I am quite possibly depleted of Vitamin D. I haven’t looked into this, but I had a B12 injection last week and am hoping to recover some energy soon. * My brain fog is absolutely off the charts, I can barely hold a conversation in person. I have loads of half written posts drafted, and not enough cognitive capacity to feel they offer you enough value to publish yet. I am extremely keen to get an article out to you on the topic of progesterone intolerance, but for the life of me I cannot remember what my lived experience of it has been. Which is ridiculous, as it is one of the reasons that I was recently approved for a hysterectomy! And I have no idea of the timescale for my upcoming surgery, which is very difficult to deal with as an autistic woman, especially with full time homeschooling parent carer duties and extremely limited respite and childcare options. * I am being treated for mast cell activation syndrome (MCAS) which is definitely exacerbating the brain fog and have started the antihistamines (H1 and H2 blockers). My body is in a state of alarm at all times, and I need to learn about the histamine elimination diet that can help my body and mind recover from the onslaught it perceives from stress, my regular diet and lack of refreshing sleep. Ironically, the MCAS-induced brain fog precludes me from understanding the complex underpinnings of a low histamine diet, which may be the primary way to combat the brain fog… But the MCAS is insisting that I rest, and I need to obey in order to reassure my nervous system that I am safe. * I have recently realised that I am most likely hypermobile and am now highly symptomatic with pain flares, ongoing gastrointestinal issues and worsening proprioceptive challenges. I think this is all highly pronounced now that I am around nine months into a chemical menopause, although I was probably asymptomatic hypermibile until now. I have signed up to The Zebra Club app for community, hypermobile-friendly workouts, and hours and hours of presentations to try and understand how to soothe my nervous system and understand my body’s needs, strengths and limitations. I have an unstable shoulder joint, currently aided by kinesiology tape, and have just taken delivery of my new firm compression tops to help with stability and proprioception. Basically, I am having to unlearn everything I thought I knew about how to move, sit, stand and so on, and relearn where my body is in space, how to stop bracing my muscles, and keep my joints within their safe, painless range. * If I were in a conventional employment arrangement, I would have statutory holiday leave entitlement. But it’s just me and my phone, and we are in a very compulsive, strained and unboundaried working relationship. Thanks to ADHD, I am “all or nothing”. Rather than the default being all in on my work, I need to switch over for a short time into going all in on rest. * The Substack gods are getting in my head, and I need to show them that I am in control of my own mind (which I am hoping turns out to be the case). My subscriber numbers are down, both free and paid, with paid rapidly approaching single digits. I need to stop checking the stats and break that habit. I love all my readers and subscribers, free and paid, and would find it extremely validating to find my paid subscriber numbers increasing. But I have zero control over that, and hope that people are finding value in my work regardless. I still offer everything for free and I would like to continue to avoid paywalling content that people may need and can’t afford to pay for at this time. Thank you to my paid subscribers for supporting all my hard work! 💐* I know we are all crazy busy and super stressed - my troubles listed here are far from unique and pretty minor on the grand scheme of things. I don’t currently have any more Auti Peri Q&A interview posts to publish because I haven’t received any responses lately, which is totally understandable. I am always seeking more Auti Peri Q&A respondents (here’s why), so please reach out if you are keen to participate.* A personal goal is that I would like to launch a proper podcast about neurodivergent menopause, to interview experts and advocate on a larger scale. I have been lucky enough to free up a room in my house which will soon become my writing and podcasting room. It currently houses many of my houseplants, a lot of my LEGO sets and a dumping ground desk already cluttered with paperwork. It is far enough up the hallway from where my kids play online with their friends, screaming and laughing, to hopefully not pick up too much background noise. I need to somehow sort out some optimal acoustic panelling or something before I can get started though. Oh and find guests. And create an intro/outro, find music, childcare *Sam enters major overwhelm…*🐈 🐈‍⬛ 🐈 🐈‍⬛ 🐈 🐈‍⬛ 🐈Here’s what you might like to doHave you listened to any great podcast episodes lately about autistic perimenopause, read any academic papers, or watched an insightful webinar on YouTube? If so, please share the links to any new credible, academic or informative resources about autistic perimenopause and beyond in the comments of the 💕 Resource Roundup 💕 page which was last updated in October 2024. (Or any links to older stuff that I missed!) If you are reading in the Substack website version, you can find it in the tab headings here:* Have you explored the archive at The Autistic Perimenopaus

Hi, I’m Sam Galloway and I have been writing from the nuanced and complex intersection of neurodivergence and menopause for over a year now at The Autistic Perimenopause: A Temporary Regression. I am so glad you are here!Content warning: ectopic pregnancy, abortion, miscarriage, blood, surgery, chronic pain. Every week I forged a sick note for my high school physical education (PE) teacher that said I couldn’t do PE that week, because I was on my period. Every week my PE teacher told me that I needed to learn to get on with it, because I wouldn’t be able to get out of work as an adult just because of my periods. Looking back now I wonder why she didn’t question the frequency of my weekly periods, although we were discouraged from speaking about such matters in my Catholic girls school. The PE communal changing rooms were catty, b****y spaces, where other girls would eye my stretch marks and cellulite, deepening my disordered eating tendencies and low self-esteem. Puberty took me early on. By 11, I was already bleeding, and my weight was double that of my peers. Not curvy, just substantial. Dealing with periods early on in an environment that hushed their presence was difficult. In primary school we received the cursory talk of sex and periods, but it was vague and scant, given the Catholic nature of my education. Emphasis within the curriculum was on theology, with morality based upon being a good girl. In high school, when we were supposedly being taught about contraceptives and birth control, our religious education (RE) teacher played a video about the instruments used to perform an abortion, circa 1995. I don’t know how much detail the video went into the procedure, because one by one every girl ran out of the classroom upset. Being highly sensitive, I was the first to leave, hysterically crying and feeling distraught at the images conjured by my own imagination.Second to leave was my 14 year old classmate and close friend, who had confided in me that she had just had a miscarriage. Her boyfriend was 26. What was their intention in showing us that video? To scare us into not having sex for fear of needing to terminate an unwanted pregnancy? Was it legitimately part of the Catholic RE syllabus, or just a misjudged error on the part of our teacher, a former convent nun?The desired effect wasn’t achieved, as so many girls left school early to have babies. I still don’t understand why frightening girls off abortion was preferential to teaching us how to use contraceptives, and learning about our reproductive systems. Luckily for me, my childhood house was opposite the local community clinic. On Thursday evenings they had the sexual health clinic, and my more cautious wise teenage friends and I would go regularly for check ups, the pill and free condoms. I was clearly unschooling myself from an early age to look beyond the narrow view presented by my so called education. Even back in high school, my periods always came accompanied with extreme menstrual cramping and lower back pain. My bleeds are still debilitatingly painful. Sometimes I am responsive to pain medication, sometimes not. Heat can help; diaphragmatic breathing; focused muscle relaxation. Managing the pain is one thing. Coping with the bleeding is quite another. Bleeding is not a neutral experience for me. I have tried all within my power to stop experiencing it, both consciously and unconsciously: not taking a “pill free week” when on the contraceptive pill, which elicits a withdrawal bleed (rather than a period resulting from ovulation and no subsequent pregnancy). The contraceptive injection in my late teens; the contraceptive implant in my twenties. Pregnancy, long term breastfeeding in my early thirties. When perimenopause took me by surprise in my mid to late thirties, I tried the Mirena IUD, in response to an extensive bleed that lasted many months. Now, I am in a chemical menopause using hormone blockers. In an effort to block out the sensation of bleeding, over the years I have used tampons to try and plug it up. Menstrual cups somehow alleviated associated period pains, although I never acted on the temptation to feed my collected menses to my rose bush. Now the rose bush is dead and gone, yet my bleeding remains. These days I wear period underwear at all times, as much to deal with unpredictable urinary leaking as much as to manage the constant threat of a sudden flow. Over the last week, old pain patterns have trotted out along with sudden, unexpected bleeding. Only this evening I could feel a trickle and couldn’t tell initially if it was a leak or a flow, although the accompanying severe pelvic pain unsubtly hinted at the prospect of yet another evening bleed, which I have had to face each night this past week. Thick blood oozing out of me and collecting in an unwanted pool is beyond what I can tolerate. The sight of it, the smell, the way it streaks and drips and soaks onto other surfaces is all too much.As a wise, kind friend told me a few days ago, “Your body is doing its best, even though you don’t like what it is doing.” She is right. Something is amiss, and I can only assume this hormonal blip is caused by my adding in an extra pump of oestrogen gel last week to my already high dose, in a bid to stop the hip and shoulder pain that has limited my movement recently. But my body is also exquisitely responsive to my mood, perhaps more so than is my mind at times. Tomorrow will be the first anniversary of my dear old Dad’s death, and it has been playing on my mind. I had a random bleed in the UK a year ago as I sat beside him on his deathbed, and another bleed in March this year when my Mum’s visit to us in Aotearoa New Zealand ended.Upon discussion with my GP, I was advised to anticipate further bleeding episodes should any more emotional events occur. Given the random nature of my bleeds, the intense pain, and my hatred of both random events and pain, I am especially glad to be awaiting a hysterectomy in the not too distant future…I cannot wait to no longer bleed. Anaemia is common for women who bleed heavily, and our iron levels need careful monitoring. The patriarchy likes its women too fatigued to put up a fight, so please do us all a favour and keep your iron levels within the normal ranges. Weakness from blood and subsequent iron loss makes me feel dizzy and dissociative, so I tend to eat a steak when I have bled to replace lost iron stores. I also conserve my energy by having a warm Epsom salts bath, then wrapping up in my dressing gown in order to complain endlessly about how much I detest bleeding.Pregnancy losses have been a feature of my adult life, having experienced an ectopic pregnancy and two miscarriages. Our bleeding patterns can communicate to us, if we are receptive to them. Which I am not; I am just reactive to and avoidant of them. Fortunately, when I was bleeding a long streaky prune juice coloured flow, another friend who had experienced an ectopic pregnancy advised me to do a pregnancy test. I was pregnant, but not for much longer, since the ectopic pregnancy was in danger of rupturing and within days I was in emergency surgery. Bleeding in pregnancy was my norm, even with my two out of five successful pregnancies. With my first pregnancy resulting in surgery, I was in constant panic at any sight of blood in my subsequent pregnancies. This week I found out that hypermobility can make bleeding in pregnancy more likely due to tissue fragility and potential clotting problems. Perhaps it is just as well I didn’t have that on the brain at the time.If only we were all prepared for menstruation, and allowed to feel empowered by our bleeds, not shamed for them. Red School is an organisation I wish I had known about decades ago. It feels too late now, my bleeds instill me with a sense of fear, not a sense of power…Imagine that knowledge of the full spectrum and power of the menstrual cycle is commonplace, and we all feel the utter rightness of having this experience within us. Imagine a world in which the menstrual cycle is respected as our spiritual practice. Imagine young people growing up in this menstrual-affirming world.Imagine a world in which menopause is recognized as a healthy, organic step in one's evolutionary journey stepping into the vital and powerful role of serving your community and the world. Imagine knowing that you’ll be profoundly met in the dignity and power of this new place you stand in post menopause.May we all trust our menstrual cycle and reclaim the spiritual significance of Menopause as the path to instate our full sovereignty. May we all recognise and relish our entitlement, dignity and authority to be channels for Menstruality and the Divine Feminine on the planet.Red SchoolI hope that, if are still cycling, you perceive your bleeds from a more holistic perspective than I have ever managed to muster. Looking back, had I learned from Red School, or any indigenous matriarchal culture, that my periods are sacred and healthful, not dirty and shameful, perhaps my pain perception would not be so debilitating. Maybe I wouldn’t actively want them to stop permanently and prematurely, had they not been something to be hushed and hidden in my Catholic school years and beyond. Perhaps I should soak my menses into the garden while I still can, and stand in my power in a bid to relish my entitlement, dignity and authority to be a channel for Menstruality and the Divine Feminine on the planet. Not long after the end of my high school years, my PE teacher was rumoured to have eloped with my Maths teacher, both of them married with families of their own. This was at a time when Catholicism and lesbianism were mutually exclusive. So I am glad that they managed to buck the good girl Catholic trend by midlife. I hope in doing so they reclaimed the spiritual significance of Menopause as the path to instate their full sovereignty. They are certainly better role models, acting on their previously covert love

How has this happened?Birthing two big babies vaginally over a decade ago has finally backfired on me. It’s been a slow burn, with bumps along the path that have led me to a diagnosis of mixed urinary incontinence. It shouldn’t come as too much of a surprise because I experienced extreme fecal urgency shortly after having my first son. He was born weighing a mighty 9lbs 6oz, and required an episiotomy, where the doctor took a pair of scissors to my perineum to dislodge him from my birth canal. I had begged them not to. Being a hyper independent woman, I wanted to “do it alone”, which I could have done, had the maternity staff not insisted on relocating me when I was already in transition from a pool for labouring mothers into a stark clinical birthing room. Their interference stalled my progress, leading to me feeling emotionally unsafe. Repeatedly I asked them if I had pooed myself yet, since I had learnt during antenatal classes that this was a natural sign that the baby’s birth was progressing. I had wanted to poo myself, but they misread this repetitive question for paranoia, anxiety, or something else that I should not have been made to feel in my vulnerable state. Everything slowed down to almost a standstill, and I ended up being instructed to lay flat on my back, feet in stirrups being told to “Push him out of your bottom!” Really it was all a recipe for fecal incontinence, and I have done well to recover especially considering that my GP at the time dismissed this as normal. Baby two born three years later was even heavier at 9lbs 12oz. I water-birthed him at home as an active resistance to unnecessarily over-medicalising his birth. This time around I tore, and stitches healed well after both births. My youngest was almost born in the downstairs toilet, as I was able to completely relax my pelvic floor muscles whilst sitting there, and felt the most comfort in a very uncomfortable situation. What is wrong with me now?Vaginal childbirth is often a contributing factor to later developing bladder incontinence, which seems to be the case for me. Leaking urine didn't really start until my kids became enthusiastic about playing on trampolines, and I wanted to get involved. Going for a wee right before a bounce was not enough to prevent me weeing again immediately mid-bounce. That was a few years ago, and I now know to stay well away from trampolines. My avoidance served me well again for a while, but very recently the leaking has become regular and with less obvious reason. I tried ignoring it and hoping it would just stop. It didn't. So I tried wearing period undies and thinking I could get away with it. Because everyone complains about leaking sometimes, right? A sneeze or a cough can be a common and seemingly unavoidable trigger. Besides, my advertising algorithm is now full of curvy, happy midlife women wearing incontinence pads and living their best lives! I thought it was normal and I just had to put up with it. Although my keen sense of smell meant that I would worry that I smelled of urine. It is one thing to know I have this problem without other people knowing about it too! But then the leaking started happening during my twice weekly personal training sessions. I love working with my trainer, and I told her what was going on. I started following the programme she set me to strengthen, and learn to relax, my pelvic floor. Last Friday it got so bad that I was leaking during the training sessions actively intended to stem the flow. What was wrong with me? Reverse lunge, drip. Reverse lunge, drip. Reverse lunge, drip. Luckily that was the same day that I was seeing the gynaecologist to self-advocate for my hysterectomy. The approval granted for the surgery was a huge weight off my mind, yet the weight of my burgeoning bladder persisted. The gynaecologist internally assessed me and diagnosed a stage one pelvic organ prolapse.Finally, I had an acceptable explanation for my urinary incontinence. It was a medical issue and not a moral failing on my part. I could live with that, and I found it oddly reassuring. All weekend I wondered if the prolapse could soon be repaired surgically during my upcoming hysterectomy. I felt vindicated in my urine leaking pattern - of course I was leaking if I had a prolapse. The prolapse must have occurred whilst birthing my baby boys, and I was asymptomatic until now. But then I worried that the surgery could in fact exacerbate the pelvic organ prolapse, worsening my bladder control. I knew I needed to be proactive in managing this condition, after listening to a great podcast episode on the topic:Why see a pelvic health physiotherapist?Here is a good visual explanation of what the female pelvic floor is and why it matters:Physiotherapist Fiona Rogers talks us through what the pelvic floor is and how it works.Do you know how to do a pelvic floor exercise properly or have you been taught to just suck everything up and in? Watch here how to do it properly.Fiona firmly believes if you understand where the muscles are and how they work then you are more likely to understand and learn how to exercise them properly.Credit: Pelvic Floor ExerciseHormonal changes during menopause can significantly impact the pelvic floor muscles, contributing to symptoms such as urinary incontinence, vaginal wall prolapse, and sexual dysfunction. A pelvic health physiotherapist can assess for muscle weakness, overactivity, or imbalance and develop individualised treatment plans. Interventions may include physiotherapy-guided pelvic floor muscle training, manual therapy, biofeedback, and structured relaxation techniques. These strategies are designed to restore muscular strength, coordination, and neuromuscular control, which supports continence, vaginal wall integrity, and overall pelvic health.Credit: Positive Pelvic Health Already armed with some basic information on my new hyper fixation, I reached out to Jennifer Dutton of Positive Pelvic Health. Jennifer is a pelvic floor physiotherapist who had been highly recommended to me. Amazingly, she offered me a cancellation for an in person initial consultation the very next day. Knowing that verbally retelling my medical issues is overwhelming for me, I brought along the notes I had prepared for the gynaecologist appointment. Jennifer took a very thorough medical background and was empathetic and reassuring. Upon internal examination, both standing and lying down, Jennifer said there was no pelvic organ prolapse present. She explained that vaginas and other organs supported by the pelvic floor will show natural signs of aging in midlife, as our skin loses collagen and oestrogen, also evidenced externally by how our faces, breasts and stomachs may also sag. Here is a video of Jennifer being interviewed about pelvic health, where she explains much of what she told me during my appointment:I wonder if the gynaecologists see any saggy vaginas in their medical training, as mine obviously can’t be a textbook model anymore! With my newly undiagnosed pelvic floor prolapse, I was able to spiral into a new panic about whether indeed my urinary incontinence was just a moral failing on my part after all…What is urinary incontinence?My current issues, known individually as urge incontinence and stress incontinence, together create a combined diagnosis referred to as mixed incontinence. Yay.Urinary incontinence is the unintentional passing of urine. It's a common problem thought to affect millions of people.There are several types of urinary incontinence, including:* stress incontinence – when urine leaks out at times when your bladder is under pressure; for example, when you cough or laugh* urge (urgency) incontinence – when urine leaks as you feel a sudden, intense urge to pee, or soon afterwards* overflow incontinence (chronic urinary retention) – when you're unable to fully empty your bladder, which causes frequent leaking* total incontinence – when your bladder cannot store any urine at all, which causes you to pass urine constantly or have frequent leakingIt's also possible to have a mixture of both stress and urge urinary incontinence.Credit: NHS webpage ‘Urinary Incontinence’.Autism, Interoception and Adult IncontinenceSo I am leaking on the regular, and trying not to blame myself for this recurring issue. It is so normalised yet hidden. TV ads for pads and absorbent pants proliferate, subtly telling us it is okay to leak urine, as long as nobody else knows. Well, f**k that s**t! When I leak, I tell everyone about it. Part of my neurodivergent profile has been a lifelong shamelessness. I don’t feel a need to hide anything. I refuse to feel shame and embarassment for urinary incontinence, despite having a niggling sense of regret that it is happening to me. Urinary incontinence is just another social taboo to stack on top of all the others I make it my mission to bust. Why would being autistic affect my urinary continence? Especially seeing as I am not aware of having any intellectual disability which may be more likely to co-occur with toileting issues. If anything, before perimenopause I may have been considered intellectually gifted. Yet my cognition has declined in this life phase, and I cling to the hope that this regression is temporary and reversible. Interoception is our capacity to identify our internal states and needs. When this is reduced, as mine has been in perimenopause, and is combined with a regression in executive functioning skills, then noticing when I need to use the toilet, and acting on the urge, can lead to me not responding accordingly.Interoception Receptors on our internal organs are responsible for interoception signals that provide information on our internal body and emotional states. Experiences: urge to urinate, hunger, temperature, pain, sadness, joy, anxiety.Interoceptive Over-ResponsivityWith interoception over-responsivity the person feels too much of their internal signals. They “over-feel” their internal sensations. Si

Thank you so much to the incredible Tamsin at 3 Red Cabbage Heads - poetry, knitting and essays of life on Substack! For more amazing bespoke knitted ambhibians and other creatures, check out Tamsin’s Art Makes section.Newt flew all the way from the UK to NZ. No - on a plane, silly! Newts can’t fly. If they could, I wouldn’t be such a fan of them. *shudders*My Nan’s house in Alperton, London was as urban as could be - the opposite of the rural village of Cornelistrum, Co. Galway in Ireland from where she hailed. In her London garden aged 6 or so, I used to stand on some loose bricks to chat to the little girl who was Nan’s next door neighbour. There was a deep garden pond full of aquatic life that was rare in such a built up residential and industrial area in my little friend’s garden. On the days I used to tiptoe on the brick step, and my friend couldn’t come out to play, I would find my own entertainment. From beneath the overturned red bricks, if I was lucky, I would find tiny little British smooth newts, also called common newts. They were unfortunately not so lucky, because it was only at 2 weeks shy of age 44 (today) that I learnt that newts are not to be handled with dry, bare hands. Oops…🦎Back to the Newt of today! After the long journey, I noticed that Newt arrived with a flat white! ☕️How very Kiwi of her! She will need it to help her cope with the jetlag although she is already acclimatising well. The beastly cats are a bit much for her, but I am sure they will all be firm friends soon.Tamsin kindly sent Newt on her way with a wealth of accessories, all of which I am trying to dissuade my ragdoll cats, Harry and Toby, from eating. Dear Sam, I am so excited to come live with you in a land that is so far away! I am really looking forward to it - and my new name if you give me one!Love Newt🐈☕️ Newt and I would appreciate a flat white should you wish to buy us one! ☕️🦎🃏🐾🧸Awwww, what a cute pair! Goodnight xxThe Autistic Perimenopause: A Temporary Regression is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.P.S. This was my first solo Substack live. For more of my random shenanigans, download the Substack app. 😁 Get full access to Divergent Menopause at samgallowayaudhd.substack.com/subscribe

Welcome to The Autistic Perimenopause: A Temporary Regression. I’m Sam Galloway and I have been documenting my despair fiercely advocating here for over a year now. Time flies when you are dissociating having fun! The Autistic Perimenopause is a safe community space for sharing our lived experience of our neurodivergent menopause. Together, we explore how hormonal flux affects us day to day, how safely unmasking helps us to self-regulate, and how to hang on when it all feels too much. Cat photos proliferate in this joint exploration. Quality of life should be high for everyone, but I suppose it is all subjective. Yes, I am living an objectively good life in the beautiful Aotearoa New Zealand surrounded by people I love and who love me. I have food, albeit overpriced; clean drinking water; and a warm, mould-free home - which isn’t a given in this country for some abysmal reason. But things don’t feel right. I am drained and have close to no motivation to get out of bed in the morning. Yes, I am depressed, but my low dose daily SSRI does a reasonable job of both levelling out my mood, and cutting my rumination-prone worry loops. I utilise a wealth of other pharmaceuticals in an attempt to brighten my gloomy emotional landscape, but my impending sense of doom remains. I have habituated to this, and I function remarkably well most of the time, until I don’t. I am trying to be rational and balanced, but that is hard right now. My cognition and mood continue letting me down in neurodivergent perimenopause. My pelvic pain flares out of nowhere, and my body temperature soars despite the presence of a Kiwi Winter, and the promise of an imminent polar blast. The world is on fire, and so am I.Rationally, I am aware that far worse things are happening to much better people than myself across the world right now. Yet woe is entirely me, and I am most certainly woe. My low mood is not a choice, and my worry at the thought of my perimenopause stretching out who-knows-how-long into the future sends me into a panic stricken state, bordering absolute desolation. Not to say that I am feeling suicidal, but I believe that something must change now. I cannot take much more. My current state of perimenopausal hell is unrelenting. Yes, hormone blockers should be flatlining all variability of hormonal rollercoasters to my mood and cognition. I suppose they are - I am in a temporary, reversible menopause thanks to GnRH Analogues which I have written about previously here, here and here. But the pelvic pain, fear of unexpected bleeding and many other symptoms are too much to continue to bear. I am in the fortunate position of living in a country where, in the right medical circumstances, I could have a hysterectomy without needing to pay. My aftercare would be in excellent hands, the risks of surgery would be well managed, and my chance of recovery is positive. A hysterectomy is the name for the surgical procedure where the uterus (womb) is removed. This induces an immediate and irreversible surgical menopause, which is my current goal in life. It would be difficult to manage my household and parenting duties in the short term, since recovery can take 8-12 weeks, but given my ongoing low mood and lack of energy, these daily tasks are already draining. Once recovered and healed, with well-titrated add back hormones (hormone therapy) and following a healthy lifestyle, I am optimistic that my life can get back on track. Am I being naïve? Major surgery isn’t something we usually elect to endure, but I have previously survived emergency surgery for an ectopic pregnancy, and so have some experience of recovering in a gynaecology ward. Everyone else who was there advanced me by decades. The other women were having routine hysterectomies, and looked upon me with obvious sorrow and pity, as I wailed for the nurses to “Give me my baby back”, had endless meltdowns and reacted adversely to prescribed painkiller tramadol, hallucinating about newborns. This time I foresee the promise of gynaecological surgery to be liberating. Empowering. Worldview enhancing. Should I get my wish, I will awaken from surgery in my crone era, albeit feeling raw and sore. Yes, I know some people do not want to have hysterectomies. Those requiring them for sudden and unexpected medical reasons sometimes report feeling bereft of their womanhood, but I do not think I will feel that way. Having my uterus, cervix and ovaries removed would be anticipated and understood by me. I have fully researched the options, and I believe I have a strong case for needing a hysterectomy in my very near future. My gynaecology referral has been accepted and, within the coming month, I will be meeting with a gynaecologist who unknowingly holds my fate in her hands. My greatest fear is meeting with a specialist who is yet another gatekeeper of surgery within the public health system. I am pretty sure that, if I had medical insurance, I could have requested a private hysterectomy a year or more ago, and be fully recovered by now. Upon Googling the named specialist on my appointment letter, her medical staff profile states that she offers a “highly patient-centred approach, taking time to listen and understand her patients and their priorities, allowing her to recommend and guide her patients through a range of treatment options”. A wonderful gynaecologist colleague of hers has told me that she is an excellent laparoscopic (keyhole) surgeon; and my HRT doctor has said, “She is known for being lovely”.Doesn’t she sound like just what I need? This has my mind at ease a little, but while I am busy self-advocating for myself and possibly sounding over confident in myself, my shoulders are hunched and my stomach is clenched. I am a ball of nerves. I am scared of having to express myself; terrified of unleashing the full weight of my emotions. Scared of having surgery and absolutely petrified that it may be denied me. If there were a way to communicate all of this with the gynaecologist in advance, I would do so. The trauma from retelling my autistic perimenopause story in person to professionals over and over again is unrelenting and soul-destroying. And the thought of sharing this writing with her makes me feel awkward, exaggerated and, quite frankly, a bit of a dick. Yet I can’t convey in a short clinical appointment everything I need to get across, when the gravitas of this meeting holds mine and my family’s future in the balance. So I think, in the name of self-advocacy, I will share a print out of this all so that I don’t miss anything. Or have a meltdown. Or go situationally mute. Several friends have offered to accompany me, as has my husband, which is so kind of them. I want to be able to “do it alone” which I know results from my trauma-driven hyper-independence. Is it better to go into these appointments alone, or to take a support person? If Harry, my emotional support cat wasn’t such a scaredy puss, I would take him along. Toby is more sociable, maybe he can come along for support…Unfortunately, I know that taking a man along to medical appointments is one way to be taken more seriously, since lone women are quick to be medically dismissed. It wouldn’t surprise me at all if one of the questions will be, “And what does your husband think you should do?” If we were both there to tell the doctor that we don’t want any more children, would it make a hysterectomy more likely? I wish I didn’t have to give this all such detailed thought, and I can’t believe I am so envious of women who have already had a hysterectomy. What is wrong with me?! Yes, I have given this a lot of consideration, and I believe a total hysterectomy (uterus/womb and cervix) with both ovaries removed is the best option in my case. So to follow in my next post will be an informed account of the many reasons that I need a hysterectomy as soon as possible, please and thank you!The reasons I have brainstormed, and that are storming my brain as I write this, are: * Progesterone intolerance* Premenstrual dysphoria disorder (PMDD)* Menopausal depression and suicidal ideation* Thickened endometrium and associated cancer risk* Pelvic pain* Fear of further bleeding* Bladder stress incontinence* Adenomyosis* FibroidsAll of these are current ongoing issues, some of which are newly diagnosed and have been present for decades unbeknownst to me, whereas others have developed more recently and acute. Combined, I believe I have a good case for a hysterectomy, with the added bonus of initiating a surgical menopause. I have too much to say on each topic and am struggling to condense it all down, but I wanted to share my current state of mind with you (sorry!), and check in to ask how you are feeling at the moment? Have you had a hysterectomy and did you find it improved your symptoms? Have you been advised to have a hysterectomy but feeling hesitant to proceed? To be continued…I will keep working on my protracted argument for why I believe I need a hysterectomy - to share with you, and with my gynaecologist. Although I am clearly passionate about it, my PDA (pervasive drive for autonomy/pathological demand avoidance) is absolutely running the show. It is telling me not to write my case for a hysterectomy, and so far I have listened. But now I need to get it written because, if I don’t, I will have to verbally articulate the impact that every issue listed above is having on my quality of life. This may well result in a meltdown followed by a shutdown, or vice versa, and I will lose all social communication skills. I have learnt this the hard way. To take the pressure off myself, and to stick two fingers up at my PDA, I am sharing the above to set the tone of my desperate plea for a hysterectomy, and will flesh it all out soon. (Whilst hoping my gynaecologist will agree to flush out my uterus, cervix and ovaries!) My ADHD time agnostic brain is still on the “not now” side of the “now/not now” time warp of the upcoming consultation, but it will