Menopause, Neurodiversity, and the Workplace: What Local Authorities Need to Know

Menopause is not a niche wellbeing issue. It is a workforce sustainability issue, a leadership issue, and, crucially for local authorities, a retention, equity, and psychological safety issue. For too long, menopause has been framed as a private, individual matter rather than a structural workforce consideration. But the demographic reality is unavoidable: a significant proportion of the public sector workforce is made up of women aged 45–55, the age bracket most likely to experience menopausal transition while also holding senior, specialist, or frontline roles that councils cannot afford to lose.

In a sector already grappling with recruitment shortages, rising demand, and chronic retention challenges, menopause becomes a strategic concern. When symptoms go unsupported, the consequences ripple across teams and services: increased sickness absence, reduced confidence, impaired concentration, and a higher likelihood of staff stepping back from progression or leaving the workforce entirely. These are not “personal issues”, they are organisational risks.

Local authorities are beginning to recognise this shift. As councils look more honestly at the composition of their workforce, the question is no longer whether menopause affects staff, but how organisations respond. The old assumption, that menopause is something to be quietly endured, has given way to a more modern understanding: that menopause intersects with workplace culture, job design, leadership behaviours, and the psychological safety of teams.

A supportive response is not simply about offering fans or flexible working. It is about acknowledging that menopause sits at the crossroads of gender equity, health inequality, and workplace design. It is about recognising that symptoms do not occur in a vacuum, they occur in environments shaped by workload pressures, performance expectations, and the emotional labour inherent in public service roles.

This becomes even more critical when we consider neurodivergent colleagues. Emerging research shows that menopause can amplify executive functioning challenges, sensory sensitivities, and emotional regulation difficulties, areas already experienced differently by autistic and ADHD staff. Without understanding this intersection, organisations risk misinterpreting symptoms as performance issues rather than physiological and neurological realities.

This article explores the impact of menopause on staff, why neurodivergent colleagues may be disproportionately affected, and what both organisations and individuals can do to create supportive, stigma‑free environments. It argues that menopause support is not a “nice to have”, it is a core component of inclusive leadership, workforce planning, and psychologically safe practice. And it offers practical, evidence‑based steps that local authorities can take to ensure that staff are not left to navigate this transition alone.

1. The Impact of Menopause on Work and Wellbeing

A major UK literature review commissioned by the Department for Work and Pensions found “considerable evidence that some women going through menopause experience symptoms which can impair their confidence and well-being at work and, to a lesser extent, their ability to effectively do their jobs.” This is not a marginal finding. It reflects a growing body of research showing that menopause can disrupt not only physical health but also cognitive functioning, emotional stability, and a person’s sense of professional identity.

Key impacts identified in the research include:

• Reduced confidence and increased self‑doubt Many women report feeling suddenly unsure of their competence, even in roles they have performed successfully for years. This erosion of confidence can affect decision‑making, visibility, and willingness to pursue progression.

• Cognitive challenges such as memory lapses and concentration difficulties Often described as “brain fog,” these symptoms can make routine tasks feel disproportionately difficult. In high‑stakes or public‑facing roles, this can be particularly distressing.

• Fatigue, sleep disruption, and emotional volatility Chronic tiredness and unpredictable mood changes can undermine resilience, patience, and the capacity to absorb stress, core requirements in many local authority roles.

• Increased sickness absence or presenteeism Some staff take more time off; others continue working while struggling significantly. Both patterns have implications for service delivery and team dynamics.

• Heightened sensitivity to workplace stressors Noise, conflict, time pressure, and emotional labour can feel more overwhelming during menopause, especially in environments where staff already operate at the limits of capacity.

The review also highlights that experiences are shaped not only by biology but by culture:

“Women’s experiences of menopausal symptoms are deeply entangled with negative stereotypes of older women as less able and the menopause as a necessarily degenerative moment.”

This cultural framing matters. When menopause is associated with decline, invisibility, or diminished value, staff are less likely to disclose symptoms, seek adjustments, or challenge assumptions about their performance. Silence becomes a survival strategy, but one that comes at a personal and organisational cost.

Why this matters for local authorities

Local authorities sit at the intersection of high demand, constrained resources, and a workforce that is:

• Disproportionately female, particularly in social care, education, housing, HR, customer services, and leadership pipelines.

• Public‑facing, emotionally demanding, and time‑pressured, with roles that require sustained concentration, empathy, and rapid decision‑making.

• Already experiencing acute retention and recruitment pressures, where losing experienced staff has direct consequences for service continuity and organisational memory.

In this context, menopause is not a private matter happening “outside” the organisation. It is a structural factor shaping workforce capacity, wellbeing, and sustainability.

A workforce resilience issue, not just a health issue

When menopausal symptoms go unsupported, the impact is felt across:

• Service delivery (reduced capacity, increased errors, slower decision‑making)

• Team dynamics (uneven workloads, misunderstandings, stigma)

• Leadership pipelines (experienced women stepping back or opting out)

• Organisational culture (silence, shame, and fear of judgement)

Conversely, when organisations respond proactively, with empathy, flexibility, and practical adjustments, menopause becomes a site of inclusion rather than exclusion. It becomes an opportunity for leaders to demonstrate psychological safety in action. Menopause, therefore, is not simply a health issue. It is a workforce resilience issue, a leadership responsibility, and a test of whether an organisation’s commitment to equity extends to the realities of its staff’s lives.

2. Why Neurodivergent Staff May Be Particularly Affected

Emerging research shows that neurodivergent people, particularly those with ADHD or autism, may experience menopause differently and often more intensely. This is not simply because symptoms are “worse,” but because menopause interacts with the very systems, executive functioning, sensory processing, emotional regulation, that neurodivergent people already experience differently.

As Dr Rachel Moseley explains, neurodivergence affects

“the way people think, communicate, experience and interact with the world,”

and menopause can amplify these differences. For many neurodivergent staff, menopause is not just a hormonal transition, it is a neurological disruption layered on top of an already complex cognitive landscape.

How menopause interacts with neurodivergence

ADHD

For staff with ADHD, menopause can feel like the ground shifting beneath them. Oestrogen plays a key role in regulating dopamine and serotonin, neurotransmitters central to attention, motivation, and emotional regulation. As oestrogen levels fluctuate or decline, ADHD traits can intensify.

Common impacts include:

• Worsened executive functioning Planning, prioritising, sequencing tasks, and switching between activities can become significantly harder.

• Increased emotional dysregulation Emotional responses may feel sharper, quicker, or harder to contain.

• Reduced attention control ADHD is not a deficit of attention but a difficulty controlling it, something menopause can further destabilise, leading to more distractibility or hyperfocus at unhelpful times.

For staff who have spent years developing coping strategies, menopause can feel like those strategies suddenly stop working.

Autism

For autistic staff, menopause can disrupt the sensory and emotional equilibrium they rely on to navigate the world.

Key impacts include:

• Intensified sensory sensitivities Heat intolerance, noise sensitivity, and changes in light perception can become overwhelming, especially in open‑plan offices or frontline environments.

• Shifts in communication patterns Some autistic women report changes in verbal fluency, processing speed, or social stamina, which can feel destabilising in roles requiring constant interaction.

• Challenges interpreting new bodily sensations Differences in interoception (the ability to sense internal bodily states) can make menopausal symptoms confusing or harder to articulate, delaying support‑seeking.

These changes can feel like a loss of predictability in a world that already demands significant adaptation.

Masking and burnout

Neurodivergent staff often expend significant energy masking their differences, modifying their behaviour, suppressing sensory discomfort, or overcompensating to meet neurotypical expectations. Masking is cognitively expensive, and menopause adds another layer of load.

The result is a heightened risk of:

• Burnout A state of physical, emotional, and cognitive exhaustion that can be misinterpreted as disengagement or poor performance.

• Withdrawal Reduced participation in meetings, networks, or leadership opportunities.

• Misunderstanding Symptoms may be misread as attitude, capability issues, or lack of resilience.

Dr Rachel Moseley captures this reality succinctly:

“Many people try to hide these difficulties and it can be exhausting.” ,  Dr Rachel Moseley, Bournemouth University

For neurodivergent staff, menopause is not simply a hormonal shift, it can be a tipping point. A point where long‑standing coping mechanisms falter, where identity feels unstable, and where the gap between internal experience and external expectations widens.

Why this matters for local authorities

Local authorities rely heavily on the expertise, emotional labour, and institutional memory of staff in mid‑career and senior roles, precisely the group most likely to be navigating both menopause and late‑identified neurodivergence.

If organisations do not understand this intersection:

• performance concerns may be misdiagnosed

• staff may quietly step back from progression

• sickness absence may rise

• burnout may accelerate

• valuable colleagues may leave the sector entirely

But when organisations recognise the interplay between menopause and neurodivergence, they can respond with compassion, flexibility, and evidence‑based adjustments that protect both staff wellbeing and service resilience.

3. What Local Authorities Can Do: Practical, Evidence‑Based Actions

Local authorities have both a duty of care and a strategic interest in supporting menopausal and neurodivergent staff. This is not simply about being a compassionate employer, though that matters. It is about protecting workforce capacity, retaining experienced colleagues, and ensuring that organisational culture does not inadvertently push people out at the point when their expertise is most valuable.

The evidence is clear: organisational culture is as important as individual adjustments. A supportive policy means little if the day‑to‑day environment is characterised by silence, stigma, or performance anxiety. What councils do next will determine whether menopause becomes a barrier or a moment of inclusion.

A. Create psychologically safe, stigma‑free environments

Psychological safety is the foundation of effective menopause support. Staff need to know they can speak openly about symptoms without fear of judgement, career penalty, or being perceived as less capable.

Local authorities can:

• Normalise conversations about menopause, mirroring the progress made in mental health. When leaders talk openly, it signals permission for others to do the same.

• Train managers to recognise symptoms and respond with empathy, not performance panic. A manager’s reaction often determines whether someone seeks support or stays silent.

• Challenge stereotypes about age, capability, and emotionality, especially those that disproportionately affect women in mid‑career and leadership roles.

• Model inclusive leadership behaviours, such as asking “What support would help you right now?” rather than assuming what someone needs.

Psychological safety is not a soft concept, it is a measurable predictor of retention, engagement, and team performance.

B. Implement flexible, adaptive working practices

Menopause symptoms fluctuate. Neurodivergent needs vary. Flexibility is therefore not a perk, it is a practical tool for sustaining performance.

Local authorities can:

• Offer flexible hours, remote working, or adjusted workloads during acute phases of symptoms. Small changes can prevent long‑term absence.

• Provide quiet spaces or sensory‑friendly environments for neurodivergent staff, recognising that sensory overload can be intensified by menopause.

• Allow autonomy over temperature, lighting, and breaks, acknowledging that heat sensitivity, fatigue, and cognitive overwhelm are common.

• Encourage outcome‑focused management, reducing reliance on rigid presenteeism or time‑based performance measures.

Flexibility is one of the most effective, lowest‑cost interventions available.

C. Review policies and procedures

Policies shape culture. When menopause is invisible in policy, it becomes invisible in practice.

Local authorities should:

• Explicitly reference menopause in wellbeing, sickness, and reasonable adjustment policies, making it clear that support is expected, not exceptional.

• Embed neurodiversity‑affirming language and practices, ensuring policies do not assume a neurotypical experience of symptoms, communication, or help‑seeking.

• Make adjustments available without requiring medical evidence, unless absolutely necessary. Many women struggle to access timely clinical support, and neurodivergent staff may face additional diagnostic barriers.

• Ensure HR processes do not inadvertently penalise menopausal symptoms, such as rigid absence triggers or performance frameworks that lack nuance.

Policy clarity reduces shame, uncertainty, and inconsistency.

D. Provide training and awareness sessions

Training is not about information, it is about capability. Managers need practical tools, not just theoretical understanding.

Local authorities can:

• Equip managers with real‑world strategies, such as how to have supportive conversations, how to offer adjustments, and how to document decisions fairly.

• Include neurodivergent experiences of menopause, ensuring training reflects the full spectrum of staff experiences.

• Use lived‑experience stories to build empathy and challenge assumptions. Hearing colleagues speak openly can be transformative.

• Integrate menopause into leadership development, not just wellbeing programmes. This signals that menopause is a strategic issue, not a side topic.

Training should empower managers to act confidently and compassionately.

E. Strengthen peer support and networks

Peer support reduces isolation, builds confidence, and creates a sense of belonging, especially for staff who may feel invisible or misunderstood.

Local authorities can:

• Establish menopause champions or staff networks, giving colleagues a safe space to share experiences and access information.

• Encourage cross‑departmental communities of practice, ensuring learning and support are not siloed.

• Ensure networks are inclusive of neurodivergent voices, recognising that experiences vary widely and that neurodivergent staff may need different forms of support.

• Create feedback loops between networks and leadership, ensuring lived experience informs policy and practice.

Peer networks are often the first place staff feel safe enough to speak.

4. What Individuals Can Do to Support Themselves

While the organisational environment matters enormously, individuals can also take steps to support their wellbeing. These actions are not about “fixing” symptoms or placing responsibility solely on the individual, they are about equipping people with tools that help them navigate a period of significant cognitive, emotional, and physical change.

A. Seek adjustments early

Small, practical adjustments can prevent symptoms from escalating into crisis. These might include:

• access to a fan or cooler workspace

• flexible breaks to manage fatigue or sensory overload

• reduced sensory load (quiet rooms, noise‑cancelling headphones, softer lighting)

• temporary adjustments to deadlines or meeting schedules

Seeking support early is not a sign of weakness, it is a proactive step that protects wellbeing and performance.

B. Track symptoms and patterns

Menopause symptoms can fluctuate daily or weekly. Tracking patterns helps individuals:

• identify triggers (heat, stress, sleep disruption, sensory overload)

• understand which tasks feel harder at certain times

• communicate needs more clearly to managers

• recognise when additional support or adjustments may be needed

For neurodivergent staff, tracking can also help distinguish between menopausal changes and long‑standing neurodivergent traits, reducing confusion and self‑doubt.

C. Prioritise rest and recovery

Both menopause and neurodivergence increase cognitive load. The brain is working harder to regulate attention, emotion, sensory input, and internal bodily changes. Rest is therefore not indulgent, it is protective.

This might include:

• building short recovery breaks into the day

• protecting sleep routines

• reducing unnecessary commitments during acute phases

• using mindfulness, grounding, or sensory regulation strategies

Rest is a strategic investment in resilience.

D. Build supportive networks

Shame thrives in silence. Connection reduces it.

Talking to trusted colleagues, friends, family, or support groups can:

• normalise experiences

• reduce isolation

• provide practical tips

• create a sense of shared understanding

For neurodivergent staff, connecting with others who share similar experiences can be particularly validating.

E. Use strengths‑based strategies

Neurodivergent staff bring powerful strengths, creativity, hyperfocus, pattern recognition, deep empathy, strategic thinking. During menopause, these strengths can act as stabilisers.

Examples include:

• using hyperfocus intentionally for tasks that feel energising

• using pattern recognition to spot early signs of overwhelm

• using creativity to redesign workflows or routines

• using problem‑solving strengths to identify practical adjustments

Strengths don’t disappear during menopause, they simply need to be harnessed differently.

5. Why This Matters for the Sector

Local authorities are facing unprecedented workforce pressures: rising demand, shrinking budgets, recruitment challenges, and the loss of experienced staff. In this context, supporting menopausal and neurodivergent colleagues is not only the right thing to do, it is a strategic imperative. The DWP review emphasises that menopause can affect “confidence, well-being, and the ability to effectively do their jobs.” When combined with neurodivergence, the impact can be even more pronounced, affecting executive functioning, emotional regulation, sensory processing, and overall resilience.

The cost of inaction is high

Without support, organisations risk:

• losing experienced staff at the peak of their careers

• increased sickness absence and presenteeism

• reduced productivity and morale

• weakened leadership pipelines

• avoidable performance management issues

• a culture of silence and stigma

These are not abstract risks, they directly affect service delivery, team stability, and organisational reputation.

But the opportunity is equally significant

With the right culture, policies, and leadership, menopause does not have to be a career‑limiting stage. It can be a moment where organisations demonstrate:

• compassion (through understanding and empathy)

• flexibility (through adaptive working practices)

• inclusion (through neurodiversity‑affirming approaches)

• leadership maturity (through psychologically safe environments)

Supporting staff through menopause is a tangible expression of organisational values. It signals that people are valued not only for what they deliver, but for who they are and what they bring across the whole arc of their working lives.

A resilient workforce is an inclusive workforce

When local authorities invest in menopause support, they are investing in:

• retention

• wellbeing

• leadership continuity

• organisational memory

• service quality

• equity and fairness

This is not a wellbeing initiative, it is a workforce strategy.