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,
and

Thanks 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 Summary
00:00 — Why this conversation matters
02:31 — Progress made… then undone
05:31 — Estrogen patch shortages & loss of choice (NZ)
09:01 — Symptoms returning on the same dose
12:01 — Collective patterns, individual gaslighting
15:31 — Neurodivergent risk & mental health impacts
18:31 — Estrogen as a brain hormone
22:01 — Why “just switch to gel” isn’t simple
25:31 — Sleep collapse as the red flag
28:31 — Admin, advocacy & exhaustion
32:57 — Suspected formulation change (mid-2025)
34:31 — Medsafe reporting & deflection
36:05 — User-error narratives & systemic gaslighting
37:42 — Absorption differences & dosing reality
39:58 — Brain fog, language loss & regression
41:25 — Estrogen receptor saturation explained
44:19 — Menopause is serious, not “just hot flushes”
45:37 — Generational harm & WHI fallout
47:03 — Surgical menopause & compounded harm
48:37 — Aging with quality of life
49:30 — Vaginal estrogen, bladder health & prolapse prevention
52:35 — Prolapse, gatekeeping & specialist care
54:38 — Medical training gaps (global)
55:10 — Vaginal estrogen & cancer-risk reassurance
56:07 — Solidarity over infighting
56:56 — Closing reflections, access & hope
Thank 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,
Sam
This 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 Breakdown
00:00 – 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 Takeaway
If 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,
Sam
If 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 plan
is 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 having
a toolkit you know to keep you regulated, regulate your nervous
system and then that that’s also creative to meet your needs. You don’t always
have to be doing something.
Sam Galloway

Further reading and resources
Allegra’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 Menopause
Author(s): Mx Rose Matthews , Christine A. Jenkins , Margaret Janse van Rensburg, Miranda J. Brady, Rachel L. Moseley, Julie M. Gamble-Turner
Publication date (Electronic, pub): 27 June 2025

This 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 Chapman

What natural treasures can you find where you live?
🍁🐚🌸

Further reading and resources
Allegra’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 Menopause
Author(s): Mx Rose Matthews , Christine A. Jenkins , Margaret Janse van Rensburg, Miranda J. Brady, Rachel L. Moseley, Julie M. Gamble-Turner
Publication date (Electronic, pub): 27 June 2025

Next 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