A woman in her 40s or 50s may be coping with perimenopause while also dealing with ADHD, whether diagnosed years ago or only now becoming obvious. In the same working day, memory lapses, sensory overload, lost focus and performance anxiety can make ordinary tasks look harder than they are. Those problems are often read as underperformance, when the real problem is an employee who is under-supported and trying to manage two overlapping conditions at once.
Why employers miss it
The overlap matters because menopause and ADHD share surface-level symptoms that are easy to misread. Concentration problems, executive dysfunction, emotional volatility, sleep disruption and fatigue can be blamed on stress, workload or attitude, when they may be interacting with hormonal change and neurodivergence at the same time.
If managers treat each symptom in isolation, they can miss the pattern and assume capability is dropping, rather than recognising that the right adjustment can change day-to-day functioning quickly.
What the evidence says
NHS England published “Supporting our NHS people through menopause: guidance for line managers and colleagues” on 1 November 2022, putting line managers at the centre of practical support. NHS Employers followed with “Menopause and the workplace” on 16 June 2026, focusing on how menopause affects people at work and what employers can do about it.
Acas advises employers to have early and regular follow-up conversations with workers to understand their needs and identify adjustments. That standard matters even more when ADHD is also in the picture, because a one-off conversation will not capture fluctuating symptoms, masked coping strategies or the way workload can amplify difficulties.
On 31 July 2025, King’s College London published new research from its Institute of Psychiatry, Psychology and Neuroscience finding menopausal difficulties increase in line with the severity of ADHD symptoms. The research also found differences between people with and without an ADHD diagnosis, and between those on and off medication.
The scale of the problem at work
The British Menopause Society’s clinician tool put the number of employed women in the UK at almost 5.5 million by the end of 2024.
A 2022 Fawcett Society and Channel 4 survey found one in 10 women had left work because of menopause symptoms. The survey revealed women were experiencing “unnecessary misery”. It was the largest representative survey of menopausal women conducted in the UK.
Acas research cited by Didlaw in November 2022 found one in three employers did not feel well equipped to support menopausal women. Brightmine later put the share of UK employers with a menopause policy at 45%, with pressure from the Employment Rights Bill pushing toward mandatory action plans by 2027.
What employers should change now
The answer is not a generic wellbeing campaign. It is a management system that assumes symptoms may shift, overlap and flare under pressure. Employers should build support around private conversations, flexible adjustments and occupational health, not around asking staff to disclose more than they want or to prove they are struggling.
Start with manager training. Line managers need to know that menopause and ADHD can affect planning, recall, focus, emotional regulation and tolerance of noise or interruptions. They also need to know that employees may not have a neat explanation for what is happening, or may not want to disclose an ADHD diagnosis at all.
Then make the adjustment process routine. Acas’s advice on early and regular follow-up conversations should be the baseline, not the exception. A good meeting is brief, private and specific: what tasks are hardest right now, what times of day are worse, what has already helped, and when will you review it again?
Practical changes often make the biggest difference:
- flexible start and finish times, especially for staff dealing with poor sleep or morning fog
- deadline review and workload triage when executive function is stretched
- written follow-ups after meetings, with clear action points and owners
- meeting agendas in advance, fewer back-to-back meetings and the option to keep cameras off when appropriate
- quieter workspaces, noise reduction or hybrid working where sensory overload is a problem
- reduced pressure for instant responses on email or chat when concentration is fragmented
- occupational health referral when symptoms are affecting attendance, confidence or safety
A symptom-aware policy should make them easier to ask for and easier to approve, without forcing staff to repeat their story to every new manager.
How to build a joined-up policy
The strongest organisations do not split menopause and ADHD into separate silos. They write policies that allow for overlapping conditions, train managers to spot the pattern and route employees to occupational health before problems harden into absence or exit.
NHS England, NHS Employers, Acas, the Equality and Human Rights Commission, the British Menopause Society, the Society of Occupational Medicine and the British Medical Association have all moved menopause into workplace policy. The Women and Equalities Committee has also kept pressure on employers and government to treat this as a serious employment issue.
For staff with severe or persistent symptoms, or where concentration, mood or sleep are breaking down, seeing a GP is the right next step. Employers should not try to diagnose; they should remove avoidable barriers and signpost properly.