Periods Are More Challenging for ADHD Girls: Three Reasons Why and How to Help

May 5

Navigating through your daughter’s first period is a challenge for most parents. When you throw ADHD into the mix, it has the making of a perfect storm. So, preparing before it arrives and creating your survival plan will go a long way toward getting you through the bursts of lightening and thunder. Because, once you understand what is churning beneath the surface of her confusing behavior, you become empowered to ease the blustery times.

Why Are Periods More Challenging For Neurodivergent Girls?

1. Developmentally Delayed by 3 Years

Even as their bodies are statistically on pace in reproductive development, neurodivergent girls are 3 years delayed in social and emotional development. This is true even if they are very smart. This imbalance in maturity means that they may be missing the social skills and emotional regulation involved in coping with periods. And, let’s face it, periods are a lot to manage for anyone.

Think about it. Girls need age level social skills to handle the mortifying situation of a pad leaking during class. They need age level emotional regulation skills to talk themselves through heavy cramps each month. Instead, girls with ADHD and Autism often have the coping ability of a 7-9 year old when their first period arrives, making them more vulnerable to overwhelm than their peers. (Littman, E., 2015)

2. Periods Arrive at an Already Challenging Stage for Girls

It is not just an identity shift away from childhood toward adolescence that is churning below the surface. It is yet another thing to manage for an already taxed tween brain. This is happening just as demands at school and home are beginning to strain executive functioning capacities of organization and planning. And worse, this is exposing her developmental delays not just to her, but to her peers. The reality of being different is now becoming clear for her. And, no kid wants to be different at this age. Developmentally, they are seeking to be like the others in order to find belonging beyond just their parents. (Orben et all, 2020)

At the same time, girl social dynamics are becoming more indirect and complex, leaving many neurodivergent girls feeling lost or left out. Girls begin to peel off into groups and start making their own plans together. Neurodivergent girls who had relied on support of parents arranging playdates are left to their own abilities now to figure out how to be included. This is made all the more challenging for neurodivergent girls who often miss social cues and timing. While some can figure out how to operate in this new social complexity, many neurodivergent girls who are quiet are now ignored and those who are domineering are excluded. And, it is in this context of emotional upheaval that hormones begin surging and wreaking havoc in girls lives.

3. Sputtering Hormone Levels Affect Dompamine and Seratonin

During an already confusing time, her hormonal engines start sputtering into action. These hormones flood her brain with dopamine and serotonin in fits and spurts until, if she is lucky, she can begin to see some consistency and a pattern. In the meantime, she seems like she accidentally ingested three Red Bulls one day and is wild with focus and initiative and other days is glued to the floor sobbing. And, she is just as surprised and confused by it all as you are.

While most girls feel these unpredictable spikes, ADHD girls are especially in need of dopamine and serotonin to function. So, shifting levels of hormones make for shifting capacities. Dopamine is required for task initiation and managing boredom. So, spikes and drops of dopamine can allow girls to accomplish things on some days, but not others, making girls look deliberately oppositional or lazy. This also makes them feel even more misunderstood and is confusing even to themselves. And since serotonin helps with keeping a balanced mood, even when they are misunderstood, spikes and crashes in serotonin will exacerbate the emotional upheaval for a girl already struggling with emotional regulation.

How Parents Can Help

1. Teach Her Self Compassion

Self compassion is not something we innately know how to do, like eating is. It is something we learn from those being compassionate toward us. Your daughter picks up signals from you. She is paying attention whether you think she is annoying or if you see how hard she is trying. And what you think about her will be what she thinks about herself now and 20 years from now. So, this is a pivotal opportunity to teach her how to have self kindness and self respect, especially when times are hard. And since she will be dealing with periods every month for 40 years, she will need to develop the skill to thrive.

2. Start Early, Talk Often, and Normalize It

Neurodivergent girls often need to know what to expect to feel in control and calmer. So, it is important to begin talks well before her first period arrives. While some parents might prefer to wait for her to initiate the conversation, she may never initiate and you both could be blindsided. In addition, many neurodivergent girls have less sensitive interoception (the ability to interpet our body’s signals to us that tell us we are hungry, etc.) and miss the signals the body may be giving that it is changing. So, let her know exactly what she might expect to feel (tenderness in breasts and lower abdomen, for example).

Since girls with ADHD and Autism often need to learn in smaller chunks in order to better process the information, talk often. And as neurodivergent girls are likely to be more anxious about the idea of blood or pain, talk in a light, casual tone and normalize the experience.

3. Be Explicit and Make a Step-by-Step Plan

As neurodivergent girls often miss implied or indirect information giving exact steps to take will help her feel more in control. More, when they are embarrassed or scared, their brains narrow in focus making them less able to problem solve a leaking pad situation. So, the more they have a plan memorized and even laminated the better.

Explicit means telling her exactly what to do in different situations, step by step. More, neurodivergent girls remember better if they have a narrative or context on which to hook the information in their brain. So, play acting out the scenarios is an excellent way to help them remember. And bonus, she is bonding with you while she learns. Make it overly dramatic and funny so she can’t forget it and it will help overcome her fear of the unknown. Just make sure she knows she should not publicly be overly dramatic if a leak happens in real life. Playact one normal scene at the end.

Take the example of leaking during class. Let her know she could ask the teacher to be excused to the restroom. If she has no supplies and there are none in the restroom, let her know that the school nurse or eventually a friend may have something available. Have her keep extra clothes in her locker in case the leak requires a change out. And then laminate the plan so she can keep copies in her bag and period kit.

Conclusion

Eventually, routines around periods will become a little more automatic, but it will take your support to make that happen. Remembering that periods are much harder for neurodivergent girls and keeping your own expectations fair about what to expect from her will help her gain confidence for the many decades of her life she will be experiencing them.