Hot and cold at the same time

The 3am wake-up starts with heat. Not gradually. Just suddenly there, whole body wrong, damp. Then freezing, within seconds. Both at once.

Normal people call this a hot flash. Normal people find it unpleasant.

I am not a normal person.

I am sensory-sensitive. Certain sounds only I seem to hear. The specific wrongness of synthetic fabric against my skin in August. I have worked around all of it for decades, with varying success.

What nobody told me about perimenopause (what I found out from Reddit, because my doctor called it stress) is that it can start at 35. Women with ADHD often hit it a decade earlier than expected. Ten years earlier. Nobody tells you that. Estrogen affects how the dopamine system functions, and when estrogen drops, the dopamine system feels it. And for someone whose nervous system was already running at capacity, the floor drops.

The sensory part is what I wasn’t prepared for.

Hot flashes are a sudden sensory event. They arrive without warning. Your body floods with something that reads as threat even when it isn’t. If you’re already someone who responds hard to sudden sensory changes, to unexpected heat, to anything that hits the nervous system without consent, then the flash isn’t just uncomfortable. It’s an alarm your body can’t turn off.

I’d lie awake with cold sweats soaking the sheets and my nervous system at full alert. Skin sensitivity amplified. The fabric of the pillowcase wrong. Too hot and then too cold, both at once, and my brain unable to file either sensation as “manageable, move on.”

None of which my doctor thought was relevant. I was told I was anxious. Stressed. Too young for this.

I was 41. Which is not, it turns out, too young.

The things that helped I found by reading what other women described, not from anything a professional offered. Some of those women were 35, 36, 37, already in this and being dismissed at every appointment because their ages didn’t fit the expected timeline. Their medication had stopped working. Their PMDD had turned the second half of every cycle into a different country.

None of this is a prescription. I’m not on the other side of it offering a map. I’m writing this because I spent two years thinking something was specifically wrong with me, and what was actually wrong was that nobody had explained the intersection.

“Hot flashes and mood changes” does not cover what happens when those hot flashes land on a nervous system that was already processing everything at maximum. It doesn’t cover the temperature dysregulation that leaves you unable to identify whether you’re warm or cold. The sensory overwhelm amplifies everything else (the emotional dysregulation, the executive dysfunction) because your nervous system is already using all available processing power just to get through the night.

You are not imagining it. You are not uniquely broken. The intersection of AuDHD and perimenopause is real, it’s documented, and a lot of us found that out from each other long before any doctor brought it up.

That part doesn’t make the 3am wake-ups easier. But it’s something.