The Impact of Hypermobility in Teenage Girls and Women: Nervous System, Hormones, Digestion and School Avoidance
Hypermobility is often described as “being double-jointed” or “extra flexible,” but for many teenage girls and women it is far more than a physical trait. For those living with Hypermobility Spectrum Disorder or Hypermobile Ehlers-Danlos Syndrome, hypermobility can affect almost every system in the body — from digestion and hormones to energy levels, mood, and the nervous system.
Increasingly, clinicians are also recognising a strong overlap between hypermobility and neurodivergence, particularly Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder. This connection helps explain why many young people experience symptoms that feel “whole body,” fluctuating, and difficult to fit into one medical category.
For teenage girls especially, these symptoms often emerge or intensify around puberty, a time of significant hormonal and neurological change.
Hypermobility and the Nervous System
The nervous system plays a central role in how hypermobility is experienced.
Many individuals with hypermobility show signs of autonomic nervous system dysregulation, including conditions such as Postural Orthostatic Tachycardia Syndrome. This can affect heart rate, blood pressure, temperature regulation, digestion, and energy levels.
When the nervous system is in a heightened state (fight, flight, freeze or shutdown), the body may experience:
Chronic fatigue or sudden energy crashes
Dizziness or “brain fog”
Heightened sensory sensitivity
Difficulty concentrating
Anxiety or overwhelm
Feeling “wired but tired”
For neurodivergent girls, especially those who are autistic or ADHD, sensory processing differences can amplify these responses. School environments – with noise, social demands, bright lighting, and pressure to perform – can become overwhelming for a dysregulated nervous system.
Digestive System and Hypermobility
The digestive system is rich in connective tissue and is highly influenced by autonomic nervous system function.
Common digestive experiences in hypermobility include:
Bloating and abdominal pain
Constipation or diarrhoea
Nausea or reflux
Early fullness or reduced appetite
Food sensitivities
Fluctuating tolerance to different foods
This is partly due to altered gut motility and also the close relationship between the gut and nervous system.
When the body is in a stress response, digestion naturally slows or becomes erratic. Over time, this can create cycles of discomfort that further increase nervous system load – a loop that can feel difficult to break.
For some individuals, these symptoms may overlap with patterns seen in Mast Cell Activation Syndrome (MCAS), adding another layer of sensitivity and reactivity.
Hormones, Puberty and Menstrual Cycles
Hormonal changes can significantly influence hypermobility symptoms.
Many teenage girls notice that symptoms intensify around puberty, and later fluctuate across the menstrual cycle. Oestrogen influences connective tissue, pain sensitivity, and autonomic nervous system regulation, which may explain why symptoms often worsen:
Before menstruation
Around ovulation
During hormonal fluctuations in puberty
During perimenstrual phases later in life
In addition, many girls and women with hypermobility experience heavier and more painful periods. This can be partly explained by differences in connective tissue integrity, particularly collagen. Collagen plays a key role in supporting blood vessel structure and uterine tissue stability. When connective tissue is more lax or fragile, the uterine lining may shed more heavily, and blood vessels may be less structurally supported, potentially contributing to increased bleeding and cramping.
Dysautonomia, heightened pain sensitivity, and inflammatory responses may also amplify menstrual pain, making periods feel more intense both physically and neurologically.
For those with hypermobility, this may present as:
Increased joint pain or instability
Fatigue and energy crashes
Headaches or migraines
Digestive flares
Emotional sensitivity or overwhelm
Increased anxiety or shutdown responses
Heavier, more painful menstrual bleeding
These cyclical changes can make symptoms feel unpredictable, especially for young people still learning to understand their bodies.
Chronic Fatigue and Energy Fluctuations
Chronic fatigue is one of the most disabling aspects of hypermobility for many women and teenagers.
This is often not simply “tiredness,” but a complex interaction between:
Autonomic nervous system load
Musculoskeletal effort required for joint stability
Digestive energy demands
Hormonal fluctuations
Sleep disruption
Sensory and cognitive overload
Many describe a pattern of “boom and bust” energy – periods of relative functioning followed by significant crashes.
For neurodivergent individuals, especially those with ADHD, this can be intensified by masking, executive function demands, and difficulty pacing activity.
School Avoidance and Hypermobility
School avoidance is a growing concern among hypermobile and neurodivergent young people.
This is often misunderstood as anxiety or disengagement, but in many cases it reflects genuine physical and neurological overwhelm.
Contributing factors may include:
Chronic pain or fatigue
Sensory overload in classrooms
Difficulty with prolonged sitting or standing
Brain fog affecting concentration
Anxiety from unpredictable symptoms
Gastrointestinal discomfort
Social exhaustion and masking
During heavier and more painful menstrual cycles, some teenage girls may feel unable to attend school due to the intensity of symptoms, particularly when appropriate accommodations (such as rest spaces, flexible attendance, or menstrual support) are not available
For autistic and ADHD students, the combination of sensory demands, social complexity, and executive functioning requirements can become overwhelming when layered on top of a physically dysregulated body.
Avoidance is not refusal; it is a nervous system protection response.
The Overlap Between Hypermobility, Autism and ADHD
There is increasing recognition of overlap between hypermobility and neurodivergence, particularly autism and ADHD.
This may be linked to differences in:
Connective tissue development
Interoception (internal body awareness)
Sensory processing
Nervous system regulation
Dopamine and arousal systems
For many girls, this combination can lead to late diagnosis, misdiagnosis, or being described as “anxious,” “sensitive,” or “dramatic,” when in reality their body is processing information and stress differently.
Understanding this overlap can be deeply validating and can shift the narrative from “something is wrong” to “my system needs different support.”
Holistic Support for Hypermobility
There is no single approach that works for everyone, but many people benefit from a combination of nervous system support, gentle movement, and sensory-aware strategies.
The goal is not to “push through,” but to support regulation, stability, and energy conservation.
Nervous System Regulation
Supporting the autonomic nervous system can be foundational:
Breathwork (gentle, non-forced)
Yoga nidra or guided rest
Time in low-stimulation environments
Predictable routines
Sensory regulation tools (ear defenders, soft lighting, weighted items)
Safe co-regulation with trusted people
Gentle and Supportive Movement
Movement should support stability, not strain it:
Walking at a comfortable pace
Swimming or water-based movement
Clinical Pilates (hypermobility-informed)
Gentle strength training for joint support
Restorative yoga
Short, frequent movement breaks rather than long sessions
Digestive and Energy Support
Regular, predictable meals
Hydration and electrolyte balance
Identifying individual food triggers without extreme restriction
Supporting constipation or motility issues with professional guidance
Rest before and after exertion
Hormonal and Cycle Awareness
Tracking symptoms across the menstrual cycle can help identify patterns and reduce confusion.
Some find support in:
Adjusting activity levels across the cycle
Planning rest during known flare phases
Gentle heat for menstrual discomfort
Nutritional support during luteal phases
School and Learning Support
For young people experiencing school avoidance, supportive adjustments can make a significant difference:
Reduced timetables
Rest breaks during the day
Access to quiet spaces
Flexible deadlines
Hybrid or home-based learning options
Sensory accommodations
Understanding staff who recognise fluctuating capacity
Importantly, support should focus on accessibility, not pressure.
A Neurodiversity-Affirming Perspective
From a neurodiversity-affirming lens, hypermobility is not simply a set of symptoms to be “managed,” but part of a broader variation in how bodies and nervous systems function.
When hypermobility coexists with autism or ADHD, it can create a system that is more sensitive, more reactive, and more easily overwhelmed, but also often more perceptive, intuitive, and deeply responsive to environment.
The goal of support is not normalisation, but sustainability.
Final Thoughts
For many teenage girls and women, understanding hypermobility can be a turning point. Symptoms that once felt confusing or isolating begin to make sense when viewed through the interconnected systems of the body, nervous system, hormones, digestion, and sensory processing.
With the right support, the focus shifts from pushing through to working with the body’s needs, building stability, and creating environments that allow regulation and recovery.
And most importantly, as always mentioned in our blog posts, it becomes possible to move from self-blame to understanding.
