Menopause is a major life transition in which the menstrual cycle ceases, and pregnancy is no longer possible.
On average, it occurs around age 51, according to the American College of Obstetricians & Gynecologists, although perimenopausal changes can begin in one’s 30s or 40s.
Common symptoms of menopause can include, but are not limited to, hot flashes, irregular periods, moodiness, night sweats, and vaginal dryness.
However, research indicates that for people with autism, a neurodevelopmental condition that affects how people communicate, behave, and interact with others, menopause may feel very different and be more challenging than it is for people without this condition.
A new study published in the journal Autism in Adulthood, looked at how autistic and neurotypical individuals think and feel about menopause, and how their experiences might affect their menopause symptoms, mental health, and quality of life.
The researchers wanted to find out if the way individuals understand and feel about menopause — referred to as “menopause representations” in the study — could help explain why autistic people often report more severe symptoms and poorer well-being during this time.
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The study involved 901 participants aged 40 to 60 years.
Among them, 476 were autistic, including those formally diagnosed and those self-identifying as autistic, and 425 were neurotypical.
All participants were either going through menopause (perimenopausal) or had finished menopause (postmenopausal). During the study, they answered online questionnaires once a week for 5 weeks.
The researchers used several self-report questionnaires to measure different aspects:
The autistic advisory panel, which included two of the authors as well as an anonymous autistic advisor, helped review the study materials to make sure they were clear and suitable for autistic participants.
The researchers also collected information about participants’ age, education, employment, and health behaviors to control for factors that might affect the results.
Data were analyzed using statistical methods to compare the two groups over time and to see if menopause representations explained differences in symptoms and well-being.
The study found that autistic participants consistently reported more severe menopause symptoms than non-autistic participants throughout the five weeks.
They also showed higher levels of depression and anxiety and reported lower quality of life.
Among the different types of menopause symptoms, psychological symptoms — such as mood changes or emotional distress — were especially more severe in autistic people, both during and after menopause.
When looking at menopause representations, autistic people felt less in control of their menopause symptoms and had a less clear understanding of what was happening to their bodies.
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These experiences could help explain why autistic participants experienced worse menopause symptoms and poorer mental health and quality of life, according to the authors.
Statistical analyses found that lower perceived control and a weaker sense of understanding menopause — known as “coherence” — partly explained the link between autism and more severe symptoms and poorer mental health.
The researchers found that these links were consistent over the 5 weeks and were not fully explained by other factors like age or lifestyle.
The study also supported earlier reports that autistic people often feel unprepared during menopause, which might make the experience harder.
The researchers noted that issues common in autism, such as difficulty with change, sensory sensitivities, and challenges in recognizing internal body signals, could add to feeling out of control and confused about their symptoms.
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Overall, this study highlights that autistic people may have unique challenges during menopause, especially related to how they think and feel about this life stage, which can affect their symptoms and overall health.
The findings suggest that giving autistic individuals better information and support about menopause might help improve their experiences and well-being.
Linda Dolin, MD, Medical Director of The Sylvia Brafman Mental Health Center, who was involved in the study, told Medical News Today that women with autism should understand that they don’t have to simply endure their menopause symptoms.
Dolin advised:
“[B]y tracking (i.e., documenting) changes in your sleep patterns, moods, sensory sensitivities, and energy levels, you may be able to recognize patterns. Once you’ve documented your findings, sharing them with your healthcare provider could provide an opportunity for a much more productive discussion regarding treatments and supports.”
Dolin added that individuals and their doctors can then come up with a menopause care plan based on individual needs.
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“For example, creating predictable routines and using sensory-friendly environments in conjunction with either medical or mental health support, etc., can greatly ease the transition into menopause,” she said.
Shannon Franklin, PsyD, a licensed psychologist at Element Q Healing, who was likewise not involved in the research, agreed with Dolin, noting that making small modifications in one’s daily routine may also help people better manage their symptoms.
“Finding healthcare providers who understand both menopause and autism is equally as important,” Franklin added.
“As women, they need to have an opportunity to explain what will affect their well-being and ask about treatment options and support,” she told us. “[A woman] does not want to try to adapt to all of the changes in her life; she wants to learn ways to manage them on her own terms.”
With support and understanding, autistic women can learn to manage their menopause symptoms in a way that works for them.
