Women's health and autism

Understanding how autism impacts women's health can reveal overlooked challenges that need more awareness and support, helping to ensure that autistic women receive the care and support they deserve. 

Below we explore some of the most common health issues for women, and how the experience for autistic women may vary. 

Autism and menopause

Menopause is a natural phase in a woman’s life, typically occurring between the ages of 45 and 55, when menstruation stops permanently. It is officially reached 12 months after a woman’s last period. Perimenopause, the transition phase leading up to menopause, can bring various symptoms as the body adjusts to changing hormone levels. These symptoms often include anxiety, mood swings, memory issues, hot flushes, and irregular periods. While these changes can be challenging for any woman, they can be particularly difficult for autistic individuals.

Research on the overlap of autism and menopause is limited, but existing studies suggest that autistic women may face additional difficulties during this life stage. The hormonal changes of menopause can intensify certain autistic traits and introduce new challenges, including:

• Increased sensory sensitivities: Hormonal fluctuations can heighten sensory sensitivities, making everyday environments more overwhelming.
• Emotional regulation difficulties: Menopause can intensify emotions, making it harder for autistic women to manage their feelings.
• Executive functioning challenges: Tasks such as planning, focusing, and multitasking may become even more difficult.
• Increased social interaction difficulties: Changes in mood and energy levels can affect social interactions and communication.
• Unpredictable bodily experiences: Varying symptoms can lead to stress and discomfort.

These additional challenges highlight the importance of individualised support and awareness for autistic women who are experiencing menopause.

Why menopause is particularly challenging for autistic women

There are many factors that make menopause more challenging for autistic women:

• Navigating healthcare: Autistic women may struggle with making appointments and communicating with healthcare providers due to executive functioning issues and social communication challenges. Many autistic women report negative experiences with healthcare practitioners, which can deter them from seeking help for menopause symptoms.
• Lack of social support: Some people struggle to establish and maintain friendships, leading to limited or no social support, which is crucial during menopause.
• Undiagnosed autism: Some women discover they’re autistic during menopause, as their traits become more pronounced. Understanding autism, and their specific needs can help them better navigate menopause. 

The importance of autism diagnosis before menopause

It can be beneficial for autistic women to receive an autism diagnosis before reaching menopause. This diagnosis can help them understand their unique experiences and develop personalised coping strategies. It can also help them be more self-compassionate and better understand why their experience of menopause might differ from that of neurotypical women.

Treatment and support options

The treatment for menopause symptoms is generally the same for both autistic and neurotypical women. The main medical treatment is hormone replacement therapy (HRT), which replenishes the hormones that decrease during menopause. However, not everyone can take HRT, such as those with breast cancer, and some may choose not to. Discussing HRT’s benefits and risks with a GP will help you decide if this is right for you.

Non-hormonal treatments for symptoms like hot flushes and low mood are also available. These options include lifestyle changes, such as regular exercise, a balanced diet, and stress reduction techniques, which can help manage symptoms. Additionally, certain medications can address specific symptoms like hot flushes or mood swings. Therapies, including cognitive behavioural therapy (CBT) and other forms of counselling, can provide support for emotional and psychological challenges.

It’s crucial for autistic women to have open and honest discussions with their healthcare providers about their symptoms and treatment preferences.

Strategies for autistic women navigating menopause

Making some simple changes can help autistic women manage menopause more effectively. Some strategies include:

• Sensory-friendly environment: Creating a comfortable, sensory-friendly space can reduce stress and sensory overload.
• Self-awareness and self-care: Practicing self-awareness and self-care can help manage physical and emotional well-being. This includes recognising and respecting your own limits and taking breaks when needed.
• Support networks: Building a support network of understanding friends, family, and healthcare providers can provide much-needed emotional and practical support.
• Clear communication: Developing strategies for clear and effective communication with healthcare providers can help address symptoms and concerns appropriately.

Pregnancy, childbirth and breastfeeding

Pregnancy and childbirth may be experienced differently by women with autism compared to the general population. Understanding these distinctions and being aware of available support can greatly improve the experience.

Autistic individuals often have heightened sensory sensitivities, which can become more intensified during pregnancy. Changes in the body and the many medical procedures involved in pregnancy and childbirth can feel overwhelming.

Managing sensory sensitivities during pregnancy and childbirth can be tough, but there are some simple steps you can take to make things easier. Start by letting your healthcare provider know about your sensory needs as early as possible so they can plan for any adjustments. When you head to the hospital, bring along items that help you feel comfortable, like noise-cancelling headphones, eye masks, or fidget toys. Don’t be afraid to ask for specific accommodations, such as dimming the lights, keeping noise levels down, or getting a private room to help you stay calm and comfortable.

Autistic people may have difficulties in communication and interaction with healthcare professionals, often feeling misunderstood or unable to express themselves clearly. Improving communication with your healthcare team can make a big difference. Start by creating a health profile that outlines your communication preferences, sensory sensitivities, and any specific support you need. Bring a support person with you to appointments—someone you trust who can help communicate your needs and offer support. Prepare for appointments by writing down any symptoms you're experiencing or questions you have ahead of time so you don’t forget to mention anything important. Also, consider using a voice memo app to record your appointments, ensuring you don’t miss any crucial information.

Pain perception

Pain perception can vary among autistic individuals. Differences in interception (the ability to sense internal states) can affect how pain is experienced and communicated.

Coping with pain during medical visits or procedures can be more manageable with the right strategies. Begin by working with your healthcare provider to create a pain management plan that suits your needs and covers various pain relief options. Make sure your healthcare team understands your pain tolerance and how you express pain so they can better support you. Don't be afraid to ask for control over certain procedures, like wiping off ultrasound gel yourself, to help reduce discomfort.

Managing anxiety and stress

Pregnancy and childbirth can cause significant anxiety and stress, especially for autistic individuals. Sensory overload, communication challenges, and fear of the unknown can increase these feelings.

Reducing anxiety and stress during pregnancy and childbirth is important for your wellbeing. Have open and honest discussions with your healthcare provider about the challenges you are experiencing and any anxieties you may have. This transparency allows them to understand your specific needs and provide better support tailored to you. Being prepared for different childbirth scenarios is also important; childbirth can be unpredictable, so keeping an open mind about various options can help you feel more in control and less anxious.

In addition to preparing mentally and emotionally, practising relaxation techniques can significantly reduce stress. Techniques such as mindfulness, deep breathing exercises, and yoga can help calm your mind and body. These practices are especially useful during labour when anxiety and stress levels are at their peak. Regular practice of these techniques before your due date can make them more effective when you need them most. Consider joining a prenatal yoga or meditation class, or use apps that guide you through relaxation exercises.

Breastfeeding challenges

Not all women choose to or can breastfeed. For those who do, it doesn’t always come naturally, and for some autistic women, it can be quite challenging. Sensory sensitivities and communication issues are often an obstacle. To make things easier, try creating a calm environment by breastfeeding in a quiet, dimly lit room to avoid sensory overload. Distractions like watching TV, listening to music, or reading can help keep you relaxed while breastfeeding. If direct contact is uncomfortable, consider using a nipple shield to reduce discomfort.

Good communication and support are also important. Ask for clear, written instructions or visuals on breastfeeding techniques to accompany verbal advice, making it easier to follow. Look for healthcare professionals who understand autism and can offer support that suits your needs. And remember, it’s okay to explore other options like expressing or formula feeding if breastfeeding becomes too stressful. The key is to find what works best for you and your baby, ensuring a positive feeding experience.

With the right support and understanding, many autistic women can have positive experiences during pregnancy, childbirth, and breastfeeding.