Do Autistic Menstruators Experience More Discomfort Throughout Their Cycle?

If you menstruate, you’re probably no stranger to period pain. Menstrual discomfort is often dismissed, but knowing when and how to talk to a doctor about period pain is critical to your well-being.

While everyone’s lived experience is different, menstruators who fall on the autistic spectrum may experience more severe discomfort during their period.  Research on autism spectrum disorder has largely been focused on males, leading to a lack of quality data on its manifestation in women. Consequently, there is minimal knowledge about how menstrual cycles play out for autistic menstruators.

However, in recent years, a few studies on autistic people and menstruation found that they may experience heightened discomfort during their menstrual cycles. In this article, we dive into some of the menstrual cycle problems that may manifest in individuals with autism.

Premenstrual Dysphoric Disorder, or PMDD, is one of the common comorbidities experienced by autistic individuals. Existing problems, such as depression, anxiety, brain fog, etc., are reported to worsen in this phase, and autistic menstruators are predisposed to these issues due to cognitive, social, and emotional difficulties.

In fact, studies show PMDD affects up to 92% of autistic menstruators. Any change in routine, particularly an unexpected change, is known to exacerbate the anxiety of autistic adults. So, if they unexpectedly get their period, they may feel overwhelmed. Changes in behaviour, on account of hormonal changes, can be more pronounced in autistic menstruators, leading to higher emotional dysregulation.

This can make it difficult for them to identify their emotions accurately, self-regulate, and return to their baseline. If left unchecked, it can result in meltdowns, shutdowns, and burnout.

Menstruation in autistic women may result in them experiencing additional sensory difficulties. This could be on account of:

• The sensation experienced during vaginal bleeding.
• Using sanitary pads, tampons, or menstrual cups. The varying smells and textures of the product may lead to additional challenges and contribute to poor personal hygiene.
• Experiencing nausea.

Autistic individuals commonly face challenges with executive function, impacting various aspects such as working memory, task initiation, planning, organisational skills, and time management. Consequently, those with autism who menstruate may encounter difficulties in recalling coping strategies during periods.

Period problems in autistic children may manifest in them finding it more challenging to learn how to put on a sanitary pad or insert a tampon. Others might struggle to remember when to change their sanitary products.

Even though period cramps are a common symptom experienced by most menstruators, autistic menstruators show a greater prevalence of period pain.  There is evidence indicating that PCOS and endometriosis are frequently occurring comorbidities in autistic individuals who menstruate.

Moreover, studies show that most autistic individuals exhibit hypersensitivity to pain and increased interoception (being aware of sensations originating within the body). This explains why period cramps may be more painful, though further research is required.

Medically reviewed by:
Dr Shruti Mane, Obstetrician and Gynaecologist