Vital Periods of life: Woman with autism: preparing for and managing periods

BY ANNA COUGHLAN

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Ever felt embarrassed about your period?

When talking about a woman's period, some underlying thoughts might be unnatural, embarrassing, dirty, or terrifying. Sure, getting your period is annoying, but it is a natural part of life and occurs for all fertile women, so why is it that you feel you’re not allowed to talk about it. Drawing from female stereotypes, “femininity” is associated with cleanliness and beauty, which directly opposes the characteristics of a period. People view menstruation with hostility, leading many women to internalize stereotypes and feel negatively around menstruation. The implications of this can mean fewer women receive the needed information surrounding periods and often have misconceptions that affect both mental and physical health. This is exacerbated for neurodiverse women with autism since limited research looks to explore experiences of neurodiverse women encountering menstruation, making it hard to know what to expect. Worryingly, what research that does exist suggests specific changes experienced for women with autism around menstruation and are likely not receiving the appropriate gynecological care. Consequently, talking about periods not only breaks down stereotypes, but can have great healthcare implications, especially for neurodiverse groups.

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Neurodiverse females’ experiences with menstruation

If you have autism and suffer extreme discomfort during your period, you are not alone. Many women with autism tend to report more painful and heavy periods. One study observing residential homes found 92% of women surveyed with autism fulfilled criteria of severe PMS (premenstrual syndrome), compared to 11% for non-autistic women3. Much of current research, though scarce, suggests higher rates of PMS and PMDD occur for women with autism without known explanations. Additionally, for someone with autism, menstruation can be a time of greater stress as compared to neurotypical females. There are many sensory and procedural changes that come with menstruation, and many people report heightened autistic traits during their periods. This included heightened sensitivities to stimuli and reported difficulties regulating emotions and behavior with mood swings made harder to manage. The culmination of these difficulties can lead to greater anxiety around periods and can result in more or worse meltdowns and self-injurious behaviour in a select population. While no woman is identical with their experiences, periods in general are a large transition and should be talked about more so neurodiverse women are not caught off guard.

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Methods to managing periods

Concerns	Possible solutions	Recommendations
Mild-moderate pain	Anti-inflammatory pain medications like acetaminophen and naproxen. Consult with a doctor if mixing with other medications. Aerobic exercise9 Heating pads on abdomen or lower back, or warm baths.	Do not take medications on an empty stomach, it can make you feel sick. Take pain medications in advance of period.
Severe pain	Consult a doctor about stronger treatments: birth control, SSRIs (Selective Serotnin Reuptake Inhibitors- mood stabilizer meds), menopausal surgery... Benefits and risks exist for every treatment, take time with the doctor to consider each carefully.	Don’t always assume bad period pain is normal. It can be a sign of medical conditions like endometriosis.
​Mood	Understand why you get mood swings, research the biology behind it. Exercise Supplements: increased calcium and vitamin B6 have been seen to improve mood and PMS symptoms10. Consult with a doctor.	Personal advice: treat yourself to what you like and not what you don’t.
​Irritability	Try different sanitary products if one is uncomfortable, including pads and tampons, menstrual cups, period discs and underwear. If possible, limit exposure to stimuli you are sensitive to.	Experiment to find what works best for you. If nothing works, consult a doctor to for stronger treatments against period symptoms.
Anxiety	Research the female-specific biology and the menstrual cycle to understand bodily changes. Track period and make plans on how to deal with your period Learning/practicing what to do in advance of menses is helpful, like how to use and dispose of sanitary items.	Knowing what to expect and why reduces anxiety. If the anxiety is overbearing, consider consulting a psychological professional.