Autistic women report more severe menopausal symptoms in largest study to date

Autistic people consistently experience more severe menopausal symptoms than non-autistic people, and those symptoms are linked to poorer wellbeing and quality of life, according to a new study from Bournemouth University published in the journal Autism in Adulthood.

The study, led by PhD student Ms Eunhee Kim, is the largest ever to compare self-reported menopause symptoms between autistic and non-autistic people. Just over 900 participants took part, most of them cisgender women, and the researchers monitored their symptoms and wellbeing over five weeks.

The findings revealed stark health inequalities. Not only did autistic participants show more severe menopausal symptoms than non-autistic participants across several weeks of the study, but they also had greater anxiety and depression and lower quality of life, all of which were linked to the severity of their menopause symptoms.

Physical health differences were also pronounced. Autistic participants were almost twice as likely to report having one or more cardiovascular conditions, such as heart disease, than non-autistic participants, and more than four times as likely to report a musculoskeletal condition, such as hypermobility. Many autistic participants also reported multiple serious and chronic health conditions.

“The findings tell us that autistic people often have complex health challenges during menopause,” said Ms Kim. “This is important because menopause can worsen pre-existing mental and physical health conditions. This is one reason why autistic people, who are more likely to have poorer health to begin with, might have an especially difficult time during menopause.”

Beyond documenting the scale of these inequalities, the study is one of the first to explore why autistic people might have a harder time during menopause. The researchers found that feeling out of control, and struggling to understand the menopausal changes happening to the body and mind, appeared to predict how severe menopause symptoms were.

That sense of confusion echoes what co-authors Professor Julie Gamble-Turner and Dr Rachel Moseley, Ms Kim’s PhD supervisors at Bournemouth University, have heard in their previous work. “Autistic people have often told us ‘I thought I was going mad’, or ‘I thought I had a disease’, because their menopausal experiences don’t resemble what they’ve read or heard about in other people,” said Professor Gamble-Turner. “Helping people feel less frightened, confused and out of control – for instance, by giving them information tailored for autistic people about what to expect during menopause – means we are better able to help them.”

The research was motivated by the need to explore autistic experiences of menopause on a larger scale. “Previous work by my supervisors at Bournemouth University has told us that autistic people can experience menopause at a time of crisis,” Ms Kim explained. “We know that menopause can be challenging for non-autistic people – the symptoms force one in ten women to leave the workforce. Autistic people can already struggle with memory, planning, managing emotions and sensory sensitivities, and many try hard to fit in and mask their differences while struggling with these things, so menopause could worsen things that are already difficult for them.”

The findings also carry implications for healthcare professionals. “Autistic people often tell us that they struggle to access help during menopause,” said Dr Moseley. “Sometimes, doctors do not believe how much they are struggling, perhaps because autistic people do not necessarily show their distress in the way non-autistic people expect. Autistic people can be in crisis yet sound quite calm and logical. It’s so important to believe any person who tells you they are struggling.”

The PhD research was funded by Henpicked/Menopause in the Workplace, an organisation that provides evidence-based menopause information and support and helps employers create menopause-friendly workplaces. CEO Ms Deborah Garlick said the research helps explain why everyone’s experience of menopause is different, and that she hopes it will make a real difference to people’s lives through greater understanding and more tailored support. Because the study relied on self-reported symptoms and health conditions over a five-week monitoring period, the authors’ findings describe associations and reported experiences rather than proven causal mechanisms, but the scale of the sample and the consistency of the symptom differences across several weeks make it an unusually detailed picture of how autistic people experience the menopause transition.

Subject of Research: Menopause experiences and symptom severity in autistic compared with non-autistic people

Article Title: Autistic women experience more severe menopausal symptoms, study confirms

Article References: Autistic women experience more severe menopausal symptoms, study confirms. Original publication (Bibliographic details unavailable.)

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Keywords: autism, menopause, health inequalities, mental health, quality of life, cardiovascular disease, musculoskeletal conditions, wellbeing, survey study, women's health, Autistic, women