Menopause and autism are important to understand together as many autistic people reach menopause unprepared for the changes they experience. Here, you’ll learn about what menopause is, the particular challenges autistic people may face during menopause, and what you can do if you are struggling. We have listed options for support at the end of this page.

Menopause is a transitional period and it will end. If you are autistic and struggling with menopause, remember you won’t feel like this forever.  You might not feel the same way in your body and mind as you did before menopause, but many of the challenging symptoms will stop, and some people say they feel better after menopause than they did before.

A note on language: not everyone who experiences menopause is a woman. We know autistic people are more likely to be gender-diverse than non-autistic people and live as a different gender than the one assigned to them at birth, so our language reflects this.

Key facts

  • Neurodivergent features can be increased by menopause; menopause symptoms can be increased by neurodivergence. If someone is neurodivergent they may notice their neurodivergent traits can intensify during menopause. If someone is neurodivergent they may be more likely to have a more intense experience of some menopause symptoms than a neurotypical person.
  • Autistic people may have a more challenging time than non-autistic people during menopause: there is no roadmap for menopause and symptoms can vary significantly between individuals. Menopause happens at a time of change and transition in many people’s lives. For example, they may be experiencing changes in their support network as their parents age. It can feel like a “perfect storm” of challenges.¹  
  • Menopause does not last forever. It is a process and it will end. If you are struggling, you won’t always feel how you feel right now. Be kind to yourself, and explore your options for what may help.
  • We don’t know enough about autism and menopause. Researchers and autistic people are working to change this.

About menopause

Menopause is a process where an individual’s periods stop due to lower hormone levels. Menopause usually happens between the ages of 45-55 but can occur earlier or later. Anyone with ovaries can experience menopause. During menopause, a lot of change happens within the body: there is a change to ovary function and hormone levels, and the individual's periods will stop.

During menopause, the body produces less of the hormones oestrogen and progesterone, and more luteinizing hormone and follicle-stimulating hormone. These can cause many symptoms, some of which relate to the brain and its functioning.

There are four stages to the menopause:

  • Pre-menopause - when someone has periods and menopausal symptoms have not started.
  • Peri-menopause - when the person is experiencing menopausal symptoms, but still having periods, although they are more irregular.
  • Reaching or passing menopause - when the person has not had a period for 12 months in a row, although they're still having menopause symptoms.
  • Post-menopause - the time after passing menopause, when periods have stopped. Menopausal symptoms may continue for some years before stabilising.

Menopause can affect your emotions, thought process, sensory experiences and mental health. Menopause symptoms include: hot flushes and night sweats, mood changes, low energy, insomnia, weight gain, headache, brain fog or difficulty concentrating.

No two people experiencing menopause will have exactly the same set of symptoms. Researchers still don’t understand why people’s experiences can be so different. We know pre-existing mental and physical health conditions can lead to worse experiences of menopause.⁴,⁵,⁶.

In the general population, researchers have found:

  • 20% of people experience few symptoms⁷
  • 80% experience hot flushes/night sweats⁷
  • 77% of people experience one or more symptoms they describe as ‘very difficult’⁶
  • 69% say they experience difficulties with anxiety or depression due to menopause⁶

I had a hard time coming to terms with early menopause. I know now that I should have been referred to a specialist clinic for Premature Ovarian Insufficiency (POI) but I was offered no support or information, other than what I researched and put in place for myself. I wasn’t offered HRT until I was post-menopause when most of my symptoms had stopped. My menopause journey was bookended by my neurodivergent diagnoses, autism at forty-one and ADHD at forty-nine. My forties were the most challenging time since adolescence but I am facing my fifties feeling like I know myself authentically for the first time.’

Karen-Anne, Insight Group Member

Autism and menopause

Neurodivergent people can be particularly sensitive to hormone fluctuations. Someone's experience of periods and previous reproductive transitions (puberty, pregnancy) affects their experience of menopause. We know autistic people are more likely to have challenging periods, puberties and pregnancies compared to non-autistic people.⁸,⁹ For example, Pre-Menstrual Dysphoric Disorder (PMDD) is more common in autistic people, where someone’s mental health is severely affected by their hormone cycle.

Autism has always been underdiagnosed in women, girls and people with ovaries. Many autistic people will go into menopause without realising they are autistic². They may have struggled without support, may have been misdiagnosed with other conditions, and/or carry trauma without having the framework to understand themselves by knowing they are autistic.

Past trauma can affect how someone experiences menopause: individuals with historic trauma might enter menopause slightly earlier and experience more severe symptoms.¹⁰,¹¹ We do not know if autistic people enter menopause earlier than non-autistic people, but sadly, many autistic people have experienced trauma, and some appear to have a difficult time during menopause.

Menopause might be more challenging for autistic people due to its unpredictable nature, as some autistic people experience anxiety related to uncertainty. There is no roadmap for menopause and someone’s body can change in unexpected ways.

Menopause can change the way someone experiences their neurodivergence. For example, someone might have been managing in their career, but during menopause, someone may find it especially difficult to focus, or perhaps their sensory differences become more overwhelming. Early research suggests autistic people self-report menopause symptoms as more severe than non-autistic people.¹²

Autistic people often have poorer education over health and reproduction. Many have smaller social circles and may miss out on friendships. Often, individuals learn about menopause through close relationships between friends and family. This can mean some autistic people can enter menopause without much prior knowledge of what to expect.

However, it’s important to note that if you are autistic and struggling with menopause, you have options that may help (see below). It’s also worth noting that this is a transitional period and will not last forever. Be kind to yourself.

Researcher spotlight

We need more research to learn more about autism and menopause. Research can help us to understand the unique challenges autistic people may face and ultimately find out what can help people who are struggling. This is an under-researched area, but researchers and autistic people are working to change that.

When autistic researcher Dr Rachel Moseley and her colleague Professor Julie Gamble-Turner wanted to find out about autistic people’s experiences of menopause in 2018, they could not find a single paper on the topic. That’s why they’ve been researching the experiences of menopausal autistic people some of whom also have ADHD, informally known as AuDHD.

They interviewed autistic people and auDHDers, finding that menopause could be a very difficult time for these individuals. Some of their participants found that menopause disrupted their lives and the coping skills they’d previously relied on. This affected their mental health, their daily functioning and their independent living skills.

Rachel and Julie have found that autistic people who struggled during menopause are more likely to participate in their research. So that they could look at a larger range of experiences, they conducted quantitative research with collaborators in Canada,² This work showed that many autistic people struggle during menopause.

We must identify how autistic experiences of menopause might differ from those of non-autistic people. Rachel and Julie are working on a new study, which aims to do just that, as well as exploring the reasons why autistic people might have a harder time.

Thanks to the kindness of autistic people who participated in research like this, we’re beginning to understand a bit more about autism and menopause.

What you can do if you are autistic and struggling with menopause

If you are autistic and struggling with menopause symptoms, you have several options that may help.

See your doctor

We know that visiting the doctor is not easy for many autistic people. Doctors can find it more difficult to read how autistic people express their emotions and experiences, so they may not always recognise how much someone is struggling.¹³

Autistic people tell us that going to the doctor can be stressful because they feel that health professionals do not understand their needs. However, seeing your doctor is an important step towards looking after yourself. Using tools like health passports may help your doctor understand your needs.

It is the law that reasonable adjustments must be made in health and social care. You can tell your doctor what reasonable adjustments you need. They can use the reasonable adjustments digital flag, so you don’t need to explain every time you use an NHS service.

Hormone replacement therapy

Hormone replacement therapy (HRT) replaces some of the hormones that decrease during menopause, particularly oestrogen and progesterone. HRT can help manage symptoms of menopause, such as hot flushes, mood and night sweats.

HRT does not delay menopause. Instead, it can help to make the symptoms more manageable and protect your body from the impact of declining hormones. You can keep taking HRT for as long as your doctor advises.

HRT can involve some trial and error, as the doctor finds the right level of hormones that works best for you. Some autistic people may struggle with the unpredictability of this process.

If you have ADHD, you will need to check that HRT does not interact with your ADHD medication.

Generally speaking, autistic people can be over (or under) sensitive to medications. Talk to your doctor so you can work together to find out what is right for you.

Talk to others

Autistic people in research studies have said that it helps to talk to other autistic people who are going through menopause.¹

One way to do this would be through the Autistica Tips Hub, where you can share a tip about what has helped you, and access tips from other people in the community.

You can also attend in-person events designed for people to talk about menopause, such as Menopause Café.

Find coping strategies that work for you

Although there is no research on the best interventions and ways of coping for autistic people, researchers Dr Rachel Moseley and Professor Julie Gamble-Turner found that autistic people they spoke to had a range of things they did to manage menopausal symptoms or help themselves feel better.

Different autistic people coped in different ways: some spent more time alone, which can be an important coping mechanism for autistic people. Some spent more time with hobbies such as gardening, reading, gaming or whatever their passions might be. Some worked out their anxiety and energy with exercise. Some explored alternative treatments like acupuncture, herbal medicine, mindfulness, or counselling.

Some people found it helpful to write things down so that they could notice patterns in their symptoms. People who struggled with memory and planning used lists, spreadsheets and apps to help with this.

One of the most important ways of coping is being kind to yourself, although this can be easier said than done.

Autistic people who spoke to Julie and Rachel said that it was extremely important to be gentle with yourself, give yourself permission to withdraw from commitments when you need to, and give your body whatever it needs. They said that menopause is a difficult thing to go through, especially if you are autistic, so try not to compare yourself to other people who are going through menopause.

CBT

Some doctors offer cognitive behavioural therapy (CBT) to help people manage the symptoms of menopause.

CBT is a type of therapy where you break down your problems into different thoughts, behaviours and actions and explore if they are helpful to you or not. CBT can be a useful tool, but it is not suitable for everyone; for example if someone has complex or severe mental health challenges.

Most of the evidence base for CBT is not specific to autistic people, and we do not know if menopause-focused CBT is effective for autistic people. Some research suggests that CBT tailored specifically to autistic people can be helpful. However, we still need to learn more about the effectiveness of CBT to improve autistic people’s mental health.¹⁴

Acknowledgements

Thank you to  Professor Julie Gamble-Turner, Dr Rachel Moseley, and Karen-Anne Manghan for collaborating on this article. 

References

[1] Bradly, M. et al., (2024)“A perfect storm”: Autistic experiences of menopause and midlife

[2] Jenkins, C. et al., (2024) “Struggling for Years”: An international survey on autistic experiences of menopause

[3] De Vissier, R. et al., (2024) Unmet need for autism-aware care for gynaecological, menstrual and sexual wellbeing

[4] Behrman, S., & Crockett, C. (2024) Severe mental illness and the perimenopause

[5] Hoyt, L., & Falconi, A. (2015) Puberty and perimenopause: reproductive transitions and their implications for women's health

[6] The Faucett Society (2022) Menopause and the workplace

[7] Brinton R et al., (2015) Perimenopause as a neurological transition state

[8] Gray, L. J., & Durand, H. (2023) Experiences of dysmenorrhea and its treatment among allistic and autistic menstruators: a thematic analysis

[9] Jaholkowski, P. et al., (2023) Associations between symptoms of premenstrual disorders and polygenic liability for major psychiatric disorders

[10] Kapoor E. et al. (2021) Association of adverse childhood experiences with menopausal symptoms: results from the Data Registry on Experiences of Aging, Menopause and Sexuality (DREAMS)

[11] Cortés YI, Marginean V. (2022) Key factors in menopause health disparities and inequities: Beyond race and ethnicity

[12] Groenman, A. et al., (2022) Menstruation and menopause in autistic adults: Periods of importance?

[13] Moseley, R. et al., (2021) Autism research is ‘all about the blokes and the kids’: Autistic women breaking the silence on menopause

[14] Linden, A. et al., (2022) Benefits and harms of interventions to improve anxiety, depression, and other mental health outcomes for autistic people: A systematic review and network meta-analysis of randomised controlled trials.