Autism and Menstruation: Why Periods Are Harder for Autistic Women
Bridgette Hamstead
Autistic women often experience menstruation in ways that are more intense, more overwhelming, and more difficult to manage than their neurotypical peers. While periods are rarely a pleasant experience for anyone, the combination of sensory sensitivities, executive dysfunction, pain processing differences, and a lack of proper education leaves many autistic individuals struggling in ways that are rarely acknowledged. From the moment puberty begins, autistic girls face additional challenges that the medical and educational systems fail to prepare them for. Many are left without the tools, knowledge, or support to manage their menstrual cycles effectively, leading to unnecessary distress, discomfort, and even long-term health complications.
Sensory sensitivities are one of the most significant factors that make menstruation harder for autistic women. The feeling of menstrual products against the skin can be unbearable, with the textures of pads, tampons, and menstrual cups triggering overwhelming discomfort. Pads may feel bulky, rough, or irritating, leading to persistent sensory distress throughout the day. Tampons can be challenging for those with heightened bodily awareness or difficulty with interoception, making insertion and removal both physically and mentally uncomfortable. Menstrual cups, while a sustainable option, can be difficult to use for those with sensory or motor coordination differences. The smell of menstrual blood, even if mild, can also be overwhelming for those with heightened olfactory sensitivity. The discomfort does not stop at external factors; the internal sensations of cramping, bloating, and hormonal fluctuations can feel unbearable to someone who experiences bodily sensations more intensely than others.
Pain processing differences add another layer of difficulty. Some autistic women have an increased sensitivity to pain, making cramps, headaches, and lower back pain feel excruciating. Others have a reduced sensitivity, which can lead to them dismissing symptoms that might indicate an underlying medical condition like endometriosis or polycystic ovary syndrome. Those with lower pain sensitivity might not realize how severe their cramps are until they become debilitating, or they may not seek medical attention for heavy bleeding, irregular cycles, or other warning signs. This disparity in pain perception can result in inadequate treatment, as many autistic women are dismissed by medical professionals when they try to describe their symptoms.
Executive dysfunction further complicates menstrual management. Many autistic women struggle with planning, organizing, and remembering tasks, which can make tracking their cycles and preparing for their periods difficult. Keeping a supply of menstrual products on hand requires planning ahead, something that can be challenging for those who struggle with time management and organization. Changing a pad or tampon at regular intervals may not come naturally, especially if someone has difficulty with bodily awareness and does not immediately register the sensation of needing to change it. The process of remembering to carry supplies, track symptoms, and manage discomfort can quickly become overwhelming, particularly for those who also experience ADHD traits.
A lack of proper education about menstruation disproportionately affects autistic girls. Many autistic children struggle with understanding abstract concepts, and menstruation is often explained in vague or euphemistic terms that do not provide the clarity they need. Schools often fail to present menstrual education in a way that is accessible to neurodivergent students, leaving them confused about what is happening to their bodies. Autistic girls who do not intuitively pick up on social cues may not feel comfortable asking questions about periods, leading to gaps in their knowledge that can persist well into adulthood. Many are not taught how to recognize early symptoms of their period approaching, how to manage mood swings, or how to advocate for themselves when seeking medical care for menstrual-related issues.
The emotional toll of menstruation can be particularly overwhelming for autistic women. Hormonal fluctuations can intensify sensory sensitivities, emotional regulation difficulties, and meltdowns. Many autistic individuals experience heightened anxiety, irritability, or depression in the days leading up to their period, often without fully understanding why they feel so different. For those who struggle with alexithymia, the experience of sudden emotional shifts can be confusing and distressing, making it difficult to identify and manage premenstrual symptoms. The unpredictability of hormonal changes can disrupt routines, causing additional stress for those who rely on structure and consistency in their daily lives.
Healthcare providers often fail to recognize the unique challenges that autistic women face when it comes to menstruation. Many autistic individuals report feeling dismissed or invalidated when seeking medical help for severe period symptoms. Doctors may downplay their pain, assuming that they are exaggerating or misunderstanding their own experiences. Others may assume that autistic patients do not experience typical menstrual discomfort simply because they are not expressing it in a way that aligns with neurotypical expectations. The failure to take autistic women’s concerns seriously leads to delayed diagnoses for conditions like endometriosis and polycystic ovary syndrome, both of which disproportionately affect neurodivergent individuals. Without proper medical care, many autistic women are left to suffer in silence, assuming that their intense symptoms are just something they have to endure.
For those who have co-occurring conditions like ADHD, dyspraxia, or connective tissue disorders, managing menstruation becomes even more complex. ADHD can make it difficult to maintain consistent self-care routines, leading to forgotten product changes, neglected hygiene, or difficulty remembering to take pain medication on time. Dyspraxia can create motor coordination challenges, making it harder to insert tampons, use menstrual cups, or handle other aspects of menstrual care that require fine motor skills. Connective tissue disorders, which are more common in autistic individuals, can cause heavier periods, more painful cramps, and increased fatigue. The intersection of these conditions makes it clear that menstruation is not just a minor inconvenience for autistic women; it is a significant and often disabling challenge.
Support systems for autistic women experiencing menstruation need to be vastly improved. Schools should provide clearer, more direct education about menstruation in ways that accommodate different learning styles. Medical professionals must take autistic women’s pain and symptoms seriously rather than dismissing them as exaggerations or misinterpretations. More awareness should be raised about the sensory and executive functioning challenges that make managing periods difficult so that accommodations can be put in place. Sensory-friendly menstrual products should be more widely available, including options with softer textures, reduced scents, and alternatives to traditional tampons and pads.
Autistic women deserve better recognition, support, and accommodations when it comes to menstruation. The struggles they face are not just individual experiences but systemic issues that must be addressed through better education, medical care, and accessibility. The conversation around periods needs to include the voices of neurodivergent individuals who experience menstruation in ways that are rarely acknowledged. No one should have to endure unnecessary pain, confusion, or distress simply because their needs are different from the neurotypical norm. Understanding and addressing these challenges is a critical step toward ensuring that autistic women receive the care and support they deserve.
Recommendations for Autistic Women Managing Menstruation
Explore Different Menstrual Products to Find the Least Overwhelming Option
If traditional pads or tampons feel unbearable due to texture, bulk, or discomfort, try alternatives like organic cotton pads, menstrual cups, period underwear, or reusable cloth pads. Some autistic women prefer free bleeding at home on heavier days if sensory sensitivities make all options feel uncomfortable.Use a Period Tracking App or Calendar Reminder
Executive dysfunction can make it difficult to track cycles, but using a period app like Clue, Flo, or a simple calendar reminder can help predict when your period is coming. Set up notifications for when to expect symptoms like mood shifts, fatigue, or cravings so they don’t take you by surprise.Prepare a Sensory-Friendly Period Kit
Keep a small bag with all your essentials, including preferred menstrual products, pain relief medication, wipes for freshness, and a spare pair of underwear or period-friendly clothing. Having a dedicated kit can prevent last-minute stress and help with executive functioning challenges.Find Comfortable Period Clothing
Tight waistbands, synthetic fabrics, or restrictive clothing can worsen sensory overload during your period. Opt for loose, soft, and comfortable clothing, such as leggings, oversized sweaters, or sensory-friendly fabrics like bamboo or cotton.Manage Pain Proactively
If you experience painful cramps, don’t wait until the pain becomes unbearable. Use heating pads, hot water bottles, or warm baths to ease discomfort. Over-the-counter pain relievers like ibuprofen or acetaminophen can help if taken at the first sign of pain, but if pain is severe or unmanageable, seek medical advice.Create a Period-Friendly Routine
Executive dysfunction can make self-care harder during your period. Set reminders to change pads, tampons, or empty menstrual cups at regular intervals. Use visual schedules, sticky notes, or phone alarms to keep track of hygiene routines like showering, staying hydrated, and taking pain relief if needed.Minimize Sensory Overload with Environment Adjustments
Dim the lights, use noise-canceling headphones, or retreat to a quiet, cozy space if sensory sensitivity increases. If the smell of blood is overwhelming, fragrance-free wipes or discreetly scented products may help. Adjusting your environment to accommodate sensory needs can reduce stress and discomfort.Plan for Energy Management
Fatigue is common during menstruation, especially for autistic women prone to burnout. Plan for lower-energy days by adjusting workloads, preparing easy meals ahead of time, and allowing yourself more rest. If possible, advocate for work-from-home days or flexible schedules during heavier days.Monitor Mood Shifts and Emotional Regulation
If you experience extreme emotional swings, anxiety, or sensory-related meltdowns before or during your period, tracking these symptoms can help you anticipate and prepare for them. Having a weighted blanket, engaging in repetitive stimming, or using self-soothing techniques can help with emotional regulation.Advocate for Yourself in Medical Settings
If your periods are extremely painful, irregular, or causing severe distress, don’t let doctors dismiss your concerns. Many autistic women have undiagnosed conditions like endometriosis, PCOS, or PMDD. Write down your symptoms in advance, bring a support person if needed, and be persistent in seeking proper medical care.Consider Hormonal Options If Periods Are Overwhelming
Some autistic women find that birth control helps regulate heavy periods, mood swings, or sensory issues, while others experience unwanted side effects. If you struggle with your menstrual cycle, discuss different options with a doctor to find a hormonal or non-hormonal method that works best for you.Seek Support from the Neurodivergent Community
Connecting with other autistic women who experience similar menstrual challenges can provide emotional support and helpful strategies. Online communities, forums, and neurodivergent-friendly health groups can offer advice tailored to autistic needs.Prepare for Unexpected Changes
If sudden changes in your cycle or symptoms are distressing, having a backup plan can help. Keep extra supplies at work, school, or in your bag. Having an emergency plan for sensory overwhelm, unexpected pain, or accidents can ease anxiety.Experiment with Diet and Hydration to Reduce Symptoms
Some autistic women find that staying hydrated, avoiding processed foods, and increasing iron intake help with period-related fatigue and dizziness. If certain foods cause sensory discomfort or digestive distress, work with your natural preferences to find a diet that supports your body during your cycle.Recognize That Your Needs Are Valid
Many autistic women have been conditioned to downplay their struggles, but your sensory sensitivities, pain levels, and executive functioning difficulties are real. You deserve accommodations, support, and medical care that respects your needs. Learning to advocate for yourself and honor your body’s needs is an important step toward managing menstruation in a way that works for you.