We’ve written before at HuffPost UK about how menopause is increasingly driving women with suspected ADHD to get a formal diagnosis. The life stage can “amplify ADHD-related challenges,” Eve Lepage, a reproductive health specialist at Clue, shared with us previously. Scientists have long suspected that hormones like oestrogen can affect how ADHD presents.

But researchers only began formally tracking ADHD symptoms across women’s menstrual cycles recently, with scientists calling the much-reported issue scientifically “overlooked”.

And in an article published in Frontiers in Reproductive Health, study authors wrote that “Autistic women navigating the menopause transition face a constellation of challenges that remain critically understudied”.

Issues with body awareness, sensory overstimulation, and systemic barriers can make the experience uniquely challenging for autistic women, they added.

Here, HuffPost UK spoke to Dr Claire Agathou, a GP with a specialist interest in women’s health and the co-founder of A-Z General Practice at HCA’s The Wellington Hospital, about the topic.

Dr Agathou told us that menopause “can affect virtually every aspect of a woman’s wellbeing from sleep and mood to concentration, memory and temperature regulation – and for autistic women there may be an additional layer of complexity”.

Emerging research suggests that autistic women might experience an intensification of autistic traits during the transition – “In particular, sensory
sensitivities may become more pronounced, emotional regulation can become more difficult, and changes in sleep, concentration and executive function may have a disproportionately disruptive effect on everyday life”.

Take, for instance, a hot flush, the GP said. “For someone who already experiences heightened sensitivity to temperature, clothing or touch, it may become intensely uncomfortable or overwhelming.

“Similarly, sleep disruption and the cognitive symptoms commonly described as ‘brain fog’ may compound existing difficulties with executive function, planning or managing competing demands”.

As with women who have ADHD, Dr Agathou continued, autistic women might find it harder to “mask” their neurodivergence during menopause.

Strategies they may have spent years adopting in order to hide struggles or navigate their professional or social sphere could be harder to maintain, which may be distressing, “particularly for women who have spent much of their adult lives functioning at a very high level, some without recognising that they may have autism”.

However, the doctor stressed that not every autistic person going through menopause will necessarily have a more intense experience.

“Menopause itself varies enormously between individuals. At present,
the evidence base is relatively small, so we need to listen to women’s individual
experiences rather than make assumptions based simply on a diagnosis,” she said.

When asked how we can support autistic women through menopause, Dr Agathou said it’s important to recognise the experience isn’t uniform.

“Healthcare professionals should actively ask about sensory symptoms, sleep, emotional regulation, executive functioning and the impact symptoms are having on day-to-day life, rather than focusing solely on hot flushes or changes to periods,” she said, adding that clear, written explanations and avoiding info-dumping on patients might also help some women.

“We should also recognise that autistic women may describe or experience internal bodily sensations differently, which can sometimes make identifying and communicating symptoms more difficult”.

But unfortunately, she continued, the intersection of menopause and autism simply isn’t all that well-studied.

“There are two historically neglected areas intersecting here. Women have traditionally been under-recognised in autism research because our understanding of autism was largely developed from studies of boys and men.

“Many autistic women… therefore reached adulthood without a diagnosis, often becoming very skilled at masking their difficulties. At the same time, menopause itself has historically been under-researched, and, for many years, women’s symptoms were too readily normalised or dismissed,” the GP explained.

“When those two gaps overlap, it isn’t surprising that autistic women going through menopause have received relatively little attention.”

This, despite some early evidence suggesting that menopause can be especially difficult and/or have unique side effects for some autistic women.

“The key message is that we shouldn’t assume menopause looks the same for every woman,” Dr Agathou ended.

“If somebody tells us that this transition has fundamentally changed how they are able to function, we need to listen, explore why, and provide care that reflects their individual needs.”

Meanwhile, the Frontiers In Reproductive Health study argued: “As the autistic population ages, and as researchers continue to learn more about the presentation of autism in the female population, it will be imperative to support autistic females in their experience of menopause”.