Autistic women experience more severe menopause symptoms

Autistic people experience more severe menopause symptoms, higher levels of anxiety and depression and poorer quality of life than non-autistic people, according to research from Bournemouth University. The study, involving more than 900 participants, is described by researchers as the largest to compare self-reported menopause symptoms between autistic and non-autistic people. It also raises questions about how employers support neurodivergent employees through menopause.

Led by PhD researcher Eunhee Kim, the research followed participants, most of whom were cisgender women, for five weeks, examining their menopause symptoms, physical and mental health, and overall wellbeing.

The research highlights an important consideration for UK employers developing menopause policies and workplace adjustments, particularly where existing support may not account for the different experiences and needs of neurodivergent employees.

Kim said the study was motivated by earlier research suggesting menopause can be a particularly difficult period for autistic people, who may already experience challenges with memory, planning, emotional regulation and sensory sensitivities.

“Previous work by my supervisors at Bournemouth University has told us that autistic people can experience menopause at a time of crisis,” she said.

“We know that menopause can be challenging for non-autistic people – the symptoms force one in 10 women to leave the workforce. Autistic people can already struggle with memory, planning, managing emotions and sensory sensitivities. 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 researchers also identified differences in physical health between the two groups.

Autistic participants were almost twice as likely to report having at least one cardiovascular condition, such as heart disease, and more than four times as likely to report a musculoskeletal condition, such as hypermobility.

Many also reported living with multiple serious or chronic health conditions, suggesting menopause may occur alongside existing health challenges that can affect day-to-day functioning and wellbeing.

“The findings tell us that autistic people often have complex health challenges during menopause,” Kim said. “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.”

The study also explored factors that might help explain why autistic people experience greater difficulties during menopause.

Researchers found that feeling out of control and struggling to understand physical and psychological changes associated with menopause appeared to predict symptom severity.

The findings suggest that access to clear, tailored information and appropriate support may be particularly important for autistic people navigating menopause.

Professor Julie Gamble-Turner, co-author of the study and one of Kim’s PhD supervisors, said the findings reflected experiences reported in previous research.

“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,” Gamble-Turner said. “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 also raises questions about whether conventional workplace menopause awareness programmes and policies adequately reflect the experiences of autistic employees.

More individualised conversations, access to relevant information and adjustments to working conditions may help employers respond to differing needs, although the study did not directly evaluate workplace interventions.

Dr Rachel Moseley, co-author and PhD supervisor, said difficulties accessing healthcare could create further challenges for autistic people experiencing menopause.

“Autistic people often tell us that they struggle to access help during menopause,” she said. “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 findings underline the need for employers, occupational health professionals and line managers to recognise that employees may communicate distress differently, and that the apparent absence of visible symptoms does not necessarily indicate an absence of difficulty.

Kim’s PhD research was funded by Henpicked: Menopause in the Workplace, which provides menopause education and support to help employers develop menopause-friendly working environments.

Deborah Garlick, CEO of Henpicked: Menopause in the Workplace, said the research would contribute to a better understanding of individual menopause experiences.

“Everyone’s experience of menopause is different, and this important research helps us better understand why,” Garlick added. “I’m incredibly proud of Eunhee and the Bournemouth University team for highlighting the challenges autistic people can face during menopause. It’s been a pleasure to fund and support this work, which I hope will make a real difference to people’s lives through greater understanding and more tailored support.”

The research, published in the journal Autism in Adulthood, adds to evidence that menopause experiences can differ significantly between individuals and that existing approaches to health support may not adequately reflect those differences.