The Connection between Menopause, Autism and PMDD
This research explores the experiences of menstruation and menopause in autistic people, a topic that has been underexplored due to the historical focus on autism as a predominantly male condition. The study aimed to determine if people with autism experience more frequent Premenstrual Dysphoric Disorder (PMDD) and increased menopausal complaints compared to non-autistic women.
The Study
Menstruation and menopause in autistic adults: Periods of importance?
Where: University of Amsterdam, The Netherlands
When: Published in August 2022 in Autism.
The Takeaway
The study did not find a significant increase in PMDD prevalence among autistic women compared to non-autistic women. However, it revealed that autistic people experience significantly higher levels of menopausal complaints, which are linked to higher levels of depression and autistic traits.
What It Looked At
The study had three main objectives: (1) replicating previous findings on PMDD prevalence in autistic people, (2) exploring whether autistic people experience more or different menopausal symptoms during the menopausal transition, and (3) investigating the relationship between menopausal symptoms and symptoms of autism, anxiety, depression, and ADHD.
Participants and Methodology:
The study involved two overlapping samples: 70 participants for the PMDD analysis (28 autistic, 42 non-autistic) and 65 participants aged 40 and above for the menopause analysis (30 autistic, 35 non-autistic). PMDD was assessed using the Mini International Neuropsychiatric Interview Plus, while menopausal complaints were measured with the Dutch version of the Menopause Rating Scale (MRS), which evaluates psychological symptoms, somatic symptoms, and urogenital symptoms.
Psychological symptoms were assessed using the Symptom Checklist (SCL-90) for depression and anxiety, and the ADHD Self-Report (ADHD-SR) for ADHD symptoms. Autistic traits were measured using the Autism Quotient (AQ).
Participants were recruited through mental health institutions, social media, autism networks, and the researchers’ social networks. Exclusion criteria included intellectual disability, insufficient understanding of Dutch, history of neurological disorders, schizophrenia, multiple psychotic episodes, and current substance dependency. Additional criteria for the comparison group included no diagnosis of autism or ADHD, and no close family members with these diagnoses.
What It Found
The study revealed that 14.3% of autistic women reported experiencing PMDD symptoms compared to 9.5% of non-autistic women, a difference that was not statistically significant (p = 0.54). In terms of menopausal complaints, autistic women reported significantly higher levels, particularly in psychological symptoms (depression and anxiety) and somatic symptoms (hot flashes, cardiac complaints) domains, but not in urogenital symptoms. The average total menopausal complaint score for autistic women was 14.1, compared to 6.42 for non-autistic women.
In autistic women, higher menopausal complaints were strongly associated with higher levels of depression and autistic traits. In non-autistic women, menopausal complaints were linked to increased inattention, hyperactivity/impulsivity (i.e., ADHD traits), and depression.
Why It Matters
Understanding how major reproductive milestones affect autistic women is crucial for providing better support and addressing their unique health needs. The study highlights the increased psychological and somatic burdens faced by autistic women during menopause, suggesting a need for tailored healthcare interventions. Moreover, it emphasizes the importance of further research to explore the underlying mechanisms and broader impacts of these findings.
Broader Implications:
The findings suggest that healthcare providers should be particularly vigilant in monitoring and supporting autistic women through menopausal transitions. Autistic women might benefit from specialized support services that address their increased sensitivity to physiological changes and psychological symptoms during menopause. Further studies are needed to explore the interplay between hormonal fluctuations, neurodiversity, and menopausal symptoms, potentially leading to more effective treatments and interventions.
Practical Applications:
Healthcare professionals should consider the heightened psychological and somatic symptoms in autistic women when designing treatment plans for menopausal care. Increased awareness and education about the unique experiences of autistic women during menopause can lead to better support networks and coping strategies.