Content note: this article mentions self- harming, suicide and abuse.
Menopause has been identified as a major life transition point at which people are vulnerable to mental and physical ill-health, as well as stress-inducing environments or events. Autism research is disproportionately focused on children, young people and males, but in the past few years, a small body of work has drawn attention to the experiences of Autistic women in later life, including at menopause. Please note that some of the research and anecdotes discussed here make for heavy reading and may be upsetting to some readers.
Many Autistic people have highlighted menopause in their stories about diagnosis, suggesting that menopause was the point at which life went “off the rails” for them. For some, this meant looking back at their lifestyle and mental health history and recognising that they had been Autistic all along. For people who already knew they were Autistic, meanwhile, menopause has been described as the point where they became “more Autistic.” These individuals found it more difficult to “hide” their autism after menopause and experienced a general loss of coping skills.
The small amount of research that has been done on this topic mirrors these anecdotal accounts. There is evidence, for example, that rates of mental illness and suicide risk peak at menopause for Autistic women (Moseley et al., 2021). Other studies pinpoint menopause as a period of broad vulnerability for Autistic people, where employment difficulties, physical health, mental health, and social isolation come to a head (e.g., Brady et al., 2024). Autistic people may also find it especially difficult to cope with the hormonal and physical changes of menopause, although their experiences are often highly variable.
Some of the research exploring the unique challenges that Autistic people face during menopause is discussed below. Please note that some studies explicitly refer to people who identify as women, while others include perspectives from people who identify as men or as non-binary. We have attempted to follow the language conventions used in each study.
Mental health, physical health, and victimisation
Moseley and colleagues (2021) interviewed 17 Autistic women about their experiences of menopause and later-life transitions. For many of the women participating, there was a baseline of mental health challenges and isolation that they felt set them up for difficulty at menopause. Many had been diagnosed with depression and anxiety earlier in life, and others had experienced eating disorders, digestive issues, and chronic pain conditions such as fibromyalgia. Others reported a history of sexual abuse and trauma.
This is consistent with other research looking at the mental health and general vulnerability of Autistic adults, which point to high rates of childhood abuse, sexual abuse, maltreatment and exploitation amongst Autistic individuals (Reuben et al., 2021). In a 2019 paper, for example, Griffiths and her colleagues found that Autistic people were more likely to face abuse of nearly every type imaginable (2019). Conditions such as chronic fatigue syndrome, joint hypermobility and fibromyalgia have also been found to be more common in Autistic people (Ryan et al., 2023; Grant et al., 2022).
This underlying vulnerability and history may mean that by the time menopause hits, Autistic people are already exhausted and overwhelmed. The physical and hormonal changes of menopause may then introduce more de-stabilisation, leading in some cases to a mental health collapse.
Women in the study by Moseley and colleagues (2021) reported experiencing increased emotional lability/instability, outbursts, and worsening anxiety and depression at menopause. As one woman said, “whereas previously I’d be a little bit grumpy…I was psychotic, like my emotions have been turned up a notch” (pg. 718). Another woman said she experienced meltdowns where she ‘sat in a corner naked, rocking and bashing (her) head against a wall” (pg. 718). Still others described self-injury and suicidal ideation. Autistic women in another study of 24 menopausal Autistic people also described heightened negative emotions at menopause (Brady et al., 2024).
Menopause was also a time when underlying health conditions tended to flare. One woman in the study by Moseley and colleagues commented that “I feel like I can’t live like this…I can’t do anything really…I don’t have the energy’. In another study, Autistic women who experienced more physical symptoms and challenges at menopause were found to have worsening symptoms of anxiety and depression (Groenman et al., 2022).
Isolation and Exclusion
Many Autistic women in the study by Moseley and colleagues felt that the way their autism presented did not match the public perception of autism (2021). For these women, this meant that their needs and preferences were often not recognised or acknowledged by people around them, including health professionals. A few had had positive encounters with medical professionals, but many were distrusting and felt their difficulties were too easily dismissed.
One woman shared that: “I suspect that GPs etc thought that the symptoms weren’t that bad because I wasn’t breaking down and crying or giving any emotional detail. … When you can’t describe what’s going on, you can’t really ask for help” (pg. 718).
All participants pointed to a need for autism-specific resources around menopause.
Autistic participants in a study by Piper and Charlton (2025) shared similar experiences with health professionals, especially their GPs. One described their GP as “unresponsive”, while others talked about having to “fight” to access medical care such as Hormone Replacement Therapy (pg. 10). Research has shown that Autistic people face numerous barriers when accessing healthcare in general (Doherty et al., 2022).
General social isolation also meant that many women in the study had no-one to talk to about the changes of menopause. They felt menopause was a “taboo” topic anyway; one said she was largely “on my own with my body and my feelings” (pg. 716).
For many women in the study by Moseley and colleagues, tolerance for social interaction and other people also reduced at menopause due to a lack of energy and motivation. Fewer women felt able to mask or conceal their Autistic traits, which for many was a positive outcome. Others felt, however, that losing the ability to mask pushed them further into social isolation. Communication difficulties also increased for many Autistic women at menopause.
Challenging Symptoms and Heightened Autistic Characteristics
Autistic women going through menopause reported an uptick in a number of different symptoms, including:
- Standard physiological symptoms of menopause such as hot flashes, fatigue, and insomnia.
- A feeling of being “out of control” emotionally
- Flare-ups of chronic illnesses such as fibromyalgia
- Brain fog
- Challenges with executive function (organisation, planning, attention and memory)
- Poor work performance
- Increased sensory issues
- Autistic burn-out/exhaustion (Moseley et al., 2021).
Generally, Autistic research participants report experiencing menopausal symptoms very intensely (Brady et al., 2024; Karavidas & de Visser, 2022). According to a survey of 508 Autistic people from 24 countries, in addition, many participants described their menopausal symptoms as unexpected. Sixty-two percent were surprised by changes in memory and concentration span, almost 60% were surprised by changes in mental health, and 47% were surprised that they experienced disturbed sleep during menopause (Jenkins et al., 2024).
For women in the study by Moseley and colleagues, these symptoms culminated in a feeling of being “more Autistic” at and around menopause. For some, this meant that they pursued an autism diagnosis for the first time; for others, this meant an end to camouflaging and masking. As in the title of one paper, some Autistic women identified menopause as the time point “When my autism broke” (Moseley et al., 2020).
A ‘Storm’ Of Transitions
Autistic people in the study by Brady and colleagues (2024) also reported that menopause was associated with a ‘storm’ of other life transitions that collectively created overwhelm and dysfunction. Some of these transitions included ageing parents dying or being diagnosed with illnesses, children leaving home, retiring from work or changing careers, health challenges, and relationship breakdowns. For some Autistic people, dealing with these changes on top of the hormonal instability of menopause led to a period of crisis (Brady et al., 2024).
Positive Experiences and Silver Linings
It’s important to note that where many Autistic people report heightened challenges at menopause, some feel that this is a positive transition that improves their mental health. Most women in the study by Moseley and colleagues (2020) welcomed the cessation of periods, for example. Others reacted positively to reduced pressure on women to “look good” and appreciated the reduced attention they received from men.
In addition to these gains, some participants felt that menopause had given them permission to be “more selfish”, pursue better self-care, let go of toxic relationships, do activities they had always wanted to do, and work out better coping strategies. For five women in the study, menopause was ultimately the reason they began to recognise themselves as Autistic. This realisation allowed them to reframe their lives with self-acceptance and compassion, and to start learning to accommodate their needs.
Still other women felt that not much changed at menopause. They reported minimal symptoms and disruption and simply identified the transition as a natural part of ageing. This marked variability highlights a need for further research and exploration of Autistic experiences at menopause.
What Helps Autistic People Get Through Menopause
Several supports, services and tools emerged as critical resources for Autistic people in the studies discussed here. These included:
- Access to knowledge about menopause and what to expect at different stages
- Self-advocacy resources and support
- Connection with other Autistic people
- Autism-informed healthcare
- Communication supports to help them express and describe their needs and challenges
- Social media groups
- Recognition of the way menopause, health conditions, and autism may interact
Generally, however, both professional and personal knowledge around menopause as well as healthcare services were found to be inadequate and inaccessible for Autistic people going through menopause (Brady et al., 2024; Jenkins et al., 2024). Autistic participants in all of the studies described here pointed to a need for autism-specific research led by the Autistic community. In particular, there is a significant gap when it comes to the experiences of Autistic people with learning disabilities or communication differences, who may struggle to recognise and report their symptoms.
Better understandings of Autistic menopausal experiences can help Autistic people recognise the signs of menopause sooner and provide reassurance and direction for what they are going through. This can, in turn, inform clinicians and policy-makers of key service gaps and barriers in supporting this vulnerable community.
Menopause Survival Guide
If you’re Autistic and going through menopause, check out the following resources and supports:
National Autistic Society Guide to Menopause:
Toolkits for advocating for your health as an Autistic person:
AASPIRE Healthcare Toolkit for Autistic Adults
Know Your Normal | Ambitious about Autism
References
Brady, M. J., Jenkins, C. A., Gamble-Turner, J. M., Moseley, R. L., Janse van Rensburg, M., & Matthews, R. J. (2024). “A perfect storm”: Autistic experiences of menopause and midlife. Autism, 13623613241244548. doi: 10.1177/13623613241244548
Doherty, M., Neilson, S., O’Sullivan, J., Carravallah, L., Johnson, M., Cullen, W., & Shaw, S.C.K. (2022). Barriers to healthcare and self-reported adverse outcomes for autistic adults: A cross-sectional study. BMJ Open, 12(2). https://doi.org/10.1136/bmjopen-2021-056904
Griffiths, S., Allison, C., Kenny, R., Holt, R., Smith, P., Baron-Cohen, S. (2019). The Vulnerability Experiences Quotient (VEQ): A study of Vulnerability, Mental Health, and Life Satisfaction in Autistic Adults. Autism Research (12, 9). https://doi.org/10.1002/aur.2162
Groenman, A. P., Torenvliet, C., Radhoe, T. A., Agelink van Rentergem, J. A., & Geurts, H. M. (2022). Menstruation and menopause in autistic adults: Periods of importance?. Autism, 26(6), 1563-1572. https://doi.org/10.1177/13623613211059721
Hirvikoski, T., Mittendorfer-Rutz, E., Borman, M., Larsson, H., Lichtenstein, P., & Bolte, S. (2016). Premature mortality in autism spectrum disorder. The British Journal of Psychiatry, 208, 232-238. doi:10.1192/bjp.bp.114.160192
Jenkins, C. A., Moseley, R. L., Matthews, R. J., van Rensburg, M. J., Gamble-Turner, J. M., & Brady, M. J. (2024). “Struggling for Years”: An international survey on Autistic experiences of menopause. Neurodiversity, 2. https://doi.org/10.1177/27546330241299366
Karavidas, M., & de Visser, R. O. (2022). “It’s not just in my head, and it’s not just irrelevant”: autistic negotiations of menopausal transitions. Journal of Autism and Developmental Disorders, 52(3), 1143-1155. https://doi.org/10.1007/s10803-021-05010-y
Moseley, R. L., Druce, T., & Turner-Cobb, J. M. (2020). ‘When my autism broke’: A qualitative study spotlighting autistic voices on menopause. Autism, 24(6), 1423-1437. https://doi.org/10.1177/1362361319901184
Moseley, R. L., Druce, T., & Turner‐Cobb, J. M. (2021). Autism research is ‘all about the blokes and the kids’: Autistic women breaking the silence on menopause. British Journal of Health Psychology, 26(3), 709-726. https://doi.org/10.1111/bjhp.12477
Piper, M.A., Charlton, R.A. (2025) Common and unique menopause experiences among autistic and non-autistic people: A qualitative study. Journal of Health Psychology. 2025;0(0). doi:10.1177/13591053251316500
Reuben K. E., Stanzione C. M., Singleton J. L. (2021). Interpersonal trauma and posttraumatic stress in autistic adults. Autism in Adulthood, 3(3), 247–256. https://doi.org/10.1089/aut.2020.0073
Ryan, L., Beer, H., Thomson, E., Philcox, E., & Kelly, C. (2023). Autistic Traits Correlate with Chronic Musculoskeletal Pain: A Self-Selected Population Based Survey. OBM Neurobiology, 7(1), 1-21. doi:10.21926/obm.neurobiol.2301155
Sara Meyer, (MA Educational Psychology) is a researcher with joined the Altogether Autism. She worked with Autistic children for several years as part of the Ministry of Education Learning Support team. Sara is Autistic and a mother of two young children. In her free time, she enjoys writing, as well as playing and teaching music.