A new study by researchers at Bournemouth University has shown that autistic people consistently experience more severe menopausal symptoms than non-autistic people, leading to poorer wellbeing and quality of life.
The new study, led by PhD student Ms Eunhee Kim, is the largest ever to compare self-reported menopause symptoms between autistic and non-autistic people. Just over 900 participants took part in the study, most of them cisgender women. The researchers monitored their symptoms and wellbeing over five weeks.
The study was motivated by the need to explore autistic experiences of menopause on a larger scale. "Previous work by my supervisors at Bournemouth University has told us that autistic people can experience menopause at a time of crisis," explained Ms Kim. "We know that menopause can be challenging for non-autistic people - the symptoms force one in ten women to leave the workforce. Autistic people can already struggle with memory, planning, managing emotions and sensory sensitivities, and 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 findings revealed stark health inequalities. Not only did autistic people show more severe menopausal symptoms than non-autistic people across several weeks of the study, but they also had greater anxiety, depression, and lower quality of life - all of which were linked to the severity of their menopause symptoms. They also had much higher rates of physical illness; autistic people were almost twice as likely to report having one or more cardiovascular conditions, like heart disease, than non-autistic people, and over four times more likely to report having a musculoskeletal condition, like hypermobility. Many autistic participants also had multiple serious and chronic health conditions.
"The findings tell us that autistic people often have complex health challenges during menopause," said Ms. Kim. "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."
Beyond showing the scale of health inequalities during menopause, the study is one of the first to actually explore why autistic people might have a harder time during menopause. The researchers found that feeling out of control, and struggling to understand menopausal changes to the body and mind, appeared to predict the severity of menopause symptoms.
Professor Julie Gamble-Turner and Dr Rachel Moseley, co-authors on the study and Eunhee's PhD supervisors, point out similarities with their previous work in this area.
Professor Gamble-Turner said, "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. 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 findings also have important implications for healthcare professionals, notes Dr Moseley. "Autistic people often tell us that they struggle to access help during menopause. 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."
Eunhee's PhD research was funded by the organisation Henpicked/Menopause in the Workplace, who exist to empower people with trusted, evidence-based information support around menopause, and to help employers create menopause-friendly workplaces. CEO Ms Deborah Garlick commented, "Everyone's experience of menopause is different, and this important research helps us better understand why. 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."
