As a gynecologist, I was a guest on the Dutch podcast hosted by Suzanne Rethans, an author, journalist, and podcast creator, alongside clinical psychologist Els Blijd-Hoogewys, chair of Female Autism Network of the Netherlands (FANN). Drawing on my medical expertise, we discussed the role of hormones. Insights from clinical psychology regarding autism in women complemented this.
Why autism and menopause deserve attention
Autism in women is often recognized late. Many women develop strategies over the course of their lives to adapt to their environment. This can work well for years, but it usually takes a lot of energy.
We know that neurodivergent women are more likely to experience hormonal mood swings and sensory overload. This is especially true for women with autism. During perimenopause – the phase leading up to menopause – we regularly see this balance shift. Women report symptoms such as sensory overload, fatigue, mood swings, and difficulty concentrating. Sometimes, it is only during this phase that a diagnosis of autism is made.
What changes during menopause?
During perimenopause, levels of the hormone estradiol fluctuate and decline. This female sex hormone plays a role not only in the menstrual cycle and reproduction but also in the brain. It helps regulate mood, stress, and sensory processing.
When this hormonal stability decreases, it can become noticeable in daily functioning. Especially for women who are already more sensitive to stimuli, this can lead to increased overwhelm and a longer recovery time after exertion or stress.
Reduced resilience
An important insight is that autism does not worsen during this phase. What changes is resilience. Whereas it was previously possible to continue functioning through adaptation and compensation, this now becomes more difficult.
This is because multiple factors change simultaneously:
- Hormones provide less stability
- Energy and recovery capacity decline
- Flexibility in dealing with stimuli becomes less natural
As a result, underlying characteristics become more visible.
Why is this often interpreted differently?
The symptoms in this phase are frequently interpreted as burnout, depression, or anxiety. While these symptoms may certainly be present, they do not always explain the full picture. By also considering the influence of hormones and potential neurodiversity, a more complete understanding of what is happening emerges.
What helps in practice
There is no one-size-fits-all solution, but a few key principles are important:
- Knowledge and understanding of the changes taking place in your body
- Reducing overstimulation
- Creating sufficient rest and recovery time
- Establishing structure
- Hormonal treatment may play a role, within applicable medical guidelines
In conclusion
The combination of autism and menopause requires a broader perspective. Not because something is going wrong, but because circumstances are changing. By better understanding this, women and healthcare providers can take more targeted action. This leads to greater recognition, less misunderstanding, and ultimately better support during this phase of life.
– Dr. Marel, gynecologist
Visit my website (in Dutch & English) for more info: https://www.doktermarel.nl/
Don’t understand Dutch, but want to listen to other podcasts on neurodiversity and menopause? Here are 4…
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