This is why PMS is worse for autistic women - A tired woman lying down on a sofa

I couldn’t write this article yesterday because I had PMS.

PMS (premenstrual syndrome) is a nuisance for many women. But few people know that PMS is even worse for autistic women. Autistic women are more likely to experience PMDD (premenstrual dysphoric disorder), the severe form of PMS. The symptoms of autism also get worse during PMS.

The stereotype of autism and ADHD as disorders that mostly affect adolescent boys hurts neurodivergent women. Healthcare professionals rarely talk about how hormonal fluctuations affect the symptoms of neurodivergent women.

My autistic life as a PMS monster

Seven days before my periods, my autistic and ADD (attention deficit disorder) symptoms get worse. I’m even more sensitive to noise and bright lights than normal. It’s difficult to concentrate and get things done. I’m also more anxious and irritated. Sometimes I even get meltdowns when I have PMS.

I try to avoid any social events during my PMS because social interaction is just too exhausting then. If it was possible, I would avoid any events at all, except for lying on the sofa while watching TV and eating chocolate.

Ideally, I would finish all tasks that require high levels of concentration when I don’t have PMS. I have meds for my ADD, but they’re not as effective when I have PMS because my ADD symptoms are so much worse then.

It’s just that autism and ADD come with executive dysfunction which makes it extremely difficult to make plans. This means I can’t plan my work effectively enough to delegate all my difficult tasks into the 3 PMS-free weeks I have each month.

Neurodivergent women experience severe PMS symptoms

According to a study that compared a group of autistic women with a group of non-autistic women who had a learning disability, “there is a marked increase in premenstrual syndrome in women with autism compared with matched controls”.

92% of autistic women showed symptoms of PMDD (premenstrual dysphoric disorder), the severe form of PMS. The occurrence of PMDD in the control group was only 11%.

In a study on the autistic experience of menstruation, many respondents reported that their sensory issues intensified before or during periods. The participants also described difficulties regulating emotions, worse anxiety, and more meltdowns.

Autistic women are not the only neurodivergent women who experience worsening of their symptoms during PMS. Research shows that ADHD symptoms also worsened in women during PMS. This is my experience as well; both my autism and ADD get worse before my periods.

Autistic women PMS - A struggling woman carrying a pile of books

Why are neurodivergent women more prone to premenstrual dysphoric disorder?

Why is it that PMS symptoms are worse for neurodivergent women? The underlying mechanism of PMS itself is still unclear, let alone how it affects neurodivergent women.

There is an interesting Japanese study on the altered autonomic nervous system activity as the potential cause of premenstrual dysphoric disorder. According to the study, the women who were diagnosed with PMDD, the severe form of PMS, showed an altered function of the autonomic nervous system. The study might indicate that women with lower autonomic function are prone to more severe PMS symptoms.

Research shows autonomic dysfunction may occur in people with ASD (autism spectrum disorder). Could autonomic dysfunction be the link between autism and PMDD?

The reason for PMDD in autistic women may also be our hypersensitive nervous system. It makes sense to me that a sensitive nervous system could also be more sensitive to hormonal fluctuations.

We need to talk about neurodivergent women’s issues

We need more research to make any conclusions. I wish doctors would show more interest in women’s health issues, especially neurodivergent women’s health issues.

People often think PMS means you’re just a little cranky for a couple of days. For some women, PMS can be like that.

For women like me, PMS means extreme anxiety and dysfunction for a whole week each month. When you’re already disabled and experience dysfunction in daily life, it’s sometimes unbearable it gets even worse because of such a natural thing as the menstrual cycle.

Autistic women’s issues are underrated in society because we are often better at masking our autism than autistic men. On the outside, it looks like we are dealing with our symptoms better.

In reality, we face many challenges that are specific to neurodivergent women. The effect hormones and the menstrual cycle have on our symptoms is one of the most invisible aspects of life as an autistic woman.

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