Covid, Menopause and an Autism Diagnosis

It took a mental health crisis for me to push for a diagnosis for autism through the NHS. The problem was at the time that there were so many other things going on at the same time including the COVID pandemic and menopause. So many symptoms were typical of them all – anxiety, palpitations, sleeping difficulties, lack of self-worth, low mood, brain fog, the list goes on. It is no wonder, looking back, that it was so confusing. Coming out the other side, I am discovering that many mature women are being diagnosed as being neurodivergent later in life coinciding with the menopause. Is there a link? Research and support seems to be very limited but I am in no doubt that the menopause affected me in a different way to my peers and highlighted autistic characteristics, ultimately leading to my NHS diagnosis of autism.

The National Autistic Society has a page specifically written about the menopause - https://www.autism.org.uk/advice-and-guidance/topics/physical-health/menopause - and suggests that autistic characteristics can be intensified during the menopause such as:

-        intensified sensory sensitivities

-        difficulty with emotional regulation

-        difficulty with executive function, for example planning, focusing and multitasking

The list item which resonated with me the most was:

-          difficulty identifying internal states, such as hunger and temperature (this is known as ‘atypical interoception’)

Before the menopause, I had never experienced shutdowns.  I was increasingly finding it hard to cope but continuing to battle through and push past my limits. Then every few weeks, I was diving into burnout with the need for bed rest. I didn’t seem to recognise the signs in advance, even though everyone else could around me. I didn’t feel tired nor hungry but my body was screaming for help. I felt a failure, a nutcase. Depression followed and a never-ending cycle of mood swings up and down. Life just felt like I was wading through mud. (I will write more about burnout and this lack of sensory perception later).

There are increasing numbers of articles online about the link between menopause and late autism diagnoses. Examples that I have found include:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7376624/

https://www.livingonthespectrum.com/health-and-wellbeing/autism-adhd-menopause/

It does seem that women develop coping mechanisms through life to mask their neurodivergent symptoms but these become less effective with age and almost impossible when hormone imbalances are added to the mix. It’s a double whammy.