Autism and periods is a subject I am particularly interested in as a professional, supporting Autistic pre-teens/teenagers and their families. Often when parents of Autistic teens come to me for professional support and advice it is when their teen is overwhelmed with the onset of having their first period or as their teen grows and develops during puberty, they find it difficult to manage when their periods become more regular.

Autism Puberty Challenges

Puberty presents challenges for Autistic teens in key areas of physical, cognitive, hormonal, and social, emotional development. We need to better prepare Autistic teens for the changes they will experience and normalize these changes.

For neurotypical teens, physical changes begin to occur between the ages of 7-14, and they begin to experience:

• Growth spurts
• Weight gain
• Breast development
• Pubic, leg, and underarm hair

New research now suggests that Autistic children start puberty about 9.5 months earlier than neurotypical children, with many Autistic children (and those with an Intellectual Disability) now experiencing precocious puberty (Corbett et al., 2020).

Within 1-2 years of the onset of physical changes, menstruation begins.

Autism and Periods

Parents often do not realize that when we consider autism and periods (menstruation), we need to prepare and teach explicitly, and we need to teach early due to the significant number of changes that are occurring. There are not only emotional changes occurring during puberty but also physical changes occurring to the teenager’s body, new daily routines now need to take place with the onset of puberty, for example, self-care routines now need to occur more frequently and new self-care routines need to be implemented and continued.

Information on Autism and periods needs to be explicitly taught early, and delivered in a meaningful way, considering information processing styles and strengths, with consideration given to the individual teen’s communication profile, and support needs.

First Period

Having your first period is a significant milestone in a teenager’s life.

Most young teens get their first period when they’re between 11 and 14½, but anywhere from 9-16 years is considered the typical age range. If an Autistic teen has experienced body changes such as growth spurts, and breast development, their first period is not usually that far away.

Autism and Periods – Preparing

When we consider Autism and periods, we need to consider from an Autistic perspective that this is a major life transition point.

The key is to prepare and be explicit and honest in your teaching. We should be having conversations about periods as early as possible, normalizing that this is a natural part of being human.

A key piece of information that is often overlooked when talking about periods to Autistic teens, is the why piece. Why do we get periods? Understanding why something happens is important for all individuals to understand but for clarity for Autistic teens in the context of periods/menstruation,` it is essential.

We need to look at all the routines that are involved with having a period. For example, some Autistic individuals due to fine motor differences may find it difficult to open a sanitary pad packet and then place the sanitary pad effectively onto their underwear. In that instance, we look to find a workaround that will support the Autistic person in a manner that focuses on their autonomy, dignity, and also safeguarding. We can look at alternatives like Period Underwear, which is underwear specifically designed to be worn during menstruation and alleviate the need to wear period products such as sanitary towels or tampons.

Autism Period Triggers

For some Autistic teens, the sight of blood on a sanitary pad / on their underwear could be triggering and upsetting. If you feel the sight of blood may be triggering to your Autistic teen, then prepare them and do not avoid what will be inevitable (ie. That they will one day see blood when they are menstruating). Strategies I have used in the past when supporting Autistic teens in preparation of their first period was to use red food colouring and place some on a clean sanitary pad. It was a visual support to explain what blood may look like on a pad and to support them to understand what may happen when they are menstruating. When considering teaching that may be triggering to your Autistic teen, use your own judgement as to whether this is something they will be able to understand or indeed cope with.

For some Autistic teens, the scented sanitary pads/towels can be overwhelming. I know for me personally I can use any period products that are perfumed at all. For Autistic teens who may have olfactory sensitivities, there are alternatives to perfumed menstruation products, for example, there are cloth pads, menstrual cups, and also there are sanitary pads by the brand Always called “Sensitive”, and these pads have a cotton feel and are unscented.

Autism Periods & Sensory Processing Differences

Sometimes the sensory processing differences of Autistic teens are not considered when supporting them during menstruation / in preparation of their first period.

For some Autistic teens interoception differences will mean they may have difficulty registering and understanding the sensations they are having within their bodies as a result of menstruation. Cramping, the actual process of blood loss during menstruation, bloating, period pain, and understanding when to change their pad can be overwhelming.

Not to mention the tactile and olfactory sensory processing differences that may make menstruation a more upsetting time for Autistic teens than for their neurotypical counterparts. Period products can often be highly perfumed, have a plastic feel or even a cardboard dry feeling that can be abhorrent to some Autistic individuals.

It is important to consider sensory processing differences experienced by Autistic individuals when supporting them to understand menstruation.

I hope you found this post helpful, check back soon for more helpful Autism and Puberty Information Posts.

References:

Corbett, B. A., Vandekar, S., Muscatello, R. A., & Tanguturi, Y. (2020). Pubertal Timing During Early Adolescence: Advanced Pubertal Onset in Females with Autism Spectrum Disorder. Autism research : official journal of the International Society for Autism Research, 13(12), 2202–2215. https://doi.org/10.1002/aur.2406