Menopause FAQs
You had questions about what the menopause is like for Autistic people, here are some answers!
Dr Aimee Grant
In October 2025, we ran a free online event about Autistic people’s experiences of the menopause transition. It was based on our evidence review (full text; summary). For those who couldn’t make it, you can watch a recording of the talk (45 minutes), or a shorter similar talk (15 minutes) on YouTube.
In the event, people asked lots of questions. Someone suggested I made an “FAQ” (Frequently Asked Questions) document. So here it is!
I’m in perimenopause and struggling – what should I do?
It can be normal to find things more difficult in menopause, although it doesn’t affect all Autistic people going through the menopause.
In some ways, this seems similar to “Autistic burnout”. The advice for treating burnout is to allow yourself more time for rest and relaxation, and based on the evidence we have now, I think this is the best thing you can do.
If you’re finding your menopause symptoms are impacting on your life, I suggest seeing your doctor (or practice nurse) to ask if you might be a candidate for HRT (Hormone Replacement Therapy). Although it’s not written about in the research yet, several people in the AM2M study have told us HRT has really helped them with menopause symptoms.
Do many people get diagnosed as Autistic during the menopause transition?
We don’t have good evidence on this yet, but one study in our review said that the average age people got diagnosed was around the age they started having menopause symptoms.
If menopause has made you think you might be Autistic, it’s absolutely OK to seek a diagnosis if you wish, but it’s also OK to self-identify as Autistic.
I’m more irritable than I used to be, is that normal?
Yes, our review found that people’s mental health, irritability, and meltdowns could increase during the menopause transition.
One reason for this was increased sensory sensitivities, such as to sounds and smells. I have definitely found I wear my noise cancelling headphones a lot more during perimenopause (even though they hurt my head), and can be very irritable without them!
How can Autistic people cope with fatigue during the menopause?
The research shows that taking more rest, and doing more things that were positive helped Autistic people navigate the menopause. Some people reduced doing things they found difficult, and found this helpful. Some people changed their jobs, or reduced the hours they worked.
It was noted that not everyone could choose to rest more, for example if they needed to care for children or older family members, or had to continue working full time as they needed the money.
There was also some evidence that knowing you were Autistic made people feel better about menopause and needing to rest.
What about food? How important is diet?
There is evidence that a diet rich in soy can reduce menopause symptoms.
Otherwise, it’s recommended that we all eat five fruit and vegetables a day, but for many Autistic people that is really hard. Some Autistic people in our review said they got new sensitives to food.
I personally think if you’re really struggling, eating your safe foods can be an important protective mechanism to reduce the risk of you having meltdowns, which can lead to burnout.
I tend to flip the advice around and say if you can try adding in one piece (or extra piece) of fruit or vegetables into your day, that’s good, but if you can’t that’s OK.
I find it really tiring to “mask” now I’m in menopause, is that normal?
“Masking” is when Autistic people behave more like non-Autistic people, so they get a positive response. We don’t always know we’re doing it, and it can take a lot of energy.
The research shows that many Autistic people found it harder to mask during menopause.
Some people found this uncomfortable, as they weren’t used to showing their unmasked self around many people, but others found it liberating.
Do Autistic people get misdiagnosed during menopause?
There were 2 people in our review who said they had been diagnosed with a mental health condition during perimenopause, and a few years later they realized it was a misdiagnosis and it was the early signs of perimenopause.
There can also be a range of issues with bodies that mimic some of the physical signs of menopause (e.g.: fatigue), so if you’re having menopause symptoms, it’s a good idea to go to the doctors for a check up.
Does HRT (Hormone Replacement Therapy) help Autistic people
Although it’s not written about in the research yet, several people in the AM2M study have told us HRT has really helped them with their menopause symptoms.
Are Autistic people more sensitive to HRT (Hormone Replacement Therapy)?
At the moment, we don’t have any research about Autistic people taking HRT for menopause symptoms. This means, there isn’t any evidence that it’s unsafe for us, so I think health professionals should prescribe HRT to Autistic people with menopause symptoms, just as they would for non-Autistic people.
It has been suggested that people who have noticed a sensitivity to hormonal contraception might also be sensitive to the hormones in HRT.
Are there any differences for Autistic people who go through a surgical or medically induced menopause?
Unfortunately, there wasn’t any research on this.
For people who have a menopause caused by surgery or medication, they may go into perimenopause very suddenly. This may mean that life suddenly becomes harder. I would suggest being very kind to yourself if this happens to you, including adding in more rest if you feel you need it (and can), and not being self-critical if you struggle to do things you used to be able to. I would also recommend asking your doctor if it would be safe for you to try HRT.