Menstruation and Autism: a qualitative systematic review

Background: Menstruation is a biological process, which can be irregular, painful, and co-occur with fatigue, social withdrawal, and increased emotions. There is some evidence to suggest that Autistic people experience menstruation differently from non-Autistic people.

Methods: This systematic review (PROSPERO registration: CRD42023399674) searched four databases in February 2023. We used thematic synthesis to analyze qualitative studies of experiences related to menstruation for Autistic people and people providing support to Autistic people. We also appraised the quality of studies with a Critical Appraisal Skills Programme (CASP) checklist.

Results: Our thematic synthesis of 12 (eight peer-reviewed; four gray literature) sources identified differing priorities between parents, professionals, and Autistic people. Autistic people reported physical, emotional, and social impacts of menstruation. Furthermore, there were reports of increased Autism-specific experiences during menstruation such as increased sensory sensitivities, burnout, and anxiety, which were often unseen by those who supported them. Autistic people’s menstruation priorities were obtaining knowledge and skills ahead of their first period. However, parents and professionals focused on external behaviors, including hygiene and obtaining independence in managing periods. Sources poorly described participant demographics and had a limited focus on Autistic perspectives.

Conclusions: We conclude that there needs to be tailored support to meet the needs of both Autistic individuals and those who support them. This should be informed by research which centers Autistic people.