Join Dr. Regan for the third episode in this series about how autistic characteristics may shift across the lifespan. This episode focuses on the life seasons of women, including monthly cycles, pregnancy, and menopause. Tune in next time for the final episode in the series which will focus on autism and aging. You may also enjoy the episode: Autism in Women Published Articles for Additional Reading: “Life is Much More Difficult to Manage During Periods”: Autistic Experiences of Menstruation Prevalence of premenstrual syndrome in autism: a prospective observer-rated study Sensory challenges experienced by autistic women during pregnancy and childbirth: a systematic review Exploratory Study of Childbearing Experiences of Women with Asperger Syndrome ‘When my autism broke’: A qualitative study spotlighting autistic voices on menopause Dr. Regan's Resources New Course for Clinicians - Interventions in Autism: Helping Clients Stay Centered, Connect with Others, and Engage in Life New Course for Clinicians: ASD Differential Diagnoses and Associated Characteristics Book: Understanding Autism in Adults and Aging Adults, 2nd ed Audiobook Book: Understanding Autistic Behaviors Autism in the Adult website homepage Website Resources for Clinicians Read the episode content: 1 00:00:04,740 -- 00:00:06,280 Hi and welcome back. 2 00:00:06,290 -- 00:00:08,130 This is Dr Theresa Regan, 3 00:00:08,140 -- 00:00:10,070 a neuropsychologist, 4 00:00:10,080 -- 00:00:13,210 mother of a teen on the spectrum author, 5 00:00:13,210 -- 00:00:17,250 speaker and your podcast host for autism in the adult. 6 00:00:17,740 -- 00:00:27,800 You are joining us for the 3rd episode in a four part series on variations in the characteristics of autism across the lifespan. 7 00:00:29,140 -- 00:00:46,260 Our first episode focused on just foundational knowledge about neurology and why we can expect neurologic characteristics to feel and be expressed with some variation across time and also across context. 8 00:00:47,640 -- 00:00:56,760 The second episode focused on adolescents as a season of the lifespan during which some of these variations can become really noticeable. 9 00:00:57,440 -- 00:00:59,470 There's chemical changes going on, 10 00:00:59,470 -- 00:01:00,730 physical development. 11 00:01:00,740 -- 00:01:09,260 A lot of increase in independence is requested of the person and also just the demands of social interaction, 12 00:01:09,270 -- 00:01:11,010 academic demands, 13 00:01:11,020 -- 00:01:15,560 all these things converging to sometimes make that perfect storm. 14 00:01:17,140 -- 00:01:32,790 This third episode is going to focus on women because there are really some pretty market hormone shifts that females experience across their lifespan and these can be accompanied by shifts in the experience of autism. 15 00:01:32,800 -- 00:01:37,000 So we want to focus specifically on that topic today. 16 00:01:37,000 -- 00:01:38,450 For the episode, 17 00:01:40,740 -- 00:01:49,760 we're going to review issues related to a woman's monthly cycle to pregnancy and post pregnancy issues and also to menopause. 18 00:01:50,940 -- 00:02:04,160 I'm going to include links to some articles in the show notes for those who want to read more and I'll let you know that many of the articles really focus on solely identifying that this area needs more study. 19 00:02:04,170 -- 00:02:08,570 So you may start to read thinking that it's going to tell you something. 20 00:02:08,570 -- 00:02:10,420 We don't know when really, 21 00:02:10,420 -- 00:02:11,260 it's just saying, 22 00:02:11,260 -- 00:02:11,580 gosh, 23 00:02:11,580 -- 00:02:13,110 there's not much out there. 24 00:02:13,120 -- 00:02:27,920 We really should be looking at this more in particular and then other studies focus on gathering comments and taking surveys of women on the spectrum and really listening to the experiences of autistic women, 25 00:02:27,930 -- 00:02:30,830 which I think is really informative and helpful. 26 00:02:30,830 -- 00:02:37,310 So we are going to kind of focus on that side of things for the majority of this episode. 27 00:02:39,540 -- 00:02:42,960 So we focused on adolescents in the second episode. 28 00:02:43,340 -- 00:02:52,270 But here we're going to focus specifically on the seasons and a female's lifespan beyond adolescence. 29 00:02:52,270 -- 00:02:57,050 So we are going to start with the topic of monthly cycles in particular. 30 00:02:57,740 -- 00:02:59,850 So these begin during adolescence, 31 00:02:59,850 -- 00:03:06,690 but they continue across much of the female's lifespan and they can impact individuals differently. 32 00:03:06,700 -- 00:03:07,280 So, 33 00:03:07,280 -- 00:03:09,560 across all human females, 34 00:03:09,560 -- 00:03:18,830 there is a lot of variation on how that cycle impacts them how much um consistency they experience in that area, 35 00:03:18,840 -- 00:03:22,500 what kinds of changes in their physical state, 36 00:03:22,500 -- 00:03:24,950 their emotional state they might experience. 37 00:03:25,830 -- 00:03:28,860 And this is really true for the autistic female as well. 38 00:03:29,540 -- 00:03:45,260 One overall theme in the comments of women who are on the spectrum is that many of the issues that can be a challenge for them on a day to day basis can really feel like more of a challenge just before and also during their cycle. 39 00:03:45,940 -- 00:03:50,240 Many of the characteristics specifically mentioned by women on the spectrum. 40 00:03:50,240 -- 00:03:56,260 Focus around sensory sensitivities emotional regulation. 41 00:03:56,570 -- 00:04:02,550 So that ability to feel calm and centered social communication. 42 00:04:02,940 -- 00:04:05,760 So figuring out what am I feeling, 43 00:04:06,240 -- 00:04:08,230 Finding words to express, 44 00:04:08,230 -- 00:04:17,450 that communicating with others in a social exchange and also feeling flexible in everyday situations. 45 00:04:17,460 -- 00:04:18,430 So, 46 00:04:18,440 -- 00:04:33,460 um I really prefer routine and now this unexpected barrier has happened and I also happened to be in that time of my cycle where dealing with these unexpected things feel so much harder. 47 00:04:34,640 -- 00:04:45,460 One woman said it can become much more overwhelming and harder to maintain control of the things that already take a lot of effort for us to keep on top of during our period. 48 00:04:46,740 -- 00:04:52,460 One woman said I have more meltdowns and worse meltdowns just before my period. 49 00:04:52,840 -- 00:05:02,970 And she also noted that understanding that this is what happens in her life makes those episodes in those periods of time more manageable. 50 00:05:02,970 -- 00:05:04,130 So they don't feel, 51 00:05:04,140 -- 00:05:09,650 she doesn't feel quite so thrown off now that she understands what to expect, 52 00:05:10,040 -- 00:05:11,660 although it is challenging. 53 00:05:12,940 -- 00:05:20,260 Some women on the spectrum reported that self injury behavior was more common before periods as well. 54 00:05:20,640 -- 00:05:28,970 Uh for some women's self injury includes um cutting or biting themselves, 55 00:05:28,980 -- 00:05:30,740 hitting their head on something, 56 00:05:30,740 -- 00:05:31,860 hitting their body. 57 00:05:32,440 -- 00:05:36,360 And there was a 2008 study which, 58 00:05:36,370 -- 00:05:36,870 you know, 59 00:05:36,870 -- 00:05:43,150 that's been a while ago and it used some diagnostic criteria that are out of date. 60 00:05:43,540 -- 00:05:47,700 And there weren't a lot of follow up studies in this regard, 61 00:05:47,700 -- 00:05:49,650 but I will link it in the show notes, 62 00:05:49,910 -- 00:06:08,350 but they found that if they looked at women who experienced Um greater than or equal to 30 difficulty with emotions and other things just prior to their periods and during their periods, 63 00:06:08,740 -- 00:06:24,950 that the prevalence of this significant shift And their ability to stay centered was 92% in the autism group and 11% in the control group, 64 00:06:25,340 -- 00:06:28,110 meaning that in their study again, 65 00:06:28,110 -- 00:06:31,090 this has not been replicated that I can see, 66 00:06:31,090 -- 00:06:38,090 but it does really um hold true as far as what we typically see in women, 67 00:06:38,090 -- 00:06:44,260 that this significantly more difficult experience of emotions. 68 00:06:44,540 -- 00:06:52,700 Um that's really much higher in the autism female group than in the neuro typical group who are experiencing monthly shifts. 69 00:06:55,240 -- 00:07:05,650 The hormone shift themselves can really heighten sensory experiences and they can make emotions more intense or even just come out easier. 70 00:07:05,650 -- 00:07:10,580 Like um I might be able to think or feel something inside typically, 71 00:07:10,580 -- 00:07:13,230 but now during this period of my cycle, 72 00:07:13,230 -- 00:07:32,860 it just really easily comes out and I feel like I don't have as much control over that gate of what I let out and what I keep in another layer seems to be that monthly cycles really increase the amount of sensory experiences and also often involve pain or discomfort. 73 00:07:33,340 -- 00:07:40,200 So the women on the spectrum is processing quite a bit more experience and discomfort than typical. 74 00:07:40,210 -- 00:07:47,630 So it's not only that hormones make the common things more disruptive, 75 00:07:47,640 -- 00:07:52,450 but also you're experiencing even more sensation than typical. 76 00:07:53,140 -- 00:07:59,120 This can increase the difficulty that women have during their periods with focusing, 77 00:07:59,130 -- 00:08:00,640 communicating, 78 00:08:00,650 -- 00:08:03,360 staying centered in their experiences. 79 00:08:03,740 -- 00:08:06,860 And one female on the spectrum said, 80 00:08:06,860 -- 00:08:07,330 you know, 81 00:08:07,340 -- 00:08:12,330 there's so much more coming at me and life is intense enough as it is, 82 00:08:12,330 -- 00:08:20,360 but every month I go through this time of even more intensity and that's really challenging for me to sort through. 83 00:08:21,540 -- 00:08:35,090 In addition to descriptions of the shifts and experience a subgroup of autistic females also expressed that they really wish they had more preparation for what the experience would be like. 84 00:08:35,100 -- 00:08:39,630 So for many on the spectrum who love routine or repetition, 85 00:08:39,630 -- 00:08:41,200 preparation detail, 86 00:08:41,200 -- 00:08:43,260 knowing what's going to happen ahead of time, 87 00:08:44,140 -- 00:08:44,580 you know, 88 00:08:44,580 -- 00:08:52,260 having as much information as possible related to monthly cycles would have felt more grounding to them. 89 00:08:52,640 -- 00:08:52,850 Mhm. 90 00:08:54,040 -- 00:09:00,170 The information they wanted more of included practical things like where do I get these supplies? 91 00:09:00,170 -- 00:09:03,280 What kinds of things do I need to buy also? 92 00:09:03,280 -- 00:09:06,150 How long is this expected to last every month? 93 00:09:06,640 -- 00:09:12,460 How to communicate their needs if they're at school and they need to leave to go to the restroom, 94 00:09:12,940 -- 00:09:13,360 you know, 95 00:09:13,360 -- 00:09:19,750 having some preparation as to what kinds of things they could do in different situations. 96 00:09:20,340 -- 00:09:20,550 Mhm. 97 00:09:21,240 -- 00:09:30,000 They also said that they wished they had understood that women experience variation um across time and also between women, 98 00:09:30,010 -- 00:09:37,150 you know that their best friend may have quite a different experience than they do and that's common. 99 00:09:38,040 -- 00:09:48,520 Um So their experience is likely to be somewhat different than their peers experience and that doesn't mean that something is wrong or that they need to feel anxious about that. 100 00:09:48,530 -- 00:10:03,050 The important thing is for them to notice what is typical for them and to communicate with family or doctors if they're typical experience shifts or it's disrupted steps in some way or changes. 101 00:10:04,440 -- 00:10:09,440 They also voiced that they wish they had understood that pain and discomfort was really normal. 102 00:10:09,450 -- 00:10:14,780 Sometimes they felt like it meant something that was really dangerous to them. 103 00:10:14,790 -- 00:10:19,200 Like maybe this was not supposed to be true, 104 00:10:19,200 -- 00:10:21,260 Maybe it meant that something was wrong, 105 00:10:21,260 -- 00:10:22,260 that they were dying, 106 00:10:22,260 -- 00:10:28,980 that they had a medical problem and also that emotional intensity and shifts were very common. 107 00:10:28,990 -- 00:10:32,490 So sometimes they had the basic physical information, 108 00:10:32,500 -- 00:10:40,260 but they really didn't understand that they can expect emotions to feel different during this period of time. 109 00:10:42,240 -- 00:10:55,560 Some individuals on the spectrum really struggle with health anxiety anyway and may quickly feel nervous if they think that they might be sick or if they don't know what to expect in their physical experience. 110 00:10:56,440 -- 00:11:02,360 Other women said it was quite a struggle because there was variation for a month to month. 111 00:11:02,360 -- 00:11:06,440 And so they didn't really know exactly what day they're cycle would start, 112 00:11:06,450 -- 00:11:07,860 how it would feel, 113 00:11:07,860 -- 00:11:09,190 how long it would last. 114 00:11:09,200 -- 00:11:13,360 And even though they had a sense of their typical rhythm, 115 00:11:13,740 -- 00:11:14,750 there's always, 116 00:11:14,760 -- 00:11:15,070 you know, 117 00:11:15,070 -- 00:11:18,620 some variation is this going to start today or tomorrow, 118 00:11:18,630 -- 00:11:20,690 How heavy is it going to be? 119 00:11:20,700 -- 00:11:28,230 Uh and so that may not feel like a big variation to neuro typical females, 120 00:11:28,230 -- 00:11:34,640 but for the autistic female that relies on repetition and detail and knowing what's going to happen. 121 00:11:34,650 -- 00:11:35,280 You know, 122 00:11:35,280 -- 00:11:43,960 sometimes that anxiety about when is this going to happen and what's it going to be like can be kind of a real struggle. 123 00:11:45,640 -- 00:11:50,460 The next season we'll touch on is the season of pregnancy and post pregnancy. 124 00:11:50,840 -- 00:11:52,900 And this could include breastfeeding. 125 00:11:53,540 -- 00:11:55,960 For women who experience this season, 126 00:11:55,970 -- 00:12:08,260 there are many significant hormone changes of course and a lot of physical changes and some women really struggle with feeling like this isn't my body anymore. 127 00:12:08,540 -- 00:12:11,550 And I have all this increased discomfort, 128 00:12:11,560 -- 00:12:13,110 I have sleep problems, 129 00:12:13,110 -- 00:12:13,980 fatigue, 130 00:12:13,980 -- 00:12:15,350 I'm nauseated, 131 00:12:15,350 -- 00:12:17,560 my appetite is different. 132 00:12:17,560 -- 00:12:21,950 I don't fit in my favorite comfortable clothes anymore. 133 00:12:22,340 -- 00:12:27,860 And so having so much different about their own physical experience. 134 00:12:28,240 -- 00:12:32,460 In addition to all the shifting hormones can really be impactful. 135 00:12:33,940 -- 00:12:38,350 Many neuro typical women experience sensory symptoms when they're pregnant. 136 00:12:38,740 -- 00:12:43,260 So a lot of times that involves increased smell sensitivity, 137 00:12:43,270 -- 00:12:52,450 like I cannot stand the smell of food or cologne or the pets have such a strong scent to them now. 138 00:12:53,240 -- 00:13:03,060 And sometimes that's most noticeable in the early months of pregnancy and then just kind of peters out for the neuro typical female, 139 00:13:03,440 -- 00:13:07,420 but for the autistic female who has sensory characteristics. 140 00:13:07,430 -- 00:13:07,960 Anyway, 141 00:13:07,960 -- 00:13:21,200 this can really be a time of heightened difficulty with a variety of census rather than just smell Some women report needing more deep pressure during pregnancy. 142 00:13:21,210 -- 00:13:21,850 Um, 143 00:13:21,850 -- 00:13:31,730 we've talked about deep pressure and other episodes that this is something that can be calming and grounding and centering for the person on the spectrum. 144 00:13:31,730 -- 00:13:40,430 And that is why some will use weighted blankets and other methods to get really some deep pressure that's calming. 145 00:13:40,450 -- 00:13:44,280 And so the women who report this feel like during their pregnancy, 146 00:13:44,280 -- 00:13:48,850 they noticed they needed more in order to feel calm and centered. 147 00:13:51,440 -- 00:13:54,820 Some talked about using things like massage. 148 00:13:54,830 -- 00:14:00,000 Other women talked about wrapping things around like their fingers, 149 00:14:00,000 -- 00:14:00,820 for example, 150 00:14:00,820 -- 00:14:02,180 or their hands. 151 00:14:02,230 -- 00:14:05,010 Some would have their pets lay on top of them. 152 00:14:05,020 -- 00:14:19,290 So whatever way they could get some extra pressure really helped them feel more grounded and calm nausea and sensitivity to food textures and sent maybe heightened. 153 00:14:19,300 -- 00:14:26,280 And many of the individuals on the spectrum already have some repetition and how they eat. 154 00:14:26,290 -- 00:14:30,690 So they may go on what I call food jags where, 155 00:14:30,700 -- 00:14:31,380 oh, 156 00:14:31,380 -- 00:14:37,550 I'm so into yogurt and salami and they'll eat that for a couple of months and then switch. 157 00:14:37,840 -- 00:14:39,740 And that's without pregnancy. 158 00:14:39,740 -- 00:14:43,610 And so when you add the pregnancy and there can be cravings, 159 00:14:43,620 -- 00:14:48,160 there can be nausea texture sensitivities that are even more significant. 160 00:14:48,640 -- 00:14:55,530 Sometimes you'll get this reliance on a few foods for nutrition and that's not necessarily a problem, 161 00:14:55,530 -- 00:15:03,060 but it may be something that they want to monitor and make sure they're getting enough nutrition during their pregnancy, 162 00:15:03,940 -- 00:15:06,960 emotions can be extra challenging to manage. 163 00:15:07,340 -- 00:15:10,550 Similar to what we discussed about monthly cycles. 164 00:15:11,150 -- 00:15:16,350 The impact of hormone changes on emotions during pregnancy may be really noticeable. 165 00:15:16,740 -- 00:15:23,060 And many individuals on the spectrum also experience sleep disturbance at the best of times. 166 00:15:23,540 -- 00:15:29,360 And the extra physical changes during pregnancy can increase problems resting and sleeping. 167 00:15:30,240 -- 00:15:35,890 So this decreased sleep may reduce resilience even more for things like staying centered, 168 00:15:35,900 -- 00:15:36,960 staying calm, 169 00:15:36,960 -- 00:15:38,080 paying attention, 170 00:15:38,090 -- 00:15:43,150 handling unexpected changes and socially communicating. 171 00:15:43,480 -- 00:15:45,010 This is what I'm experiencing. 172 00:15:45,010 -- 00:15:46,250 This is what I need, 173 00:15:46,640 -- 00:15:51,510 what do you need And also similar to monthly cycles, 174 00:15:51,510 -- 00:16:00,000 having to process so much more sensation for such a long period of time can also be noticeable to the autistic woman. 175 00:16:00,440 -- 00:16:11,380 So once the baby is born there are hormonal shifts again and this can be impacted by whether or not the mother chooses to breastfeed or use formula. 176 00:16:11,560 -- 00:16:35,860 And so awareness of how hormone shifts can impact this experience and the expression of autistic characteristics that can help the mother and her partner and her friends and her family at least have this context for what she is experiencing and then they can think um kind of intentionally about what she needs and how to be supportive. 177 00:16:36,240 -- 00:16:37,980 So they can think about Heywood, 178 00:16:37,980 -- 00:16:39,150 deep pressure help. 179 00:16:39,740 -- 00:16:54,210 Um and thinking in that way may really help this season go more smoothly so that she feels more resilient as we talked about in the previous episodes, 180 00:16:54,210 -- 00:17:03,670 Physical changes are often occurring at the same time of life that a lot of just life complexities land on our doorstep. 181 00:17:03,680 -- 00:17:05,590 And when we talk about pregnancy, 182 00:17:05,600 -- 00:17:09,360 we're of course talking about all the life changes that go with it, 183 00:17:09,640 -- 00:17:12,300 so changes in the physical environment, 184 00:17:12,300 -- 00:17:13,010 for example, 185 00:17:13,010 -- 00:17:13,890 of the house, 186 00:17:14,240 -- 00:17:16,610 there's extra furniture in your space, 187 00:17:16,610 -- 00:17:18,630 people are moving things around, 188 00:17:18,830 -- 00:17:23,060 you might have to get rid of things that actually you feel kind of attached to. 189 00:17:23,540 -- 00:17:28,910 Uh and sometimes we just have to get used to having more clutter around and this, 190 00:17:29,340 -- 00:17:29,560 you know, 191 00:17:29,560 -- 00:17:35,270 maybe stressful for the person that likes their physical environment to be a certain way. 192 00:17:36,940 -- 00:17:43,140 Some autistics really depend on their physical environment to help them feel grounded and calm. 193 00:17:43,150 -- 00:17:46,670 Um there's a subset of people on the spectrum, 194 00:17:46,670 -- 00:17:47,410 for example, 195 00:17:47,410 -- 00:17:51,270 that really love a visually simple space. 196 00:17:51,730 -- 00:17:57,670 Other people really love to have objects in certain places or facing a certain way. 197 00:17:58,040 -- 00:18:05,450 So having a shift in the environment can impact this sense of grounded Nous. 198 00:18:08,440 -- 00:18:27,790 Women may report feeling like they have less control over the environment and therefore they may need to rely more on other strategies to find that peaceful place in their own spirit preparing for baby often involves more social contact. 199 00:18:27,800 -- 00:18:35,890 And so people may come up to her and want to touch her or talk to her about their own birth experiences. 200 00:18:35,900 -- 00:18:39,010 They might ask questions about her pregnancy. 201 00:18:39,020 -- 00:18:54,380 So there can be less personal space in a social context and this can feel demanding and draining to the autistic woman who's already really managing a lot of physical and environmental changes. 202 00:18:55,040 -- 00:19:00,460 So this woman may want to decide ahead of time how much social context she wants, 203 00:19:01,040 -- 00:19:03,070 Does she want a baby shower? 204 00:19:03,080 -- 00:19:07,670 Does she want family to visit and stay over when the baby's born? 205 00:19:09,040 -- 00:19:29,000 She may want to practice comments that she can make when strangers want to ask her about the pregnancy in order to just kind of create a safe space for herself without feeling like people are kind of coming into her space more often than she can really handle and and balance. 206 00:19:31,840 -- 00:19:42,240 Some women on the spectrum realize that they have really high standards for themselves and they don't want to take risks or fail or make mistakes. 207 00:19:42,460 -- 00:19:47,440 Inattention to detail may be very important to them and getting this right. 208 00:19:47,450 -- 00:19:48,730 And in that sense, 209 00:19:48,730 -- 00:20:01,770 pregnancy and childbirth and parenting may feel really daunting because it's really difficult to get through that process without realizing that you don't have as much control as you wish you did. 210 00:20:01,780 -- 00:20:05,390 And it feels like a big risk in some ways, 211 00:20:05,400 -- 00:20:08,030 like I can influence the situation, 212 00:20:08,030 -- 00:20:11,170 but I don't have all the answers and nobody else does either. 213 00:20:11,440 -- 00:20:14,400 And that can kind of increase anxiety. 214 00:20:14,840 -- 00:20:21,100 And so having this self awareness if this is your um kind of rhythm, 215 00:20:21,100 -- 00:20:28,860 your internal rhythm that you try to stay on top of so many details and facts so you can get everything right. 216 00:20:29,440 -- 00:20:41,760 Um you may need to process how can you manage that during this really complex life change of pregnancy and becoming apparent. 217 00:20:43,240 -- 00:20:48,970 Some described feeling guilty when there were problems during their pregnancy. 218 00:20:48,980 -- 00:20:57,960 So if they went to the doctor in their blood pressure was high or their sugars were high or there was something that the doctor wanted to monitor more. 219 00:20:58,840 -- 00:21:03,720 They kind of felt like they had failed their doctor's appointment and you know, 220 00:21:03,730 -- 00:21:19,270 having this awareness of what the struggle is about and how to process that can really help um adjust to not having all the answers and not being able to get everything right and avoid risk. 221 00:21:19,740 -- 00:21:31,310 Many women describe to that pregnancy birth plans and breastfeeding and also parenting issues became their special interest and this isn't necessarily a bad thing at all. 222 00:21:31,310 -- 00:21:33,060 They become very informed, 223 00:21:33,440 -- 00:21:41,260 they have strong opinions and things they would like to choose in their parenting um in a really intentional way, 224 00:21:41,270 -- 00:21:58,050 but some also say they wish they had been more aware that this is what was happening so that when they hit obstacles or rough spots and they felt out of control um they could also focus on balance. 225 00:21:58,440 -- 00:22:01,320 Like I have some other interests. 226 00:22:01,330 -- 00:22:05,280 I have um ways of restoring myself, 227 00:22:05,280 -- 00:22:10,780 I have ways of grounding myself and this is a special interest that's okay, 228 00:22:10,780 -- 00:22:17,580 but I also want to seek balance and um and what I'm doing so that when these difficult, 229 00:22:17,580 -- 00:22:19,050 unexpected things happen, 230 00:22:19,050 -- 00:22:21,360 I can still hold the course and be okay. 231 00:22:23,740 -- 00:22:28,260 Also the increased chaos in the home after baby is born, 232 00:22:28,270 -- 00:22:30,190 that really needs no explanation. 233 00:22:30,190 -- 00:22:33,670 There are so many more demands on the parent. 234 00:22:33,680 -- 00:22:35,790 They have less rest time, 235 00:22:35,810 -- 00:22:38,240 there's a lot more sensory input. 236 00:22:38,250 -- 00:22:46,090 So really close attention to having strategies ahead of time and as you go along, 237 00:22:46,090 -- 00:22:51,170 adjusting strategies so that you know what you need, 238 00:22:51,930 -- 00:23:11,820 whether that's pressure or quiet time or um rest breaks and all of these things to really do this marathon of mothering rather than trying to sprint through doing everything perfectly all the time again, 239 00:23:11,820 -- 00:23:38,770 this is really a common experience for any woman who's gone through that season and it just maybe more so for the autistic female that they really want to figure out how to add balance and restorative kinds of activities in their life as we move on to menopause. 240 00:23:39,140 -- 00:23:40,020 Um, 241 00:23:40,280 -- 00:23:41,210 this again, 242 00:23:41,220 -- 00:23:50,020 is a season of a lot of hormonal shifting and some women report that they really did well, 243 00:23:50,020 -- 00:23:52,880 understanding their autistic characteristics, 244 00:23:52,890 -- 00:23:58,360 using their strengths to get ahead at work to get promoted to accomplish life goals. 245 00:23:58,840 -- 00:24:05,270 And they found compatible partners and they really got into this nice groove with um, 246 00:24:05,270 -- 00:24:15,660 a life that fit them and it fit their nervous system and all of a sudden menopause happens and there just was a lot of shift that they didn't expect. 247 00:24:16,040 -- 00:24:22,020 Um one woman described that she felt that her autism broke during menopause, 248 00:24:22,020 -- 00:24:23,790 that it kind of broke through, 249 00:24:23,800 -- 00:24:29,860 whereas she didn't really have to think about it a lot during other Seasons of Life, 250 00:24:31,040 -- 00:24:34,420 A quote from a woman in menopause said during menopause, 251 00:24:34,420 -- 00:24:42,070 I was on three meltdowns a week at times and my meltdowns were of the nature that people would call a basket case, 252 00:24:42,640 -- 00:24:46,660 I'd strip down to my underwear sometimes during a meltdown at work, 253 00:24:47,440 -- 00:24:50,750 so that feeling that my body, 254 00:24:50,750 -- 00:24:51,820 my nervous system, 255 00:24:51,820 -- 00:24:57,730 my my whole system is so overwhelmed that I need to just strip down. 256 00:24:57,730 -- 00:25:00,780 So I'm not getting so much sensory input, 257 00:25:00,780 -- 00:25:10,050 I'm not getting input that feels like it just takes me over the edge of feeling upset. 258 00:25:10,060 -- 00:25:17,770 Um and so I love these quotes because I feel like it really helps us here, 259 00:25:17,770 -- 00:25:19,370 the humanity of that, 260 00:25:19,380 -- 00:25:33,450 and we can probably all relate in certain areas or certain times of our life where we have felt um just overwhelmed by change or by things that hit us harder than we thought. 261 00:25:33,940 -- 00:25:35,360 Um So here again, 262 00:25:35,360 -- 00:25:40,020 we're talking about similarities with the report of many women during menopause, 263 00:25:40,020 -- 00:25:50,670 but it's really crossed with these common autistic characteristics that I feel more anxiety that I feel more sensory difficulty that I have more meltdowns. 264 00:25:50,940 -- 00:25:55,290 An autistic woman may feel that her attention to detail in getting things right, 265 00:25:55,290 -- 00:25:58,050 worked for her and so many aspects of life, 266 00:25:58,440 -- 00:25:59,820 but that during menopause, 267 00:25:59,820 -- 00:26:04,400 her hormone shifts have really led to this increased anxiety. 268 00:26:04,410 -- 00:26:08,060 This feeling of being overwhelmed by the demands of the environment. 269 00:26:09,440 -- 00:26:16,500 And she may feel like she's now getting stuck on detail rather than using that as a real gift. 270 00:26:16,500 -- 00:26:19,280 That helps her move forward with projects. 271 00:26:19,280 -- 00:26:25,850 So getting stuck to the point that it really makes it hard to move on with things to make decisions to feel calm. 272 00:26:26,640 -- 00:26:30,700 Women also report that changes in their physical form again, 273 00:26:30,700 -- 00:26:43,070 that our body really changes without our permission and there are weight changes and wrinkles and sometimes the ways that we use to exercise or have fun and do our leisure time. 274 00:26:43,070 -- 00:26:46,900 Sometimes we just can't physically engage in the same things. 275 00:26:47,340 -- 00:26:54,650 Sleep disturbance is common in menopause and of course for the autistic who already had sleep disturbance. 276 00:26:54,650 -- 00:26:56,760 That can be really challenging. 277 00:26:57,220 -- 00:27:10,350 And the emotional symptoms can all impact how this season feels the physical and hormonal changes impact many aspects of the autistic experience itself. 278 00:27:10,740 -- 00:27:14,380 And similar to other portions of our episodes, 279 00:27:14,380 -- 00:27:18,720 we need to look also at the life season changes as well. 280 00:27:18,720 -- 00:27:20,780 So life complexity, 281 00:27:20,790 -- 00:27:22,670 environmental changes. 282 00:27:23,510 -- 00:27:26,490 Some women are facing the need to downsize, 283 00:27:26,490 -- 00:27:27,560 for example, 284 00:27:27,590 -- 00:27:29,140 during menopause, 285 00:27:29,140 -- 00:27:31,060 maybe they're empty nesters, 286 00:27:31,440 -- 00:27:34,670 maybe they've gone through the loss of a partner, 287 00:27:34,670 -- 00:27:47,300 a divorce or the death of a spouse and they may be thinking about getting rid of their um possessions enough that they're downsizing into a new space. 288 00:27:47,310 -- 00:27:49,500 How will this new space feel? 289 00:27:49,500 -- 00:27:50,960 That can be really hard. 290 00:27:51,640 -- 00:28:00,380 Some women on the spectrum are going to be very attached to things in the environment in a way that feels stronger than a neuro typical may feel. 291 00:28:00,410 -- 00:28:05,260 And doing all this in the midst of physical changes can be really difficult. 292 00:28:06,640 -- 00:28:15,460 They may also be caring for ill or aging parents or have experienced loss in other aspects of their life. 293 00:28:16,340 -- 00:28:17,420 So as we said, 294 00:28:17,420 -- 00:28:31,160 these physical changes that occur in menopause also coincide with shifts and life experience and all of these things together can lead to some pretty big changes and how autism is experienced and expressed, 295 00:28:31,740 -- 00:28:38,040 A woman may feel like she needs to figure out how her system works again from the beginning. 296 00:28:38,050 -- 00:28:40,780 Like I used to have this figured out, 297 00:28:40,790 -- 00:28:43,800 I had come to understand myself and what I need, 298 00:28:43,800 -- 00:28:48,450 but now things have changed and I really have to figure this out again. 299 00:28:50,940 -- 00:28:51,550 Finally, 300 00:28:51,550 -- 00:28:55,850 it is important to recall that these are generalizations. 301 00:28:55,850 -- 00:28:59,810 So I I really want to emphasize that, 302 00:28:59,810 -- 00:29:07,400 I'm not saying that everything falls apart in certain seasons of hormonal shift, 303 00:29:07,410 -- 00:29:09,930 there's so much generalization, 304 00:29:09,940 -- 00:29:22,370 but I think that when the autistic woman goes through a season of life and the things that she thought she understood about herself really seemed to shift, 305 00:29:22,380 -- 00:29:29,520 I think it is helpful to know the context for that that has a context within the nervous system, 306 00:29:29,530 -- 00:29:31,730 within the autistic experience, 307 00:29:31,730 -- 00:29:36,960 within all these life changes and that in itself can be really helpful. 308 00:29:37,540 -- 00:29:38,290 And also, 309 00:29:38,290 -- 00:29:43,070 I think it allows us to be intentional about what do I need now? 310 00:29:43,080 -- 00:29:44,730 I didn't used to need this, 311 00:29:44,730 -- 00:29:45,870 but I need this now. 312 00:29:45,870 -- 00:29:48,500 And so I'm prepared to shift. 313 00:29:48,510 -- 00:29:58,170 I understand that it's not that I figure myself out for a lifetime and I need the same things all the time. 314 00:29:58,540 -- 00:30:04,480 It's that I figure things out for a season and I am prepared to shift when that changes. 315 00:30:05,440 -- 00:30:14,170 I hope this gives a nice overview of some of the physical and life season changes that impact autistic women. 316 00:30:14,840 -- 00:30:17,870 And in our final episode of the series, 317 00:30:17,870 -- 00:30:19,130 coming up next time, 318 00:30:19,130 -- 00:30:23,050 we're going to talk about shifts that have to do with aging. 319 00:30:23,060 -- 00:30:25,430 So we're going to talk about the aging, 320 00:30:25,430 -- 00:30:26,890 brain and body. 321 00:30:26,900 -- 00:30:34,550 We're going to talk about retirement and other aspects of just aging within the context of autism. 322 00:30:34,840 -- 00:30:42,270 I hope you join us for that next episode as we round out this series.

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“What did the council decide on item 42?” — answered with the speaker and the moment.

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