"I'm so glad I get to exist at a time when women are taking our own health into our hands. For too long men have called the shots and made decisions about our bodies."
Hi, I’m Sam (she/her). A late diagnosed neurodivergent woman, a tenacious midlife struggler, and an advocate for people in autistic perimenopause here at The Autistic Perimenopause: A Temporary Regression AKA The Auti Peri.
I am delighted to be the host of The Auti Peri Q&A Series!
In this series, I host a Q&A interview with a fellow autistic person about their experience of the menopause transition.
Everyone’s experience of the autistic menopausal transition is different. I aim to elevate the voices, lived experiences and reflections of autistic people’s menopausal transition.
Autistic perimenopause is a highly individual, dynamic and sometimes prolonged life stage caused by reproductive hormonal fluctuations. As autistics can be highly sensitive to bodily and environemntal, we may experience fluctuations as physical, psychological and cognitive symptoms.
Academic research into auti peri is in it’s early stages, yet it is a matter or urgency that we bust the social taboo and get used to talking about this.
Today’s guest is Julie M Green, creator of The Autistic Mom here on Substack: “The Autistic Mom charts the experiences of a late-diagnosed autistic woman raising an autistic child.”
Julie M Green is the author of MOTHERNESS, a forthcoming memoir about "generational autism, parenthood, and radical acceptance" (ECW Press, 2025).
Her writing has been featured in Washington Post, Globe and Mail, HuffPost, Healthline, Parents, The Mighty, Chatelaine, Today's Parent, and more. She has appeared on various programs, including CTV, BBC Radio, Sirius XM, CBC Radio, and HuffPost Live. In 2024, she was a finalist for the CBC Nonfiction Prize. She writes The Autistic Mom on Substack.
Julie currently lives in Kingston, Canada, with her husband, teenager, and bulldog. In her spare time, she runs a women's book club and volunteers at an arts centre for adults with developmental disabilities.
Perimenopause, but on steroids! As autists we often experience the world more intensely. So it follows that as autistic women we would experience a heightened response to The Change.
When did your autistic perimenopause symptoms start and what are they?
Symptoms crept up on me after my 40th but have been noticeably worse in the past 5 years. I'm now 48. Basically I've learned that any unpleasant thing in my life right now can likely be blamed on peri, including (but not limited to): Dry skin. Night sweats. Gushing/heavy and more painful periods. Night wakings and insomnia. Rage and irritability. Depression and anxiety. Dwindling libido. Frequent migraines.
I've struggled with many of these symptoms throughout my life, but they have definitely ramped up in the past few years. My sensory issues and ability to regulate have also seriously compromised.
What happens if/when you present with autistic perimenopause to a healthcare professional?
I am lucky to have a wonderful family doctor who also happens to be postmenopausal with feminist leanings. She was supportive of me seeking an autism assessment several years ago, and I have no doubt she will be equally supportive if/when I choose to pursue hormone-related treatment. I'm not going to let her retire, ever.
What has your treatment protocol been in managing your autistic perimenopause (medical, lifestyle, alternative therapies etc.)?
My doctor talked me into going back on an SSRI after me trying to be (stupidly) stoic about managing my mental health. She helped me face the fact that my depression is a boomerang that will keep coming back to kick my ass, and that I need to stick around the planet for a while. I am so glad she talked sense into me because my mood has definitely taken a hit in peri. Sertraline is my BFF. I adjust the dose during winter months when I feel everything more acutely.
I'm a lifelong migraineur. Hormonal fluctuations are a big trigger. Owing to an unrelated condition, I am not allowed to take NSAIDs like ibuprofen. This is BAD news for my migraines and period pain. My doctor was sympathetic, knowing that my attacks are crippling. She was willing to prescribe a heavy painkiller for days when I would otherwise be bedridden and fetal. At the same time, she is a realist. She told me there is not much likelihood without some extenuating reason (cyst) of me being approved for a voluntary hysterectomy because—patriarchy.
I'm better about taking supplements like Vitamin D and Omegas for brain fog. Exercise is a must. I need to walk or jog every day, ideally outside (although in -20C Canadian winters that's not always an option). And I've started a light weightlifting program, which helps with my energy levels as much as my mood. I'm kind of allergic to anything too woo-woo, but as part of my general autistic wellness, I am militant about getting lots of sleep and not taking on too much. Of course I live in the world so that's not always possible. But I try to balance busy days with recovery days in which I stay home in PJs and cuddle with Doug, my bulldog.
How has your everyday life been impacted by autistic perimenopause (your caring/employment responsibilities, hobbies, relationships etc.)?
My family definitely suffers from my irritability and pendulum moods. I use a tracker, but my husband will always—unhelpfully—point out when I'm PMSing. The worst part is, he's usually bang on. (At which point, the Rage increases exponentially. Manslaughter is medically excusable, right?).
Heavy period days are a write off. I am pretty much housebound and prisoner to the knife cramps and gushing, so everything is on hold.
As a writer who is autistic, peri is an occupational hazard. The days when I struggle with word retrieval and verbal memory (due to lower estrogen levels) are especially brutal. I do the whole 'walk into a room, forget why you're there' thing regularly. I've had moments of sheer panic, convinced I'm experiencing early onset dementia. And I have to catch myself and say, No, Julie, it's 'just' your hormones fucking with you.
Are there things that make or have made your menopause transition especially difficult for you as an autistic person? If so, what kinds of things?
I think the transition is hard for everyone in possession of a womb. But it is extra for autists because we can't always intuit what's going on in our bodies (interoception), much less communicate it to someone else. So we don't always get the care or attention we need. The rest of the time, we are routinely dismissed and gaslit like any other woman, sadly.
Are there things that could make or could have made your menopause transition easier for you as an autistic person? If so, what kinds of things?
Just being fully informed helps a lot—knowing there is a perfectly valid and biologically based reason for what I'm going through. In other words: I'm not going mad or senile. Thinking 'this too shall pass' stops me from doing anything radical that I may regret. One of my friends nearly ended her 20+ year marriage before realizing the Rage she felt stemmed (at least partly) from her body rather than her relationship. Of course her partner wasn't blameless, but she was glad that realization came before she saw a divorce lawyer.
What supports, resources and services are available to people experiencing autistic perimenopause where you live?
No idea! I haven't come across anything specifically targeted at neurodivergent women. However, the fact that there is more information generally helps us all. At least that's what I tell myself. It's a step in the right direction, albeit the teensiest baby step, compared to past generations when girls and women were totally in the dark about what was happening to them. Imagine the abject terror of finding a pool of blood in your pants!
What kinds of services, resources or supports would you find most helpful?
Q&As like this one are a great start. We need to look to each other to know what to expect and, above all, to know we aren't alone.
In addition to routine physicals, regular wellness checks during the peri- and menopausal years to address these specific issues and check in without waiting for our desperate cries for help. Online support groups and or 'what to expect' workshops would be helpful. Proactive rather than reactive and holistic healthcare. Hey, a girl can dream...
What is the easiest way for you to access information about autistic menopause?
Probably online because—autistic.
What would you wish for all people to know about autistic perimenopause?
It's a thing. We shouldn't have to grin and bear it.
Is there anything else you’d like to share regarding your autistic experiences of menopause?
I'm so glad I get to exist at a time when women are taking our own health into our hands. For too long men have called the shots and made decisions about our bodies. The sooner we take 'MEN' out of MENstruation, MENopause, and MENtal health, the better. Change is gonna come, and I'm here for it.
I hope you enjoyed this Q&A. If you would like to be featured as part of this series, please message me. I’d love to share your story!
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