Autism and the Menopause Transition: A Mixed-Methods Systematic Review

The menopause transition commonly occurs between the ages of 45 and 55 years. In a general population, hormonal shifts result in a range of biological, psychological, and social changes. Recently, research has begun to focus on Autistic people's experiences of the menopause.

We undertook a prospectively registered (PROSPERO: CRD42023450736) systematic review of research and first-hand accounts from grey literature related to Autism and menopause. We utilised the Joanna Briggs Institute convergent integrated synthesis approach.

Our search identified eight studies and seven pieces of grey literature, primarily comprising Autistic people. No studies evaluated interventions or provided data from those supporting Autistic people. We developed three themes. First, "knowledge of the menopause transition and peer support" focused on Autistic people's lack of knowledge of menopause symptoms, including differences for Autistic people, and the role of peer support in obtaining knowledge. Second, "Autistic people's experiences of menopausal symptoms" describes a broad range of negative symptoms which sometimes had significant impacts on mental health and daily activities. Limited quantitative evidence highlighted increased menopause symptom severity for Autistic people compared to non-Autistic comparison groups. Menopause symptoms impacted on work and relationships, and there was an inter-relationship between menopausal symptoms and Autistic identities. Third, "treatment of menopause symptoms" describes non-medical and medical approaches, including Hormone Replacement Therapy, to reduce symptom impacts. Most reports of medical treatment highlighted barriers to access, or negative experiences of appointments.

There is a clear need for better menopause supports for Autistic people. This should include Autism-friendly information to increase knowledge of menopause, and how it may impact Autistic people. Corresponding information should also be available for health professionals, with systemic barriers to healthcare also reduced to allow the best chance for Autistic people to receive menopause support. Autism-specific menopause peer support may be worthy of evaluation.