Book Review: Autistic Menopause

In this episode, I share the symptoms that had me wondering if I had entered perimenopause and what is has been like navigating a tangled mess of PMDD, Autism, Autistic Burnout and Perimenopause.

I also review the book Autistic Menopause: A Guide to the Menopausal Transition for Autistic People and Those Supporting Them by Dr. Rachel Moseley and Professor Julie Gamble-Turner, sharing my reactions and top takeaways.

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Transcript

Title: Book Review: Autistic Menopause

Episode number: 30

Date: 03.31.26

URL: https://mindfulnessforpmdd.buzzsprout.com/2253562/episodes/18935913-book-review-autistic-menopause

Solo episode: Diane is the only speaker

EXCERPT (00:00)

Autistic menopause appears to be a distinct experience, and symptoms of perimenopause can be experienced more intensely by autistic people.

INTRO (00:12)

If you want to learn how you can live better with PMDD, this podcast was created for you. This is Mindfulness for PMDD with Diane. I'm Diane and I'm a registered dietitian and lactation consultant. I'm also a mom, a PMDD warrior, and a trauma-informed mindfulness teacher, and this is where I discuss topics related to PMDD through the lens of mindfulness and meditation, and where I share all about how mindfulness has gotten me to a place of greater peace and acceptance with my PMDD. I also chat with people who have helped and inspired me along the way, so they can share their wisdom with you, too. So let's get started.

SAFETY NOTE / DISCLAIMER (01:04)

This podcast is not a substitute for psychological therapy or medical advice. Please take care when listening to this podcast, as some may find certain words or subjects triggering or difficult to hear. Take only what serves you and leave the rest behind.

WHEN YOUR BODY FEELS LIKE IT HAS NOTHING LEFT (01:21)

Hello, friends. As I record this today, I am day 21 of my cycle and about three days out from my period, and to be completely honest with you, it has been a struggle this cycle. The biggest thing I've been dealing with this cycle in particular, the past two weeks, I'd say, is really extreme fatigue.

It's to the point where just earlier I got out of the shower and I was styling my hair, and I, you know, I put my product in my hair, and when I went to pick up my hair dryer to diffuse my hair, I realized that was it. I had run out of energy. There was nothing left. I couldn't stand there any longer. I couldn't hold up a hair dryer, and I had to go rest before being able to go back into the bathroom and diffuse my hair. I mean, so that's, that's like the kind of fatigue we're talking about today.

The other thing is I've been really struggling with some horrific hives, and that I think may be related to perimenopause, which actually brings us to today's topic.

Today I'm going to be talking about perimenopause and autism, and how all that relates to PMDD as well. In fact, I am also going to do a little bit of a book review of a book that I read that was so wonderful, so needed, so validating for me that I really felt I needed to share it with you all.

WHY IT CAN BE SO HARD TO TELL WHAT'S PMDD, BURNOUT, OR PERIMENOPAUSE (02:53)

So let's get into that. So for about a year or so now, I've been wondering if maybe I am in early perimenopause, but between the PMDD and the autistic burnout, it's been tricky to tell what's what and whether my symptoms are related to existing conditions or something new. And then I came across the book Autistic Menopause and have felt so validated and so relieved to realize that, number one, I may be onto something, right? Like I'm not crazy, I'm not making it up. And two, I'm not alone.

So I'm going to share about the Autistic Menopause book today. But first I'll give a little more background about my own experiences. So just over a year ago, I started experiencing some new symptoms that led me to wonder if I was entering perimenopause, things like super dry, itchy skin and flaky scalp, jawline acne, brain fog that was a lot worse than usual. I also started experiencing worsening anxiety, specifically new feelings of panic and paranoia, and my PMDD app, my symptom tracker, had also started telling me that I was having the occasional atypical cycle here and there.

Usually meaning that there had been a change in either the length of my cycle or the length of my period. So either a change in the number of days between periods or the number of days I was bleeding. And these changes would sometimes be outside of what's considered typical. I couldn't feel sure that it was perimenopause though, because first of all, in the very early stages of perimenopause, it's not so easy to know exactly what's going on, but also at that time I was going through a pretty severe and long drawn-out period of autistic burnout.

So let me pause here, because if you're listening, you may have come to this podcast for the autism chat or the menopause chat or the PMDD chat, and you may not be intimately familiar with all three. So some quick definitions to make sure we're all on the same page, so to speak.

PMDD is a cyclical hormone-based mood disorder, and it's a severe negative reaction in the brain to the normal hormonal changes of the menstrual cycle. So PMDD is not a hormonal imbalance, but the brain's abnormal and outsized response to normal hormonal fluctuations, and symptoms like anxiety, depression, irritability, mood swings, fatigue, and brain fog occur only in the luteal phase, which is the time between ovulation and the menstrual period, sometimes lasting as long as into the first few days of the bleed. So that's PMDD.

Autistic burnout is a total physical, mental, emotional exhaustion that often leads to increased sensory sensitivities and decreased executive function, cognitive decline, loss of skills that you may have previously had, including even the ability to speak or the ability to manage daily living tasks and hygiene activities, things like taking a shower or brushing your teeth.

Autistic burnout often comes with a lot of emotional dysregulation and big intense mood changes. It is not a recognized medical or clinical diagnosis, but it is a common phenomenon experienced and reported by autistic people, and it usually comes as a result of an accumulation of chronic stress, sensory overload, and prolonged masking.

Finally, perimenopause is the transition to menopause. Menopause being the point in time when you've gone a full year without a menstrual period. Menopause is just one day in time, and perimenopause is the time leading up to that marked by fluctuating hormones, irregular periods, physical symptoms and mood changes, including irritability and brain fog.

So you might already have a sense where I'm going with this, which is autistic burnout and PMDD have some overlapping symptoms. Things like fatigue, brain fog, anxiety, overwhelm, irritability, and even increased sensory sensitivity. But I knew I was in burnout recently because all my worsening symptoms were now happening in the follicular phase of my menstrual cycle as well, not just in the luteal phase.

So I was experiencing all of these symptoms in addition to others, like worsening of my usual social withdrawal all throughout the month, not just in the days between ovulation and my period. Plus, the person who did my autism assessment agreed and confirmed for me that it was autistic burnout.

But then when I started getting these new symptoms last spring, so the crazy itchy skin and the flaky scalp and the chin acne, which were like the very first of the new symptoms, it was really hard to tell if that was just from the chronic stress of living with autistic burnout and PMDD or if I was beginning to experience symptoms of perimenopause.

I was also 44. I'm now 45, and for me personally, it felt maybe slightly early for perimenopause, mostly because I knew that women in my family have tended to enter perimenopause later, as far as I know, secondhand through what my mom has learned and shared with me. At the same time, I did wonder if all the years of living in chronic stress through PTSD, through PMDD, through autistic burnout, may have had the effect of triggering perimenopause a bit early.

To complicate things even further, just a couple months after I finally felt like I had emerged from autistic burnout and was feeling more like myself again, I started to experience panic attacks. And I had never experienced panic attacks before in my life. Certainly nothing like this.

Anyway, my instinct was often to try to understand what exactly was causing each of my symptoms, and it was so overwhelming and so confusing trying to tease apart everything I was going through. To sort of categorize my symptoms and try to say, oh, this is the PMDD and this is the autistic burnout, and this over here, that's probably the perimenopause.

And I think that's an experience that's probably common among other neurodivergent people and other people with PMDD because both neurodivergent people and people with PMDD frequently live with multiple comorbidities. And sometimes the different conditions you're living with may have similar and overlapping symptoms. And that can be tricky if you're trying to understand the cause of your symptoms so you can figure out the best way to manage them.

THE BOOK THAT MADE AUTISTIC MENOPAUSE FEEL LESS LONELY (10:14)

So there I was, constantly running through all of this in my head, trying to understand what was going on with me, when I learned about the book Autistic Menopause and became so excited that this book existed that I accidentally ordered both a hard copy and the audiobook. And I ended up blasting through the audiobook before I could ever even open the front cover of the physical book.

And let me tell you, this book was so validating. It really confirmed a lot of my instincts about what was happening to me and opened my eyes to the unique experiences of someone who's both autistic and going through perimenopause.

So the full title of the book is Autistic Menopause: A Guide to the Menopausal Transition for Autistic People, and Those Supporting Them. It was released earlier this year, 2026, and it was co-written by Dr. Rachel Moseley and Professor Julie Gamble-Turner, two researchers who joined forces back in 2018 to study the autistic experiences of menopause.

And Dr. Moseley and Professor Gamble-Turner arranged their book into four parts. So in the first part, which is called Understanding Menopause and the Backdrop to Autistic Experiences, they explain how menopause affects the brain, body, and mind, and how your health and life experiences can affect your experience of menopause.

The second part, called Autistic and Menopausal: The 'Double Whammy,' looks at how the autistic experience can affect the experience of menopause and vice versa. So the first part more broadly talks about menopause and how menopause can be affected by your health and life experiences. The second part specifically looks at how autism can affect menopause and how menopause can affect autism.

Now, part three, Autistic Experiences of Menopause, is the part that was really the most invaluable to me because it was so validating to hear the shared experiences of the experts interviewed for the book. So Dr. Moseley and Professor Gamble-Turner interviewed a number of autistic people who have experienced, or at the time of the interviews were currently experiencing, menopause and perimenopause, and they shared their stories in the book and they refer to these people as the experts, and it was just so good to hear my own experiences reflected in other people's stories.

And then finally, part four of the book is called Managing Menopause, and it covers advice for coping with autistic menopause and also talks about how professionals can help.

FOUR TAKEAWAYS THAT HELPED ME FEEL LESS ALONE (13:20)

So as I made my way through the book, I found these four key takeaways to be the most profound.

1. Your body, mind, and life experiences affect how you experience perimenopause and menopause.

2. Autistic menopause appears to be a distinct experience, and symptoms of perimenopause can be experienced more intensely by autistic people.

3. I am not alone in feeling like I'm trying to navigate multiple conditions and experiences and in trying to understand the specific causes of my different symptoms. I'm not even alone in trying to navigate both autism and perimenopause, or even autism and perimenopause and PMDD.

And that's huge because, for a lot of us, when we are struggling with chronic illnesses or neurodivergence, it can feel very isolating at times. Especially if we feel misunderstood, especially if we have a hard time finding a community to connect with, it can feel very isolating and lonely. So it's always nice when you can have the reminder that you're not alone in these experiences.

And finally, number four, the fourth big takeaway that I got from this book is that chronic stress really might trigger an earlier and/or more intense perimenopause. That was so validating to hear because I really found myself wondering about that quite often.

Now I will say that as I made my way through the book, I wondered if there would be any mention of PMDD, and while they didn't specifically mention PMDD, there was some discussion about how autistic people can have different and more intense experiences of menstruation and PMS. And they even mention how other transitional times in the lifespan related to reproduction, like pregnancy and the postnatal period, can also create challenges that are unique to or more intense for those of us who are neurodivergent.

I also really appreciate that the book touches on issues like menopause and other forms of neurodivergence like learning disabilities, ADHD, and AuDHD, as well as experiences from ethnic, sex, and gender minorities.

So, I think this book fills a gap where there just has been such a lack of both information and validation, and I highly recommend it if you are an autistic person who menstruates and is experiencing or has yet to experience perimenopause.

MAKING SPACE WHEN YOU CAN'T SORT EVERY SYMPTOM INTO A PERFECT BOX (16:20)

Now, as a mindfulness coach and as someone who practices mindfulness, I of course am always looking for how I can bring mindfulness into different areas of my life. So, here's what I want to say about my mindful approach to this seemingly tangled mess of PMDD, autism, autistic burnout and perimenopause inspired by my reactions to this book, and that is: while I do still feel the urge, from time to time, to identify what exactly is the specific cause of each of my symptoms, I'm also trying to embrace some level of acceptance in that maybe I don't need to know exactly which condition is causing which symptom.

I mean, broadly, I know what I need to do to feel as good as I can, and a lot of times it comes down to the basics of taking care of my physical and mental health through my diet and exercise and stress management, and pacing myself and understanding my sensory sensitivities and my capacity for social experiences.

And I won't stop trying new ways to manage symptoms. But I also don't think it's my goal anymore to know exactly how much of a particular symptom is coming from PMDD versus autistic burnout versus perimenopause. And I feel like that's a big thing as an autistic person to say, because I do often feel like I, I want to get all the information on a particular thing or a particular experience I'm having and I want to understand it inside and out and kind of keep going until I feel like I fully understand what's going on and have collected all the data.

But also knowing that autism, PMDD, and perimenopause all have effects on each other helps me to see them as parts of a larger experience that I'm having in this season of life right now. They affect each other. They exist together within me, and that's not only okay, it's also pretty common, and I intend to address myself and my experience as a whole and know that I'm not alone.

Now, maybe I'll feel a little differently as I continue on this journey. And maybe this sort of outlook isn't for you. Maybe you're working with your healthcare professional right now looking into hormone replacement therapy, and maybe for that reason you do want a bit more clarity around your own symptoms. That is perfectly reasonable. That makes sense, right? I personally am not a candidate right now for HRT due to my medical history, which perhaps is a story for another day.

But either way, I want to remind you that mindfulness is bringing your attention to your present moment experience and accepting what you find there with kindness and without judgment. It's not resignation, but it is making space for clarity about how to work with whatever it is we have been given.

So if you can relate to any of what I've shared today, my hope for you is that you can find a little bit of space and stillness between yourself and all the thoughts and feelings you may have around your own perimenopause experience and health journey or PMDD experience or autism experience, so that you can have a bit of clarity around how you want to move forward.

And I highly recommend checking out the book Autistic Menopause by Dr. Rachel Moseley and Professor Julie Gamble-Turner. That's it for me today, you guys. I've got some resting to do, so take care and I will catch you in the next one.

OUTRO (20:27)

Thank you so much for listening. If you liked the show, please subscribe wherever you get your podcasts. For links to everything mentioned in this episode, you can check out the show notes, and you can find me, Diane DeJesus, on Instagram @mindfulnessforpmdd. Now I invite you to pause, take a breath, and look around.