Managing Menstrual Cycles In Pubescent Females With Autism Spectrum Disorder

Puberty is a time of change for any child, but for a young female with autism spectrum disorder (ASD), fluctuating hormones and the onset of menstruation bring on additional challenges. Confusion about what is happening to her body, fear, sensory issues, and pain and discomfort caused by menstrual cramps can lead to your child suffering increased anxiety, withdrawal, or even depression.

Some girls with ASD become more aggressive and obsessive, or may engage in more repetitive behaviors during that time of the month. Therefore, it's important to provide her with emotional support and take steps to help get her through the difficulties of puberty – particularly the onset of menstruation.

  1. Start by preparing her in advance. Keep your explanations of the changes that will occur in her body simple and to the point. You may have to explain several times what a period is and what happens during that time each month. If you think your daughter will benefit from the additional instruction, have her practice changing sanitary pads to learn the skill even before her menstrual cycle begins.

    Despite educating her beforehand, your daughter still may get extremely upset and need plenty of reassurance when she actually gets her period for the first time.

  2. Use pictures and anatomically-correct dolls. The use of visuals and social stories can help teach your daughter what to expect and understand that getting her period each month is normal. Since menstrual hygiene can be a major issue of concern, after she gets her period, a visual schedule that shows the steps of how to change a sanitary pad may be helpful.

    Whether your daughter with ASD needs help in caring for herself or feels intense discomfort from sanitary pads due to sensory issues, adequate education about the process is essential.

  3. Watch for the physical signs. If your daughter has experienced a major growth spurt in both height and weight, her first period may be on its way. Weight gain usually occurs as more body fat in the upper arms and thighs. Breasts development and growing more hair on the legs, under the arms, and around the pubic area are other signs of puberty.

  4. Track her cycle once menstruation begins. Besides keeping your own calendar of her cycle, show your daughter how to use a calendar or an app so that she'll always know when her next period is due. Place symbols on the calendar to remind her that those are the days when she will have to wear sanitary pads.

    You also can use a calendar to document your daughter's bleeding. This will help you identify any irregular periods or excessive or decreased bleeding so that you can inform her gynecologist of any potential problems.

  5. Learn to note the signs. Loss of appetite, mood swings, sleep problems, and increased problem behaviors may signal that your adolescent's monthly period is on the way. While many girls feel moody right before their periods begin, research suggests that premenstrual syndrome may be more common in females with autism.

    It may help to keep a daily record of symptoms your daughter experiences for several months to identify changes and patterns of behavior that occur that may be related to her menstrual cycle.

  6. Encourage her to let you know when she suffers discomfort. Cramps, pain in the lower abdomen, low back pain, pain radiating down the legs, and headache are all symptoms that can accompany a female's menstrual cycle. But for an adolescent girl with ASD who may have problems communicating, difficulty expressing how she feels can make her even more anxious and agitated than usual. Explain to your daughter that you can give her over-the-counter medication to help ease the pain before it becomes too severe, but that she has to let you know it hurts.

To learn more, speak with your gynecologist.