How autism intensifies your PMDD

Feeling more overstimulated than usual before your period? You’re not imagining it. As a woman with autism, hormonal changes across your cycle can make everything feel more intense - especially in the luteal phase.

Your brain processes the world differently to neurotypical people, and your menstrual cycle is no exception. In fact, women with autism report a much more negative experience of their period (Steward, 2018).

So what could be making your cycle feel like a rollercoaster of destabilization?

Up to 92% of women with autism experience premenstrual dysphoric disorder (PMDD) (Obaydi, 2008), which could explain your struggle.

Not new news- just newly researched

Autism in women is often missed or misdiagnosed. Similar to ADHD, this is partly because diagnostic criteria were originally based on how autism shows in men and boys. You're also more likely to mask or internalize your traits, which can make your autism less obvious to doctors.

While awareness of autism in women is growing, research remains limited - especially on PMDD and autism combined. However, the insights we do have can help you understand why your cycle feels different and so hard to manage.

PMDD and Autism: what does it look like?

Although your experience with autism might be different to other women's, one thing you’ll likely have in common is how PMDD shows up, and how intense it can be.

Studies and lived accounts suggest your PMDD symptoms may look and feel completely different from neurotypical women.

Specific symptoms observed are (Obaydi, 2008):

· Self-harm

· Heightened irritability or anger

· Social withdrawal

· Insomnia

· Amplified repetitive movements (Stimming)

One important study collected survey responses from autistic women about their menstrual cycles. Most described their experience as overwhelmingly negative, with intense sensory sensitivity and emotional dysregulation before, during and after their period. Many experienced ‘shut down’ and felt anxiety and withdrawal (Steward 2018). So if all this is feeling very familiar, know that you’re not alone.

One reason why you might not have realized your cycle is particularly tough, is that you’re less likely to have learnt about your period from chatting to your peers, which is a key way women find out their cycle is not normal. This is why learning about how your autism affects things like PMDD is so important.

Why this overlap isn’t a coincidence

Just like we talked about trauma in a previous blog, the way your brain works with autism may make it more sensitive to hormonal changes. :

1. Sensory sensitivity. 

Autistic people are more aware of light, sound, touch and smell than neurotypical people and hormonal changes in the luteal phase are known to make these senses stronger.

In fact, a study found that women respond faster to threats in their luteal phase, showing they’re on high alert. You can think of these reactions to threats like jumping when a spider scuttles across the floor. This is thought to be due to the higher levels of progesterone (Li 2022).

This can quickly lead to sensory overload, as you’re already more sense-aware.

2. Executive functioning

Executive functioning is what helps you to plan and organize daily tasks, as well as manage your emotions. It is supported by a branch of your nervous system called the autonomic nervous system (ANS). The ANS has many roles. Importantly, it is involved in stress responses and emotional regulation.

We can measure how well your ANS is working, and therefore how well you regulate emotion, by something called ‘Heart rate variability’ (HRV). If you have PMDD, your HRV is lower than average, which means your ANS isn’t working as well and you’re less likely to feel in control of your emotions. (Brown, 2024).

This added change can increase difficulties with focus, emotion regulation and task management.

3. Reduced blood flow to the brain

During your luteal phase, some blood flow is redirected to the uterus. This has been found to slightly reduce blood flow to the brain, specifically the pre-frontal cortex (PFC), an area key for emotion and planning.

People with autism already have lower blood flow in their PFC, and there are many hypotheses to why this is. A further lowering of blood flow can amplify your executive dysfunction and emotional instability, resulting in a worsened experience of both your autism and PMDD (Hutson, 2024).

4. Interoception

Interoception is your ability to sense what’s happening inside your body, such as hunger, pain and hormonal changes. Your levels of interoception is different, meaning you might find you're very aware of internal changes, or you don’t notice them at all.

Either way, it can make it much harder to interpret and manage your PMDD symptoms (Autism Understood, 2025).

As you can see, autism and PMDD share features that intensify each other, making your menstrual cycle feel particularly challenging.

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What can you do to help?

Navigating your menstrual cycle with autism can be more difficult as it is far less understood than the experience of a neurotypical woman. This lack of recognition may leave you feeling isolated, confused, or unsure how to manage your cycle.

Tracking your cycle via Samphire can help you to learn about your cycle, filling in the gaps and helping you spot patterns. You can then find extra support on days you know will be tough, enabling you to manage your PMDD experience.

In those difficult days before your period, Nettle™ is there to restore balance by using brain stimulation to support your brain, mimicking the calmer follicular phase. Nettle™ is clinically proven to help you improve your mood and relieve pain - helping you to think more clearly.

Because every woman, neurotypical or neurodivergent, deserves support for her brain and cycle..