Understanding the impact of prior depressive and anxiety symptoms and autism diagnosis on menopause symptoms.

This study followed 80 people through menopause for 4.5 years to understand what makes menopause symptoms worse. They found that autistic people tend to have more severe menopause symptoms, especially if they had depression before menopause started. Younger people going through menopause and those with sensory sensitivities also experienced worse symptoms. This suggests autistic people may need extra support during menopause.

This longitudinal observational study examined menopause symptom severity in 52 autistic and 28 non-autistic people assigned female at birth over 4.5 years. Participants completed baseline measures of depression and anxiety symptoms, with menopause symptoms assessed at follow-up using the Greene Climacteric Scale. Regression analyses revealed that younger age, higher baseline depression symptoms, and autism diagnosis significantly predicted greater menopause symptom severity. When examining specific autism characteristics, younger age, baseline depression, mentalising difficulties, and sensory reactivity were significant predictors.

The findings suggest autistic people may experience additional risk for challenging menopause symptoms beyond the established risk factor of prior depression.

Healthcare providers should monitor autistic people more closely during menopause transition, particularly those with depression history. Sensory considerations and communication adaptations may be needed. Early identification and management of depression symptoms could help mitigate menopause difficulties in this population.

Small sample size (n=80) limits generalizability. Study relied on self-report measures which may introduce bias. Limited to people assigned female at birth. The 4.5-year follow-up period may not capture full menopause transition for all participants.

BackgroundThere is growing awareness from qualitative research studies that menopause may be particularly challenging for autistic people. Research in the general population suggests that preexisting conditions may be a risk factor for negative experiences during menopause. However, there are limited studies examining variables associated with experiences of menopause symptoms for autistic people.ObjectivesTo explore whether pre-existing depression and anxiety symptoms impact menopause symptoms for autistic and non-autistic people.DesignThe study design is classified as STROBE.MethodsAutistic (n=52) and non-autistic (n=28) people assigned female at birth participated in the longitudinal AgeWellAutism (AWA) study. They reported self-report depression and anxiety symptoms at baseline and menopause symptoms (Greene Climacteric Scale) at follow-up after 4.5 years.

Age, autism diagnosis and autism characteristics of mentalising difficulties, sensory reactivity, and social anxiety (subscales from the self-reported Ritvo Autism and Asperger Diagnostic Scale, RAADS) were recorded.ResultsRegression analyses were conducted with menopause symptoms as the dependent variable and as independent variables: Step 1, age; Step 2, baseline depression and anxiety symptoms, Step 3, autism diagnosis (alternative step 3, RAADS subscales). In the final regression model, younger age, higher baseline depression and autism diagnosis contributed significantly to explaining menopause symptom severity. In the alternative model (including subscales of the RAADS), younger age, higher baseline depression, mentalising difficulties and sensory reactivity contributed significantly to explaining menopause symptom severity.ConclusionsResults align with research from the general population suggesting that a history of depression symptoms increases risk of negative experiences during menopause, furthermore, being autistic confers additional risk. Further studies examining the influence of lifetime experiences on menopause symptoms for neurodivergent people are required to better understand and mitigate risk during this critical time.