Hello Folks, today’s post may be most useful for those of us who get periods, but even if you don’t I would still recommend reading this because why not! When we’re talking about autism, one of the most well known traits is an aversion to certain sensory inputs, be it lights, sounds, textures, tastes, etc. Unfortunately, periods bring a certain number of these things to the metaphorical table. Where a person is in their cycle may also affect their mood, their sensitivity, their behaviour, etc. Therefore, I wanted to talk about periods in relation to autism, because as much as you might not want to think about it, the two naturally affect each other. This post is a solid mixture of humorous and informative, and so I will be discussing periods in some detail. If you have an aversion to words such as “period”, “vagina”, “blood”, and “uterus”, then feel free to click off this post.
Just in case anyone is unfamiliar with what a period is (I know it’s unlikely, but just bear with me), a “period” refers to the time in which those who have a menstrual cycle experience bleeding due to the lining of their uterus shedding. (Other material is included in the period fluid, but I refer to it as “blood” in this post for ease.) Some people also experience pain in the form of cramps when this happens, some do not. There are a range of other symptoms associated, such as back pain, breast tenderness, mood swings, tiredness and more. These symptoms vary from person to person, and often, period to period. The average cycle length is about 28 days, but many people will have longer or shorter cycles, or even irregular cycles. There is no one-size-fits-all, so this is just the generic information. I do get periods but I am not a medical doctor, and so if you want more specific medical-advice, stop reading blogs and go to a licensed medical professional.
First and foremost, lots of people find talking about periods uncomfortable. The purpose of this post isn’t to discuss why that is, or indeed to try and persuade you to be more open. If you want to read this underneath a blanket, in the dark, alone at night, then go for it. I personally am open about periods because roughly half the population has them, and the other half will be around people who have them. It’s not anything to be ashamed of, and it can be quite amusing to say something like, “my uterus seems to be auditioning for a slasher film” in front of your local dudebro, and watch his face pass through about 15 expressions in 2 seconds. One other myth I have heard is that people should be able to “hold” their periods. That is not true. Once a period starts, it is impossible to stop it, and indeed could potentially lead to medical problems if you tried to prevent the blood from coming out
When it comes to how periods and autism interact, there are perhaps 2 main categories: physical and emotional. The first, physical, is perhaps the most straightforward. If you have sensory tolerance issues, in particular physical touch or sensation, periods can pose a very real problem. Anyone who has experienced them will know that it is generally an unpleasant feeling. The blood is warm and wet, and without wishing to go into any further —and potentially more graphic— detail, if it’s not being completely and immediately absorbed… it’s quite gross. And so to deal with that particular sensation (and also to stay clean and hygienic), there are 3 main options. 1. Sanitary pad, 2. Tampon, 3. Menstrual cup.
The menstrual cup is the newest “invention”, for want of a better term, and is made of latex-free, hypoallergenic silicone. It is designed to be inserted into the vagina to catch any blood before it leaves the body. To change it, you can remove it, empty and wash it, and then reinsert it. At the end of your cycle, it needs to be sterilised. That being said, the cup cannot be left in for more than 12 hours maximum, as any object inside the body puts you at risk of toxic shock syndrome. TSS is an extremely rare, but extremely dangerous condition, and should not be taken lightly. Some people also feel uncomfortable with the idea of putting it in, and it must be positioned far enough inside that it isn’t noticeable and doesn’t leak. There is also the issue that if you need to change it whilst in a public space, washing it could be a problem as you may not feel comfortable doing so in a public bathroom.
Benefits of a menstrual cup are that if used correctly, you shouldn’t be able to feel it, and it catches the blood before it leaves the body, thus eliminating the sensation otherwise felt when wearing a pad. It is also heralded as a more sustainable option, as it is reusable. It can hold more blood than a pad or a tampon, and so may provide fewer leaks.
Tampons are also inserted into the vagina, but instead of catching the blood to be poured out later, they are designed to absorb the blood and then to be removed and disposed of. Tampons can broadly be split into 2 further categories, applicator and non-applicator. (Although there are differences between types to allow the wearer to adjust for different flows.) The difference is fairly self-explanatory. Applicator tampons come with an applicator. This is a small tube, usually made of plastic but some brands are now making cardboard ones, which is designed to assist the user in inserting the tampon. Non-applicator tampons do not have this feature.
The drawbacks of tampons are pretty similar to that of the menstrual cup: some people feel uncomfortable with putting it in, it raises the risk of TSS, and if not positioned correctly it could be uncomfortable. It is also worth noting at this point that some people cannot physically use menstrual cups or tampons, for various reasons. If so, there is one other mainstream option.
Sanitary pads are essentially sheets of absorbent material designed to be placed within a person’s underwear to prevent the blood from reaching the clothes. Gone are the days where people were required to wear belts to hold up their pads. Now they have a mild adhesive on one side which allows the user to attach them to underwear. Sanitary pads are a good option because they don’t require anything to be inserted inside a person, there are lots of different options in terms of brands, thickness, absorbency, etc., and they are easy/intuitive to use. However, sanitary pads can cause some very real sensory issues, and if you are on your period and so perhaps experiencing heightened sensitivity, it is important to discuss these issues and get an understanding of how to approach them.
Firstly, the material used can present problems. While I have grown out of many of my textural aversions, there are a couple of brands of sanitary pad that feels akin to wearing sandpaper. I dislike it with the intensity felt by Othniel Charles Marsh towards Edward Drinker Cope during the Bone Wars. (FYI, both of them were being incredibly childish and jeopardised future paleontological finds because they were sulking.) Thickness of the pad also affects how it feels, as some are very thin and hardly noticeable, whereas others are like wearing a nappy. To find the one that is right for you, I would recommend trying a few different brands until you find one you are happy with. Given that most people who have periods will need, on average, a pack or so per cycle, any remaining ones from a brand you dislike can be given to friends. I’ve done exactly that, as the cumulative cost of buying sanitary products is frustratingly high, so receiving free pads is always a win.
Other physical symptoms occurring during “shark week” can add to the general feeling of discomfort, thus making it more difficult to stay focused on masking when your uterus is throwing a hissy fit and destroying itself. General day to day activities can take more energy for autistic people, e.g. walking into town when there are lots of people around, and so anything that is tiring or uncomfortable only serves to lower your threshold for what you can handle. Even non-autistic people who experience periods find it tiring and/or painful, so adding in a difference in how the world is perceived is unlikely to make things better.
The other aspect of menstruation, and indeed the entire menstrual cycle, is how it affects your emotional state. Many people experience heightened emotions, such as sadness, anger, or even elation. I would like to stress that this is not anything to be ashamed of, or to make fun of. I’ve been known to shed a tear or two at times when I would otherwise be completely unaffected. I’ve also been quicker to anger when on my period (although I am remarkably difficult to anger as is), only to realise that I perhaps overreacted a few days later. However, the important thing to note here is that the emotions don’t just spring out of nowhere. They are just exacerbated versions of what was already there. Crying at a film? You probably already found it sad. Shouting at your parents? You probably already have some unresolved issues. And so next time someone says to you “oh it’s that time of the month”, before high-fiving their friends after you tell them to leave you alone, I would say it is a perfectly appropriate reaction to tell them that the level of arseholery they are displaying is staggering, that you will not tolerate that level of disrespect simply because they are unable —or unwilling— to look critically at their own behaviour and how it has been driven by a misogynistic, patriarchal society which treats those who menstruate as little more than expendable pieces in a cruel game of life, and then punch them in the face for good measure.
(Okay, I cannot condone violence, so maybe leave out the punching them part… But then again, I can’t tell you what to do, so while I am very clearly stating to not punch them, I understand that some people might choose to ignore my message, and I cannot be held responsible for any injuries that may occur when people are being douchebags.)
The final point I wanted to make is how some autistic people report being more sensitive to sensory stimuli and meltdowns at different points in their cycle. I cannot speak to this personally, as I have not noticed anything in particular, nor have I given much thought as to whether or not it might be a factor. And so I know that is a rather lame ending to the post, but if anyone has any thoughts about how this affects them, then please leave a comment on this post, or message me so that I can add it to the end!
That was probably the most underwhelming ending I have ever written, but I don’t want to comment on an experience I don’t have. Everything I write is from my life and personal perspective. I have no desire to lose integrity by trying to guess the experiences of other autistic people, we already have enough neurotypicals trying to do that for us. I just want to give the information that I know to be true for me.
p.s. There are also now options for reusable sanitary pads which are made out of fabric and can be machine washed. These again are said to be more environmentally friendly as you don’t have to buy disposable pads. This is great in theory, but I have seen some rather vicious and shaming advertising for them. If this is not something you feel comfortable doing, you are perfectly welcome to use the normal pads. Again, they present difficulties such as how you change them in public bathrooms, and so as much as I advocate for making more environmentally sustainable options, personal hygiene and sensory discomfort does not need to suffer because of this. Instead, just make sure not to cause any oil spills and that will be far more productive.