How to help autistic children manage periods

What to know about periods and autistic children

Autistic children go through many changes in puberty, just as all children do. First periods are a significant milestone.

Most children get their first period when they’re between 11 and 14½ years, but anywhere from 10-16 years is considered normal. If a child has a major growth spurt and has grown some underarm hair, periods are likely to start soon.

Autism doesn’t affect when children start their periods.

How to explain periods to your autistic child

What to say about periods

Before their first period, your child needs to know:

what periods are
what will happen
how to manage them.

A social story about periods

Social stories can help you explain periods in a way your child can understand. Here’s an example that you can adapt to your child’s needs:

As my body changes I will get my period.
When I get my period, blood comes out through my vagina.
I will need to use special underpants, a pad or a tampon so my clothes don’t get stained.
Periods usually come every 28 days. Sometimes it might be sooner or later. This is OK.
A few days before I get my period, I might feel more upset about things. I might feel angry, I might feel sad, I might feel frustrated, or I might feel other emotions. Feeling this way is normal and usually stops when my period starts.
My breasts, stomach and the lower part of my back might feel sore at this time. This is normal.
Putting a hot water bottle on my stomach and having some pain relief medicine can help me feel less sore.
I might have my period for 4-7 days. It might be shorter. This is OK.
If my period goes for longer than 7 days, I will talk to an adult who cares about me.

When to start talking about periods

It’s good to start talking about periods early because you can’t know exactly when your child will get their first period.

Periods can be unsettling, upsetting or even frightening for autistic children. When you start talking about periods with your child early, you can help them understand and feel ready for this change in their life.

How to help your autistic child manage periods

Introducing period products

You know your child best, so you’ll be able to help them decide which period products will work best for them, particularly if they’re sensitive to textures, smells or physical sensations:

Pads work for some children. But they can also feel bulky or uncomfortable if your child is sensitive to pressure or moisture against their skin. Thinner pads or pads with a soft, cloth-like surface might more comfortable.
Period-proof underwear feels most like regular underwear and can be a comfortable starting point if your child has sensory sensitivities.
Tampons and menstrual cups involve internal insertion, which some children find easy, and others find overwhelming. When your child is first starting with tampons, the types that comes with applicators can be easier to use.

Choosing period products

You and your child could go to the supermarket and choose products together or look at them online. Your child might need to experiment to find products that suit them.

Let your child handle and try out the products before they need them, so the sensation isn’t a surprise.

Using period products

A visual schedule for your child’s choice of period product might help. For example:

Period-proof underwear – when to change and what to do with used underwear
Pads – where to attach a sanitary pad, when to change and what to do with used pads
Tampons – how to insert, when to change and what to do with used tampons.

Note – if your child prefers pads, it can also help to mark their underwear to show where the pad goes.

If your child keeps their period-proof underwear, pads and tampons in a particular drawer in their bedroom or the bathroom, your child will know where these things are when they need them.

Creating routines for managing periods

Building period care into your child’s existing routines can help periods feel more manageable. Try these tips:

Use a tracking app or wall calendar together so your child’s cycle becomes a predictable part of the month.
Add period care steps to your child’s daily visual schedule, if they use one.
Use a visual countdown app so your child knows when to check or change their period-proof underwear, pad or tampon.

Getting a period at school

You might need to tell your child what to do and who to go to if they get their period at school – for example, go to the school nurse.

Work with your child’s occupational therapist or paediatrician on an approach to managing periods that fits your child’s needs. If your child needs physical support with personal care, carers and support workers will need clear, consistent guidance on helping your child manage periods in a way that respects their dignity and comfort.

How to help your autistic child manage mood changes before and during periods

Like any child, your autistic child might experience mood changes before or during the first few days of their period. But if your child has difficulty communicating or regulating their emotions, this time of the month might be particularly challenging.

What to tell your child

You can let your child know that they might:

feel irritable
have trouble concentrating
feel depressed
feel sleepy.

You could turn this information into a visual support with pictures to illustrate these feelings.

How to make the link between moods and periods

You could note your child’s behaviour and make the link for them. For example, ‘You seem to be finding things harder than usual today. I wonder if your period is coming soon’.

If your child understands why they’re having these symptoms and how long the symptoms are likely to last, it can help them feel more in control of their changing body.

A social story about how your child feels when they’re getting their period

A social story specific to your child’s emotional symptoms might also help. Here’s an example.

For the first two weeks after my period, I feel fine.
In the third week, I start getting headaches, feel tired, have trouble concentrating and get annoyed more often.
I know this means I will probably get my period in a few days.
I know these feelings will go away and that I will feel better soon.

If your child’s symptoms seem to be severe or are stopping them from doing their usual activities, talk to a GP about medical and other options for managing the symptoms.

How to help your autistic child manage period pain and other symptoms

Your child might experience pain or discomfort when they get their period. For example, they might get stomach cramps or headaches.

Tips for managing period pain

Buy over-the-counter pain relief. If your child can tolerate it, it’s best taken at the first sign of pain or discomfort, rather than waiting until pain is severe. Ask your pharmacist or GP about the right dose and timing for your child.
Suggest your child uses a heat pack or warm water bottle on their lower stomach or back. Some children also find a warm shower or bath soothing.
Encourage your child to rest in a comfortable, quiet environment with low stimulation. This can reduce their sensory load if they’re already in pain.
Watch for indirect signs that your child is in pain. For example, they might withdraw, stim more, seem irritable or go quiet.
Speak to your GP if your child regularly experiences pain that stops them from doing their usual activities or if their pain seems severe.

Learning about periods is a process, not a one-time conversation. You might need to go over information with your child many times. If it’s challenging, you could look for online communities or local support groups to share experiences and get ideas that have worked for others.