Autistic girls: periods

Periods and autistic children

Autistic children go through many changes in puberty, just as typically developing children do. First periods are one of the most significant milestones. A first period is a sign that the physical changes in your child’s body have only a couple of years to go.

Most young people get their first period when they’re between 11 and 14½, but anywhere from 9-16 years is considered normal. If a child has a major growth spurt and has grown some underarm hair, periods are likely to be just around the corner.

Autism doesn’t affect when young people start their periods.

When to start talking about periods with autistic children

Autistic children often need longer to adjust to and understand changes in their lives than typically developing children do. And because you can’t know exactly when your child will get their first period, it’s a good idea to start talking about it early.

Also, if children don’t know or understand what periods are, they could be frightened that something is wrong with them or that they’re hurt. It can help to make sure your child is prepared.

How to prepare autistic children for periods
Social stories can help you and your child get ready for periods. Here’s an example.

Social story: I will begin to have my period
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.
Most girls and women have a period 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 medication 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 seven days, I will talk to an adult who cares about me.

Practical preparations for periods

Your child will need to know what sanitary pads, period-proof underpants, tampons and menstrual cups look like and how to use them. You could go to the supermarket and choose some different pads or tampons together, or look at these items online.

You know your child best, so you’ll be able to decide whether period-proof underpants, pads, tampons or a menstrual cup will be best for them.

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

If your child uses visual supports, a visual schedule that shows the steps involved in changing period-proof underpants, pads or tampons can be useful. It will also help if you show your child where to attach the sanitary pad – you could mark their underwear to show where it goes.

Once your child’s periods have started, you could show your child how to use a calendar or an app to plan when their period is due.

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

Children of any age can use tampons, but it can take some time and practice to get used to them. It’s probably easier to manage and less overwhelming for your child if they start with period-proof underpants or pads before tampons. When your child is first starting with tampons, the type that come with applicators can be easier to use.

Mood changes or emotional symptoms before and during periods

Like typically developing children, autistic children might experience mood changes just before or during the first few days of their periods. But if your child has trouble communicating or finds it hard to regulate their emotions, their emotional symptoms might lead to challenging behaviour.

You can help your child to manage mood changes and emotional symptoms by letting them know that they might:

feel cross and cranky
have trouble concentrating
feel depressed
feel sleepy.

Pictures to illustrate these feelings might be useful.

If your child understands why they’re having these symptoms and how long the symptoms are likely to last, it can help your child feel more in control of their changing body. At first you could note your child’s behaviour and make the link for them. For example, ‘You seem a bit grumpy today. I wonder if your period is coming soon’.

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

Social story: how I feel when I’m getting my period
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 normal activities, talk to a GP about medical and other options for managing the symptoms.

You’ll probably need to go over these messages many times with your child. Try to be patient with your child – and yourself. It might help to share experiences and get support from other parents. You could try online or face-to-face support groups.