Over the last few years, I have noticed something interesting in my counselling practice.
I am seeing more and more women in their forties and fifties who are either exploring whether they might be autistic or who have recently received an autism diagnosis.
Of course, there are some obvious reasons for this.
Many women begin questioning whether they might be autistic after one of their children is identified. As they learn more about autism, they often recognise aspects of themselves in what they are reading and hearing.
However, I have found myself wondering whether there is more to the story.
Why are so many women arriving at this realisation during perimenopause and menopause?
As I listened to clients describe their experiences, a pattern began to emerge.
Many spoke about feeling more overwhelmed than they used to.
Some found social situations increasingly exhausting. Others noticed heightened sensory sensitivities, reduced tolerance for busy environments, greater emotional overwhelm or a growing need for recovery time after everyday activities.
What stood out most was that many women described finding it harder to maintain the coping strategies they had relied upon for years.
The things that had once helped them blend in, fit in and keep going no longer seemed to work in quite the same way.
Many described feeling unable to keep masking.
When the Strategies Stop Working
Many autistic women reach adulthood without knowing they are autistic.
Instead, they learn how to adapt.
They study social rules, observe other people closely, rehearse conversations, suppress natural responses and work hard to appear as though they are coping.
Over time, these strategies can become so automatic that they are barely noticeable, even to the person using them.
From the outside, these women may appear confident, sociable and successful.
Yet maintaining this level of adaptation often comes at a significant cost.
Many describe feeling exhausted, anxious, disconnected from themselves or constantly worried about getting things wrong.
Masking can be an incredibly effective survival strategy.
But it requires energy.
A great deal of energy.
Could Hormonal Changes Play a Role?
As I explored the research, I found myself wondering whether hormonal changes themselves might contribute to this experience.
Research tells us that oestrogen does much more than regulate reproductive health.
It also plays a role in attention, memory, emotional regulation, stress responses and cognitive functioning. Many women notice changes in concentration, resilience and their ability to manage everyday demands during perimenopause and menopause.
For autistic women, this raises an interesting possibility.
Masking is not effortless.
It often involves constantly monitoring social interactions, interpreting expectations, managing sensory discomfort, analysing situations and adapting behaviour in order to fit into environments that may not feel natural or comfortable.
This requires considerable cognitive and emotional resources.
If hormonal changes affect some of those resources, it seems reasonable to wonder whether maintaining a mask might become more difficult.
The research does not currently tell us that declining oestrogen causes autistic women to unmask.
However, it may help explain why some women report that the strategies they have relied upon for decades suddenly feel exhausting, fragile or unsustainable.
Many women describe feeling as though they can no longer keep all the plates spinning.
Not because they have chosen to stop masking.
But because the effort required to keep masking has become too great.
The Moment Things Begin To Make Sense
This is often the point at which many women begin searching for answers.
They may initially wonder whether they are experiencing stress, anxiety, burnout or simply struggling with the effects of menopause.
Then they come across information about autism.
For the first time, they read descriptions of masking, sensory differences, social exhaustion, difficulties with change, special interests or lifelong feelings of being different.
And something clicks.
Experiences that never quite made sense suddenly begin to fit together.
The issue is not that autism has suddenly appeared.
Rather, the effort involved in compensating for autistic differences has become harder to sustain.
What was once hidden becomes harder to hide.
What was once manageable becomes exhausting.
What was once explained away begins to make sense.
More Than Awareness Alone
It would be easy to say that more women are discovering they are autistic simply because awareness has increased.
Awareness is certainly part of the picture.
But I am not convinced it is the whole story.
The women I meet are not simply learning new information.
Many are experiencing a genuine shift in their ability to continue adapting in the ways they always have.
The strategies that carried them through childhood, education, work, relationships and parenting are no longer working as effectively.
And it is often this struggle that prompts them to ask questions about themselves that they have never asked before.
A Different Way Of Looking At Midlife Autism Identification
Perhaps autism does not become more visible during perimenopause and menopause because autistic traits increase.
Perhaps it becomes more visible because the effort required to hide those traits becomes harder to sustain.
For some women, this period of life creates an opportunity to understand themselves in a way they never have before.
But because the coping strategies that once concealed their struggles are no longer working in the same way.
The women I meet in therapy are not becoming autistic during perimenopause or menopause.
Rather, many seem to be reaching a point where the strategies they have relied upon for decades are becoming harder to maintain.
As masking becomes more exhausting, lifelong patterns that may once have gone unnoticed begin to stand out more clearly.
For some women, this becomes the beginning of a new understanding of themselves.
Not because autism has suddenly appeared.
But because, perhaps for the first time, they are able to see it.
