Supporting Autistic Young People with PMDD

**** Content Warning: This resource discusses suicide and self harm ****

Premenstrual Dysphoric Disorder (PMDD) is often described as a severe form of PMS that causes intense anxiety, depression, and physical symptoms in the luteal phase of the menstrual cycle. For autistic young people, these experiences can be even more overwhelming, exacerbating things like sensory sensitivities, fatigue from masking, and managing strong emotions that are often as a result of existing in environments and systems not designed for them.

Often people are not aware of PMDD, or that you are more likely to experience it if you are neurodivergent. Many parents and professionals struggle to find the right information and support strategies, we felt it was important to create some resources around this.

This article is aimed at parents and professionals, however if you would like a resource written for young people, we have one over on our Autism Understood website here: https://autismunderstood.co.uk/health-and-wellbeing/periods-and-pmdd/

What Is PMDD?

PMDD is linked to hormonal changes during the menstrual cycle, with symptoms that are severe and impact on daily life. Unlike PMS, which might cause milder mood swings and physical discomfort, PMDD can be debilitating, affecting mental health, emotional regulation, and daily functioning. Symptoms typically emerge during the luteal phase (the two weeks before menstruation) and disappear once the period starts. This can start from someone’s first period, which is why we feel it is important to talk about it in relation to young people.

Common Symptoms of PMDD:

Severe mood swings, irritability, or anger
Depression, feelings of hopelessness, self-harm and suicidal thoughts
Intense anxiety and panic attacks
Extreme fatigue and physical pain
Difficulty concentrating and brain fog
Heightened sensory sensitivities and overwhelm (leading to more meltdowns and shutdowns)
Increased emotional dysregulation and Rejection Sensitive Dysphoria (RSD)

Why Autistic Young People May Be More Vulnerable to PMDD:

Being autistic comes with differences in how we experience sensory input, emotions, and executive functioning, all of which are also impacted by PMDD. This overlap can make symptoms much more intense and harder to manage. Here are some reasons why this might be:

Trauma and Anxiety Responses

Autistic people often experience higher rates of trauma just from existing in a world designed for neurotypical brains. Trauma impacts nervous system regulation, which is further disrupted by the hormonal changes in PMDD. This can increase anxiety, panic attacks, and feelings of being out of control. Recent research suggests a link between widespread inflammation, caused by chronic stress and trauma, and the likelihood of experiencing PMDD. This link is really important to explore when thinking about how to support autistic young people who may be experiencing PMDD.

Heightened Sensory Sensitivities

Autistic people often experience sensory processing differences, meaning we might already be more sensitive to pain, sounds, lights, or textures. The hormonal shifts in PMDD can make these sensitivities even more extreme, leading to sensory overwhelm, meltdowns and shutdowns.

Emotional Dysregulation & Rejection Sensitivity

Many autistic people can struggle with emotional regulation and Rejection Sensitive Dysphoria (RSD), where perceived criticism or rejection feels intensely painful. PMDD can amplify emotional responses, making rejection, social misunderstandings, or frustration feel unbearable.

Executive Functioning Challenges

PMDD can cause brain fog, forgetfulness, and a lack of motivation, exacerbating existing executive functioning differences that we may already be struggling with.

Resources:

The following resources may be useful when supporting an autistic young person struggling with PMDD.

Downloads:

Menstrual Cycle Tracker - tracking symptoms and when they occur in the menstrual cycle can be key when seeking diagnosis and for planning support for young people.

Communication Support Tools - a Pain Scale, Overwhelm Scale and Feelings & Sensations Wheel resource to help support communicating feelings of distress.

Suicide Safety Plan Template - if your young person experiences suicidal ideation or self harms when feeling overwhelmed during the luteal phase it can be important to have a plan in place for this.

Who can I Talk to? - A resource that explores who young people can reach out to when they are struggling and also offers scripts for starting conversations and healthy boundaries around friends who might reach out to them for support.

On-Demand Webinar:

In this two-hour webinar, we explore the complex relationship between PMDD (Premenstrual Dysphoric Disorder), trauma, neurodivergence, and hormonal fluctuations, and why understanding these links is crucial for getting the right support for autistic young people.

The webinar is for parents, caregivers & professionals supporting autistic young people, however due to the distressing nature of some of the content, particularly around suicide and self harm, the webinar is likely not suitable for young people themselves.

While the main focus is on autistic young people, the webinar does also mention information and support strategies for ADHD young people as well. The webinar and resources also take into account that not all of the young people who need support with this will identify as female, and aims to provide gender affirming information. In addition to the 2 hour webinar recording, you will also receive a pdf copy of the presentation slides and an accompanying resource Padlet.

Why Learning about PMDD Matters:

Autistic and ADHD people are more likely to have PMDD, yet research and recognition are lacking.
Suicide rates among those both people who struggle with PMDD and autistic people are shockingly high, and understanding the link can save lives.
Healthcare barriers and societal stigma mean many struggle to get proper diagnosis and treatment.

Content Covered:

What is PMDD? - Symptoms and the impact they have on wellbeing.
The autism-PMDD connection - and why understanding this link is key for ensuring young people get the support they need when they need it.
The role of trauma, inflammation, and histamine in PMDD - and why this can be especially relevant when supporting autistic young people.
How PMDD impacts emotional regulation, sensory processing, and executive functioning - and why autistic young people may struggle more premenstrually than their neurotypical peers.
Barriers to diagnosis and treatment - and what we can do to navigate them.
Practical strategies for tracking, supporting wellbeing, and advocating for support.

Purchase Webinar Recording