Why Perimenopause Is When Women Seek Out an Autism Diagnosis

From hormones to confidence, mid-life changes mean women want answers.

Posted April 4, 2026 | Reviewed by Tyler Woods

I was in my late forties when I started considering autism as a possibility for the challenges and difficulties I’d faced throughout my life. And I’m not alone. Anecdotally, the vast majority of my clients are women in their forties and fifties, often going through perimenopause , and starting to explore autism as an explanation for what has, for many, been a long-standing sense of difference without a clear reason.

Research shows that autism diagnosis rates in the U.S. rose by up to 175 percent between 2011 and 2022¹, with a significant rise in girls and women who are also more likely than males to be diagnosed at a later age. The fact that autism is often missed or misdiagnosed in women and girls when they’re younger is well-documented², and part of the reason for the significant increase in later-life diagnoses is simply due to women being more aware of autism as something that was missed earlier in their lives.

Perimenopause comes with a unique set of demands and changing perspectives. When clients are perimenopausal, here are some of the most common challenges they talk to me about.

Perimenopause makes things harder

Perimenopause is a time of life when many things become more challenging. Hormonal changes, which can have far-reaching physical, cognitive and emotional impacts, mean that it’s more difficult to cope in many ways. For those autistic women who have “got on with it” for most of their lives, despite finding situations extremely challenging, perimenopause is a time when things simply become even harder.

This includes heightened sensory sensitivities and emotional volatility³, which are things that might have always been problematic, but which become intolerable during perimenopause. Many of my clients have reached a point of extreme burnout , the result of continuously pushing through what seems “doable,” but which has taken a considerable toll. Combined, this means that what seemed just about manageable, even if it required a lot of effort, reaches a point where it’s no longer manageable. Which leads to women searching for answers as to “why”.

Midlife is a wake-up call for many of us that we’re not going to be around forever, and it’s important to live a life that feels more appropriate to who we are. Many of us realise that, to move forwards differently, we need to understand who we are and why we experience things in the way we do. We want answers. And reaching midlife is often the catalyst for seeking those answers.

Cheryl told me, “Nobody sees how hard things have been for me. But I have struggled every day since I was about five. And I want things to be a bit easier going forward. I’m fed up. This is my time to change things”.

Focusing on our needs

For many women, perimenopause is a time when there’s an inner focus, and for some women, this transitional phase is liberating⁴. Often, children are reaching their teenage years or have left the family home. For some women, there’s a strong realisation that they need to use this new focus to look after themselves, and exploring their experience in more detail—which for some women includes exploring autism in more detail—is a part of that process.

Menopause can be extremely hard for some women, and can lead to a loss of confidence . For others, it can be a time of greater confidence than they might ever have felt before. It’s from this new, more confident state of mind that they refuse to keep doing things in the same way.

They become more confident around setting boundaries , making informed choices and challenging the status quo in their relationships. Once they experience the positive effects of these changes, they often ask the question, “Why do I get on better when I do things differently?” This, in turn, can lead to an exploration of neurodivergence.

Annie told me, “I’ve already made changes. I’ve felt more confident in saying no to things. I don’t people-please in the same way. I’m slowly feeling a bit better and discovering why that is—and if it’s autism—is important to me”.

They’ve had a lifetime of exploration

By the time my clients come to me, they’ve often spent years trying to find answers for a sense of difference and why things felt so challenging. I can identify with the process of reading self-help books, starting a psychology degree aged 18, having years of therapy and training as a therapist, all to try and establish what was at the root of those huge challenges I faced.

After a lifetime of questioning, autism is often the one thing that makes sense, and the fact that there’s so much more awareness of women’s autism means that women in mid-life have the opportunity to explore it as an explanation.

As Reika said, “If this isn’t it, I don’t know what else it can be. I just know I’ve looked into everything else, and I need answers now”.

It’s never too late to explore autism as an explanation, and perimenopause is often a time when women realise the importance of finding answers to a lifetime of difference.

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Grosvenor LP, Croen LA, Lynch FL, et al. Autism Diagnosis Among US Children and Adults, 2011-2022. JAMA Netw Open. 2024;7(10):e2442218. doi:10.1001/jamanetworkopen.2024.42218
Bargiela, S., Steward, R., & Mandy, W. (2016). The experiences of late-diagnosed women with autism spectrum conditions: An investigation of the female autism phenotype. Journal of Autism and Developmental Disorders.
Brady MJ, Jenkins CA, Gamble-Turner JM, Moseley RL, Janse van Rensburg M, Matthews RJ. "A perfect storm": Autistic experiences of menopause and midlife. Autism. 2024 Jun;28(6):1405-1418. doi: 10.1177/13623613241244548. Epub 2024 Apr 15. PMID: 38622794; PMCID: PMC11135000.
Giggins OM, Cullen Smith S, McLysaght A, Doyle J. A robber of joy or a natural transition? a qualitative exploration of women's menopause experiences in Ireland. BMC Womens Health.

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Claire Jack, Ph.D. , is a hypnotherapist, life coach, researcher, and training provider who specialises in working with women with autism spectrum disorder (ASD). She was herself diagnosed with ASD in her forties.

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This article is part of the Bringwise Psychology Journal — daily insights on human behavior, mental health, and personal growth.