An occupational perspective on the lived experience of menstruation for autistic adults

Menstruation is known to have potentially adverse impacts at multiple levels of occupational performance (Armour et al 2019). Little research has to date, however, directly investigated the everyday menstruation experiences of autistic individuals, for whom menses and menarche are widely thought to be particularly occupationally disruptive (Steward et al 2018). In this presentation, a qualitative research design was employed to address the lived experiences of menstruation among a small set (n=6) of autistic adults in the UK. In-depth online interviews were conducted. These yielded 34,734 words of transcript, which were thematically analysed using the six steps described by Braun and Clarke (2006), and interpreted through an Occupational Perspective of Health Framework (Wilcock and Hocking 2015).

Three interconnected global themes were identified:
1. ‘Sense of self’, addressing participants’ sensory overload and amplified experiences of anxiety, ‘brain fog’ and concern with cleanliness.
2. ‘Attributional work’, addressing events and contexts which were taken to trigger and/or exacerbate key problems (such as the need to use public restrooms).
3. ‘Reclaiming orderliness’, addressing participants’ pragmatic strategies for overcoming the increased unpredictability inherent in their lives during periods.

It was concluded that menstruation poses specific, significant challenges for autistic individuals which require autism-specific solutions. These challenges impact individuals’ ability to perform, in particular, occupations of self-care, productivity and leisure. As such, occupational therapists have a key role to play in the provision of support to address the impact of menstruation on occupational engagement and participation.

References:
Armour M, Parry K, Al-Dabbas M, Curry C, Holmes K, MacMillan F, Ferfolja T Smith CA (2019) Self-care strategies and sources of knowledge on menstruation in 12,526 young women with dysmenorrhea: a systematic review and meta-analysis. PloS One, 14(7), e0220103. doi: 10.1371/journal.pone.0220103.
Braun V Clarke V (2006) Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101. doi: 10.1191/1478088706qp063oa.
Steward R, Crane L, Mairi Roy E, Remington A Pellicano E (2018) ‘Life is much more difficult to manage during periods’: autistic experiences of menstruation. Journal of Autism and Developmental Disorders, 48(12), 4287–4292. doi: 10.1007/s10803018-3664-0.
Wilcock AA Hocking C (2015) An occupational perspective of health. Thorofare, NJ: SLACK Incorporated.