PMDD, Autism and Sensory Overload: A Lived Experience Perspective

Editor’s note

We originally published this guest article because Laura’s reflections captured something that many autistic women and people with PMDD have described for years: the sense that hormones, sensory processing, emotional regulation and neurodivergence may be interacting in ways that are not yet fully understood.

Laura writes from lived experience, and we have kept her original words because they offer a valuable perspective on what that can feel like from the inside. Her observations about interoception, sensory overwhelm and hormonal change were shaped by her own experience, her advocacy work and the conversations she was seeing within autistic and PMDD communities.

Since this article was first published, research into autism, menstrual health and PMDD has grown, and some of it echoes themes Laura was already talking about, including increased sensory sensitivity, emotional regulation difficulties and greater overwhelm around the menstrual cycle. There is still much more to learn about the mechanisms involved and about how common PMDD may be within autistic populations.

We have added an updated research section at the end of the article so you can read her lived experience alongside what the evidence is beginning to tell us now.

Content note: Laura speaks openly about suicide attempts and severe mental health experiences in this article.

My experience of PMDD and autism

I’m Laura, a 34 year old, neurodiverse mother of two beautiful neurodiverse girls and wife to a wonderful neurodiverse man. I have struggled with PMDD, Postpartum Depression and Psychosis, and Menstrual Psychosis in my life. I’m passionate about learning and advocating for others who are suffering menstrual related disorders and advocating for the autistic/neurodiverse population. I talk openly about my own experiences through out my life, including my suicide attempts due to my menstrual related disorders. I have two passions in life, which both relate to myself and my kids: autism and menstrual mood disorders.

I’ve been part of the Premenstrual Dysphoric Disorder scene longer than I have been part of the autism scene, but both felt like home immediately. We talk about finding our tribes, our homes, with people who immediately understand us without questioning what we are going through, without invalidating our thoughts and feelings. Imagine my surprise when upon finding my autism crowd that many struggled with PMDD or other menstrual/hormone related disorders too. See, in the neurotypical world, PMDD is little known and talked about. However, in my autism support group, it’s not uncommon to see it in discussions.

I’m not formally diagnosed autistic. I self-identify and after a few years of research (which started because of my daughter’s diagnosis) quickly became a special interest of my own when I started to relate so much myself.

Women, autism and masking

Women and AFAB individuals often experience autism differently than male/AMAB counterparts. We are often discounted or ignored because we are more social, and we tend to mask our struggles. Women as a whole are expected to mask their struggles in life, neurodiverse or not. Classic theories of emotion posit that awareness of one's internal bodily states (interoception) is a key component of emotional experience (Jamil Zaki, 2012).There is talk in some autistic groups I participate in of PMDD or hormonal mood disorders being more prevalent in those that are autistic.

Could interoception be part of the picture?

This leads me to believe that this sensitivity to hormone fluctuation may be part of the interoceptive sense. When a person has a sensory disorder, we think most commonly of touch, auditory, taste, sight, and smells. Sometimes vestibular and proprioceptive sense is included. What is rarely discussed in sensory disorders is interoception sensory issues/processing and just how it can affect a person and what it can actually mean for mental/emotional health when its processing is disordered. Yes, for a sensory avoidant person such as myself who shies away from bright light because it hurts or loud noisy areas because those too are painful and overwhelming, my interoception sense is also avoidant and extra sensitive to overwhelm.

But what is interoceptive sense and why in the world would there be a connection to PMDD? For a long, medical definition of interoception you can read more here. For a simpler definition I am borrowing a passage from www.inspiredtreehouse.com:

Interoception refers to our perception of what is going on inside our bodies and is responsible for feelings of hunger, thirst, sickness, pain, having to go to the bathroom, tiredness, temperature, itch, and other internal sensations. What’s even more interesting about interoception is that it goes deeper than physical sensations because – as with all of our sensory systems – when our brains receive these internal signals, we interpret, attend to, and analyze them. So interoception is also associated with our sense of well-being, mood, and emotional regulation. (Heffron, 2017)

We know that the interoception sense is often part of a sensory processing disorder. We also know that under stress or overwhelm that our interoception is affected, often greatly. Think of our heart rate increasing during a panic attack or irritable bowel issues due to anxiety. And these also affect our emotions, maybe our heart rate is faster than normal, so we become anxious, creating a more rapid heart rate.

”Influential theories suggest emotional feeling states arise from physiological changes from within the body.” (Hugo D Critchley, 2017). Now, we know that PMDD has a physiological response system. The rise and fall of hormones within the body triggers a physical response from several systems in our body, not just ovaries and uterus, but deep within our gut, adrenergic systems, our cardiovascular system, and our brain.

How hormonal changes felt in my body

Compare the response of a sudden surge of progesterone in the late luteal phase to that of an individual with sensory processing disorder being overwhelmed by a sudden shove into a noisy gymnasium, with bright lights, many bodies, smells and a cacophony of sounds. Said individual would likely go into either shutdown or meltdown mode, as they were unprepared for such an assault on their system and may even have difficulty regulating their emotions; in fact their temper may become frayed quickly, they may find themselves having a panic attacks, anxiety may overwhelm them, their body may start producing pain signals to the overloaded senses, they may even collapse under the weight of it all.

A person without the sensory issue may find this environment exhilarating. I would certainly be huddled in a corner until I felt that I could safely slip away unnoticed. Or, I would start to snap at those around me because of a desperate need to get away. During the monthly cycle, my sensory system would be overwhelmed by the rise and fall of hormones and I felt completely out of control, emotionally. Because I was out of control. My sensory processing could not keep up with both the physical and emotional toll of what my body was going through. I see so many sad stories of young girls starting menses and the emotional outbursts and meltdowns make absolute sense if you think of hormones as overwhelming a sensory system that just cannot handle it. Any homeostasis change in our environment is difficult to cope with, especially drastic hormone fluctuations during the menstrual cycle.

It’s not that there is anything abnormal about the menstrual cycle itself, but rather how our body processes the sensations and systems that cause a rise and fall outside of the comfort zone.

My theory about PMDD and sensory processing

I believe that this can explain why women are affected by PMDD and how it all works. We found out in the last couple of years that there is a genetic link to PMDD. We also know that it is a sensitivity to hormone fluctuations, not the hormones themselves. Putting two and two together is what led me to this thought process, that it is part of the sensory systems and a processing disorder that causes a severe response, or meltdown, to our hormonal cycle. Obviously, not every woman who experiences PMDD or PME or other menstrual related disorders is autistic or has a sensory processing disorder; however, many are highly sensitive, both physically and emotionally.

What does the research tell us now?

Laura wrote this article from lived experience and was asking a question that researchers are still trying to answer: is there something about autism that changes the way some people experience the menstrual cycle?

There is now more evidence that the menstrual cycle can be particularly challenging for some autistic people. A 2025 qualitative systematic review found reports of physical, emotional and social difficulties around periods, alongside an increase in experiences such as sensory sensitivity, anxiety and autistic burnout during menstruation. Importantly, the researchers concluded that support needs to be shaped around autistic people's own experiences rather than assuming that everybody experiences their cycle in the same way.

This fits with earlier qualitative research in which autistic participants described a cyclical amplification of sensory differences and difficulties regulating emotions and behaviour around their periods.

Where the picture becomes less clear is PMDD specifically.

There have been claims that PMDD is dramatically more common among autistic women, but the evidence does not currently justify presenting that as established fact. One study found that 14.3% of autistic women met PMDD criteria compared with 9.5% of non-autistic women, but the difference was not statistically significant.

A 2025 study examining autistic and ADHD traits alongside premenstrual disorders similarly found no significant association between autism alone and PMS severity, while ADHD and co-occurring autism and ADHD were associated with increased odds of moderate-to-severe PMS. This is another reminder that neurodivergence is not one homogenous experience and that ADHD may be an important part of the hormonal health conversation too.

A wider 2025 scoping review concluded that our knowledge of autism, menstruation and mental health remains limited. The available research suggests that some autistic people experience cyclical changes in mood, emotional regulation and autistic characteristics, but study quality, small samples and inconsistent ways of measuring symptoms make it difficult to draw firm conclusions about prevalence or cause.

And what about interoception?

This remains an interesting question, but at present we cannot say that differences in interoception explain PMDD.

Interoception refers to how we perceive and interpret signals from inside the body, and research has long explored its relationship with emotion and autism. Laura's suggestion that hormonal fluctuations might be experienced as a form of sensory overwhelm is therefore an interesting lived-experience hypothesis, particularly given what autistic people themselves report about sensory changes around their periods.

But there is a difference between an idea being plausible and it being proven.

At the moment, the more accurate conclusion is that autism, sensory processing, interoception and hormonal health may interact in important ways, but we are still working out exactly how.

That uncertainty is not a reason to dismiss the experiences people are reporting. If anything, it is a reason to research them properly.

Why this matters at work

There is an important workplace conversation here too.

An autistic woman managing significant cyclical symptoms may be dealing with more than mood changes or period pain. At certain points in her cycle she may also experience heightened sensory sensitivity, reduced capacity for masking, changes in emotional regulation, greater fatigue or increased need for predictability and recovery.

That can make an already demanding working environment much harder to navigate.

Think about an open-plan office full of noise and movement, a day of back-to-back meetings, fluorescent lighting, an unexpected change of plans or a role that requires constant social interaction. Someone may cope with that environment relatively well for much of the month and find it considerably harder at another point in her cycle.

The useful response is not to assume she is suddenly less capable. It is to understand what has changed and what might help.

Perhaps that means more control over the sensory environment, the option to work somewhere quieter, greater flexibility around where work happens, clearer communication, fewer unnecessary meetings or simply having a manager who understands that neurodivergence and hormonal health can interact.

This is also why workplace conversations about women's health and neurodivergence should not sit in completely separate boxes.

People do not experience themselves in organisational categories.

Their brain, hormones, health, working environment and life outside work all arrive at work together.

Want to understand hormones and neurodivergence at work?

At See Her Thrive, we help organisations understand the intersection between women’s health, neurodivergence and working life.

Our Women, Hormones & Neurodivergence sessions explore how experiences such as autism and ADHD can interact with the menstrual cycle, PMDD and menopause, what the emerging research tells us, and what this can mean for wellbeing and performance at work.

The aim is not to make assumptions about neurodivergent women or pathologise normal hormonal changes. It is to give managers, teams and organisations a more informed understanding of experiences that have been overlooked for far too long, and translate that knowledge into practical, human support.

If this is a conversation you would like to bring into your organisation, get in touch to talk about a session for your team.

You can also explore our Women, Hormones and Neurodiversity: What Do We Know? article, read more about autism in women, or browse the wider See Her Thrive Library.

Laura’s original references

Heffron, C. (2017, February 27). What is interoception? The Inspired Treehouse. https://theinspiredtreehouse.com/what-is-interoception/

Critchley, H. D., & Garfinkel, S. N. (2017). Interoception and emotion. Current Opinion in Psychology, 17, 7–14.

Zaki, J., Davis, J. I., & Ochsner, K. N. (2012). Overlapping activity in anterior insula during interoception and emotional experience. NeuroImage, 62(1), 493–499.

Further research and updates

Ellis, R., et al. (2025). Menstruation and autism: A qualitative systematic review. Autism in Adulthood.

Groenman, A. P., et al. (2022). Menstruation and menopause in autistic adults: Periods of importance? Autism, 26(6), 1563–1572.

Kondo, C., et al. (2025). Association between premenstrual syndrome or premenstrual dysphoric disorder and neurodevelopmental traits.

Skommer, J., et al. (2025). Autism, menstruation and mental health: A scoping review and a call to action.

Steward, R., Crane, L., Roy, E. M., 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, 4287–4292.