Autism And Menstrual Pain: Predictors Of Menstrual Experiences In An Autistic And Non-Autistic Popul

Background & Aims

Autistic children and young people are overrepresented in chronic pain services (Lipsker et al., 2018). In particular this pain presentation seems to more common in autistic women and girls as well as non-binary and trans individuals. These populations have been typically excluded in research in autism given that males are more likely to receive these diagnoses. There has therefore been almost no research exploring issues specifically thought to affect autistic women, such as menstrual pain. One of the few existing studies in this area give cause for concern, with more painful and heavy periods reported (Jeffery et al., 2013) however little research has specifically examined pain associate with menstruation in an autistic population and how individual differences measures might predict pain. Our previous research has found that fear of pain and pain anxiety are higher in autistic populations and that these variables predict pain response well in this population (Failla et al., 2020)

Methods

Ninety total participants, 40 autistic, and 50 non-autistic completed a battery of online questionnaires. To measure menstrual symptom severity the Menstrual Distress Questionnaire (MEDI-Q) was used. Predictors in this study were Sensory Profile Questionnaire, Toronto Alexithymia Inventory, Multidimensional Assessment of Interoceptive Awareness, Version 2 (MAIA-2), The Pain Anxiety Symptoms Scale-20 (PASS-20), Fear of Pain Questionnaire-III (FPQ-III), & Camouflaging Autistic Traits Questionnaire (CAT-Q).

Results

There were significant differences in menstrual experiences between the groups, with the autistic group experiencing more pain and more distress. Additionally, autistic individuals experienced significantly more camouflaging. Significant predictors of menstrual symptoms and distress were found in the total population and in non-autistic individuals with pain anxiety predicting pain frequency and distress. Critically these effects were not observed in the autistic group.

Conclusions

Autistic people who menstruate experience more frequent and distressing menstrual pain. This further supports the greater pain difficulties experienced by this often understood population. Unlike in our previous research however our autistic population did not report greater pain anxiety or fear of pain. Further, contrary to our previous psychophysical studies pain affect did not predict pain frequency or distress in our autistic group. Further research is needed to understand the role of individual differences in predicting autistic peoples pain.

References

Failla, M. D., Gerdes, M. B., Williams, Z. J., Moore, D. J., & Cascio, C. J. (2020). Increased pain sensitivity and pain-related anxiety in individuals with autism. Pain reports, 5(6), e861.
Jeffery, E., Kayani, S., & Garden, A. (2013). Management of menstrual problems in adolescents with learning and physical disabilities. The Obstetrician & Gynaecologist, 15(2), 106-112.
Lipsker, C. W., Bölte, S., Hirvikoski, T., Lekander, M., Holmström, L., & Wicksell, R. K. (2018). Prevalence of autism traits and attention-deficit hyperactivity disorder symptoms in a clinical sample of children and adolescents with chronic pain. Journal of Pain Research, 2827-2836.
Whitney, D. G., & Shapiro, D. N. (2019). National prevalence of pain among children and adolescents with autism spectrum disorders. JAMA pediatrics, 173(12), 1203-1205.

Presenting Author