Neurodiverse girls and periods: why we’re still getting this wrong

If periods are hard for lots of girls, they can be brutal for neurodiverse ones.
And yet, many still talk about them as if all girls experience menstruation in roughly the same way.

They don’t.

If you are parenting, teaching, or supporting an autistic girl, a girl with ADHD, or a girl whose nervous system is simply more sensitive, periods are not just a monthly inconvenience. They can be a full-body, full-brain, full-identity event. And too often, these girls are expected to just “get on with it”.

They can’t. And they shouldn’t have to.

A girl who taught me

I once worked with a girl – I’ll call her Ella – who was bright, articulate, and utterly undone by the days leading up to and week of her period. At school she was labelled “moody” and “dramatic”. At home she sobbed, shut down, or raged in ways that frightened her parents.

When we really listened, it became clear that Ella wasn’t “overreacting”. She was autistic and sensitive. Hormonal shifts amplified everything – noise, smell, touch, emotions, shame. Her period didn’t just arrive in her body. It arrived everywhere.

No one had joined the dots. That’s the problem. We’re still treating periods as a hygiene issue, when for neurodiverse girls they are a nervous system issue. And a hygiene issue.

What makes periods especially hard for neurodiverse girls?

Here’s a few things we often miss:

Sensory overwhelm
Pads, tampons, period pants – the textures, smells, sounds, pressure and unpredictability can feel unbearable. Add cramps, headaches, bloating and fatigue and you have a body that feels hostile to live in.

Interoception differences
Many neurodiverse girls struggle to interpret internal body signals. They may not notice a period starting until it’s heavy. Or they may feel flooded by sensations without being able to explain what’s wrong.

Emotional amplification
Hormonal changes can intensify anxiety, rejection sensitivity, anger or despair. Girls with ADHD often report dramatic emotional swings. Autistic girls may feel emotionally hijacked without language for what’s happening.

Shame and secrecy
Because neurodiverse girls are often already working hard to mask, periods become another thing to hide. Leaks, smells, blood, tears – all deeply threatening if you are trying to appear “fine”.

School environments that make it worse
Crowded toilets. No bins. No privacy. Rigid rules about not leaving lessons to go to the toilet. Being told to “wait until break”. No safe adult to go to. For some girls, this is enough to trigger school refusal.

None of this is trivial. And none of it is the girl’s fault.

What neurodiverse girls actually need

They don’t need tougher skin. They don’t need to “normalise” it faster. They need support that fits their nervous system.

For many neurodiverse girls, especially at the beginning, periods are not something they can manage alone – and that is not a failure or a delay. It’s a need. Some girls may need a parent or trusted adult to take care of parts of it for a while: disposing of used pads, helping get blood-stained pants into the wash, noticing when supplies are running low, or discretely keeping track of when the next bleed is due, so it doesn’t arrive as a terrifying surprise. Choice matters too. Having different period products available – pads of different textures and thicknesses, period pants, reusable options, tampons – allows girls to experiment and discover what feels least distressing to their body.

Before they know to, keep the bleed week lighter, reducing social demands, allowing more rest, and showing them that this can really help with the overwhelm. The truth is, much of what many of us learned over years of trial and error – how to anticipate our cycle, how to prepare, how to make it manageable – may need to be held and done with our daughters at first. Slowly, gently, and without shame. This is not about dependence. It’s about care, scaffolding, and passing the knowledge on in a way their nervous systems can actually absorb.

From parents

• Explicit, concrete teaching
  Neurodiverse girls often need step-by-step explanations about periods long before they start. Not euphemisms. Not hints. Clear language. Visuals. Repetition.
• Choice and experimentation
  There is no one right period product. Let her try different options without pressure. What works one month may not work the next.
• Permission to rest
  Periods are not a character test. Fatigue, withdrawal and needing comfort are not failures.
• Belief
  If she says it hurts, it hurts. If she says she can’t cope today, listen. Trust builds regulation.

From schools

This is where I get a bit more direct. If schools are serious about inclusion, period support must be part of SEND provision.

That means:

• access to quieter toilets or safe spaces
• flexible PE expectations
• permission to leave lessons without interrogation
• named trusted adults
• staff who understand that emotional dysregulation may be hormonal, not behavioural

No girl should not have to choose between bleeding through her clothes or being punished for leaving class.

From policymakers

We need to stop treating menstrual health as an optional add-on.

That means:

• period education that includes neurodiversity
• training for teachers on how periods intersect with autism and ADHD
• recognition that menstrual difficulties contribute to school absence and mental health risk
• earlier, integrated support for girls whose cycles significantly affect wellbeing

This is not niche. This is safeguarding.

From the girls themselves

When I ask neurodiverse girls what they want adults to understand, they say things like:

“I don’t know what’s wrong with me until it’s already too much.”
“I feel hijacked by my body.”
“I wish someone would just let me be quiet.”
“I’m not being difficult. I’m overwhelmed.”

They are not asking for special treatment. They are asking for understanding.

Where Rites for Girls comes in

At Rites for Girls, our programmes – Girls Journeying Together and Girls’ Net – are particularly supportive for neurodiverse girls because we give things time. Social rules are made explicit. Feelings are named. Bodies are talked about honestly. There is space to opt out, to listen, to speak when ready.

In my book From Daughter to Woman, the chapter Periods – bloody nuisance or bleedin’ miracle? explores how we can reframe menstruation not as something girls must endure silently, but as a rite of passage that deserves care, preparation and respect – especially for girls whose systems are more sensitive.

Many neurodiverse girls tell us our groups are the first place they’ve been able to talk about periods without feeling weird, wrong or broken. That matters.

A few books I often recommend

• The Autism-Friendly Guide to Periods by Robyn Stewart
  A clear, practical and reassuring guide written specifically for autistic girls using straightforward language, visuals and step-by-step explanations to reduce anxiety and build confidence around periods.
• The Spectrum Girl’s Survival Guide by Siena Castellon
  Practical, validating and written by a neurodivergent woman who gets it.
• Period Power by Maisie Hill
  Not neurodiversity-specific, and best used as a parent guide or selectively with teens who want more information, rather than a first puberty book for neurodiverse preteens.
• From Daughter to Woman by Kim McCabe
  Especially the chapters on puberty, periods and body changes, written with sensitivity for girls who feel more intensely.

This isn’t about fixing girls

Let me be clear.

Neurodiverse girls do not need to be toughened up to cope with periods. We need to soften the systems around them.

When we do that, something shifts. Girls stop fighting their bodies. Parents stop blaming themselves. Schools stop misreading distress. And girls learn that their sensitivity is not a flaw – it’s information.

Periods are not just a monthly event. They are a mirror.

If we can learn to support neurodiverse girls well through menstruation, we will be doing something quietly revolutionary.

And we’ll be making growing up kinder, safer and more humane for every girl.