Womens Health

Periods, Pregnancy, Menopause and More

In this section you will find information on how neurodiversity can have an effect on women's health.

Whether you are 16 or 96, your body needs to be looked after carefully and responsibly.

This can be extra challenging for people who are born with uteruses as you may also have to manage periods, pregnancy, menopause and many other health issues.

If you are neurodivergent, this can make managing these aspects of your health more difficult.

Please note that this page will at times refer to 'women', 'females', 'men' and 'males'.

However, we fully respect that biological sex (chromosomes/karyotypes) and gender are not the same, and also that other karyotypes exist.

A variety of gender-neutral and gender-specific terms are used across the page to acknowledge that not all people with uteruses are women, but also that some of these people prefer the gender-specific terms. This is often because gender-neutral terms based around the reproductive organs can offend people who believe it reduces their life experience to one body part or bodily function.

The easiest way to be inclusive of everyone's preferences is to not focus solely on one, and to instead use a variety.

The information below applies to any person who has the chance of experiencing periods, pregnancy, postnatal depression, menopause, and/or gynae issues. This includes transmen, intersex and non-binary people.

Periods

And ADHD

Hormonal changes during your period can impact ADHD symptoms by decreasing the levels of oestrogen and dopamine in your body.

Some people with ADHD find this worsens their impulsivity, forgetfulness and irritability. Others get very bad premenstrual syndrome (PMS).

You might have trouble sleeping, maintaining close relationships, and focusing on household or school tasks. Mood swings in children and teenagers may be exceptionally challenging. Depression and anxiety can be worse during your period, too.

To help cope with ADHD and your period, you or your child can try:

Mindfulness Techniques
Meditation, yoga, breathwork and sensory exercises can reduce stress and lessen the feelings of anxiety and depression. Try searching on YouTube for Guided Meditation videos. Even just 5 minutes a day is beneficial.
Increase Breaks
Take a few extra moments each day to catch your breath and refocus. Box Breathing (see below) is a great 1-minute exercise that can be done almost anywhere to refocus and calm your mind.
Look After Your Body
Physical health and mental health are closely linked, so whilst your period is getting you down you can focus on improving both in small, easy steps.
Encourage healthy bedroom habits to aid sleep, such as no screens for an hour before bed. Where possible, prioritise nutritious foods full of relaxing compounds such as almonds, white rice, Chamomile tea and oats. If you or your child has ARFID, sticking to well-tried 'safe' foods during your period can reduce unnecessary stress caused by unknown or unwanted foods. Cut back on caffeine and alcohol, both of which negatively impact sleep. Exercise within your limits, even if this is just a short walk.
Talk
If your period is making you miserable, reach out and talk about it. Whether it is a trusted family member, peer support, a therapist or healthcare professional, talking about the problem is a helpful first step in overcoming it.
There are medical treatments available for PMS, very heavy periods and behavioural problems associated with your period. If you prefer to avoid medicines, talking therapies are also very beneficial to help you manage this difficult time of the month.

And autism

If you or your child has autism, menstruation may be more likely to cause:

Difficulty focusing (executive function difficulties)
Inability to self-regulate emotions, causing more frequent meltdowns
Increased sensory sensitivity and sensory overload
Higher levels of bleeding and/or period pains

But why is this?

Hormonal changes such as the dip in oestrogen and dopamine in the week leading up to your period are thought to be responsible for PMS and menstrual difficulties in a lot of people. However, autistic people often already have difficulties with executive function and emotional regulation, so the stress of these hormonal changes very easily becomes a 'tipping point' into stress and sensory overload.

Some of the challenges autistic people who menstruate face are:

Learning the process of changing a pad, tampon or menstrual cup
Remembering to change sanitary products regularly
Confusion due to slang terms and euphemisms (having the decorators in, on the rag, time of the month)
Lack of clear, detailed information about menstruation
Disruption in routine due to wearing and changing sanitary products, and possibly having to use public toilets to do so
Difficulty coping with uncertainty and change, as each period can be very different to the one before it
Difficulties in communicating to carers, friends and family or healthcare workers about the emotional symptoms of PMS
Difficulty sleeping, intensifying mood swings, meltdowns, depression and anxiety

Ways to Help

If you are caring for an autistic person, there are several ways you can prepare for their period and support them through it:

Start Early
In order to give them time to adjust and understand their period, it is best to explain it to them before it happens. Provide clear descriptions of what is going to happen and what they need to do to manage it. There are lots of easy-read guides available online (see example) that can help you. Some people might prefer models or YouTube videos.
Give Them Options
There are lots of different sanitary products to choose from, including tampons, pads/towels, cups, discs, reusable products and period underwear. Show them where to buy these items and how to use them. If they are able, help them to choose what feels most comfortable to them. If they cannot make this decision themselves, they might find period underwear the most familiar-feeling choice. It looks very close to normal knickers, and heavy-flow versions can be worn for up to 24hrs without changing.
If they choose pads, you can add a coloured dot or line in permanent marker on their underwear to remind them where the pad should be placed.
Make a Plan
Explain important hygiene measures, such as when to change sanitary products. They may benefit from setting a schedule or using alarms/reminders on their phone.
They can also use a period-tracking app (such as Flo) or a calendar to track their cycle. Learning how many days is normal for their cycle can help them prepare for their next period.
Find a nominated person at school or work who can help them if their period starts whilst they are not with you or at home.
Consider plans to manage distress and fear over public or communal toilets. For example, seeking access to disabled or private toilets instead.

If you are autistic, ways you can self-manage your period include:

Track your emotions as well as your cycle. Keeping a diary or using a period-tracking app (such as Flo) can help you start to recognise when, how and why your emotions change during your period. Apps can also send you alerts of when your period is likely to start.
Set alerts or reminders on your phone to remind you to change your sanitary products.
Carry spare underwear and sanitary products with you. This can be at all times, or if you have learnt that you have a regular cycle can be in the few days leading up to your next period.
Keep spare products and underwear in places you visit often, such as your place of work or family member's houses.
Consider talking to your GP, Brook or Les Bas Centre about hormonal contraceptives. These can help make irregular cycles more regular and predictable, and may reduce PMS symptoms for some.
Nominate a friend, family member or carer to help you understand, plan for and manage your period. You may not need this, but for some it can be helpful.

And neurodiversity as a whole
Neurodiverse people are disproportionately more likely to suffer from menstrual problems such as severe PMS and Premenstrual Dysphoric Disorder (PMDD). They may also have other co-existing physical and mental health problems that are also affected by the cycle of hormonal changes.

Here are some self-care tips that might help neurodiverse people:

Talk
If your period is making you miserable, reach out and talk about it. Whether it is a trusted family member, peer support, a therapist or healthcare professional, talking about the problem is a helpful first step in overcoming it.
There are medical treatments available for PMS/PMDD, very heavy periods and behavioural problems associated with your period. If you prefer to avoid medicines, talking therapies are also very beneficial to help you manage this difficult time of the month.
Trans and non-binary people might find talking about their period difficult. You might worry about being misgendered, or feeling worse dysphoria. How you feel about your period is unique to you, but Mind have a helpful list of LGTBIQ+ organisations you can reach out to if you want to talk to someone who understands your experience.
Track Your Cycle
Using a calendar or an app, track your period and your feelings every day. You may be able to work out if there is a pattern. For example, you might find your symptoms are worst in the seven days before your period.
Knowing when your next period is due and when you might feel bad can help you to plan how to cope with the worst days. You might rearrange stressful events and errands, plan relaxing activities, or make sure you have support in place.
Look After Your Body
Physical health and mental health are closely linked, so whilst your period is getting you down you can focus on improving both in small, easy steps.
Encourage healthy bedroom habits to aid sleep, such as no screens for an hour before bed. Where possible, prioritise nutritious foods full of relaxing compounds such as almonds, white rice, Chamomile tea and oats. If you or your child has ARFID, sticking to well-tried 'safe' foods during your period can reduce unnecessary stress caused by unknown or unwanted foods. Cut back on caffeine and alcohol, both of which negatively impact sleep. Exercise within your limits, even if this is just a short walk.
Look After Your Mind
Meditation, yoga, breathwork and sensory exercises can reduce stress and lessen the feelings of anxiety and depression. Try searching on YouTube for Guided Meditation videos. Even just 5 minutes a day is beneficial. You can scroll up to the Periods and ADHD section to see a short exercise on Box Breathing.
Spend time in nature, or any space where you feel safe and relaxed.
Create a Self-Care Box
This can be a physical box, drawer or shelf full of items that normally cheer you up and help you to relax.
For example:
1. Your favourite tea bags or hot chocolate sachets
2. Some tasty biscuits, granola bars or other favourite snack
3. Your favourite book or DVD
4. Some positive affirmation cards (scroll down for examples)
5. A notebook and a pen to write down your feelings
6. A favourite soft toy or fidget toy
7. Where suitable, mild pain killers like paracetamol or ibuprofen to help with period pains
8. A hot water bottle
9. Photos of friends, family or pets
10. Pamper products you like, such as bubble bath or face masks

Remember, excessively long periods and/or those with PMS symptoms that are severely affecting your daily life are not normal. Consult your doctor if you are worried about these problems.

Positive affirmations
Click to expand and download

Pregnancy

Before Pregnancy

ADHD

If you have ADHD it’s important to tell your doctor before you start trying to get pregnant. This is to make sure you are on the right type and dose of medications to keep you and your future baby safe and well.

Your doctor might advise you to stop taking your medication, or change to a different type. We don't fully understand how some ADHD medications could affect a developing baby, but methylphenidate and amphetamines have the most research into their effects during pregnancy so doctors might suggest one of these as the safest option.

Do not stop taking your ADHD medications before speaking to your doctor, as this may make your symptoms suddenly worse.

If you are already pregnant, tell your community midwife or obstetric team straight away and before you stop taking your medication.

Autism

Autistic people are more prone to common mental health problems like anxiety and depression. If you are taking medication for a mental health condition, it is important that you talk to your GP before trying to get pregnant. Some medications are not safe in pregnancy, so you may need to change the type of medicine you are taking.

During Pregnancy

Your community midwife will talk to you about Parent Education classes, sometimes called Antenatal Classes or Parent Preparation. There is a free course in Jersey called Baby Steps which most first-time parents choose to attend. It is packed with information not only on birth and newborn babies, but managing stress and emotions during pregnancy and after the birth. You may also consider private classes, such as hypnobirthing. First-time parents should try to attend at least one parent preparation course. If you or your partner are neurodivergent and attending classes would be difficult, speak to your midwife. They may be able to offer short 1-2-1 sessions.

ADHD

Your midwife or obstetric team can support you to understand your pregnancy care and attend appointments.

If you forget important details easily, ask your midwife to give you written information as much as possible. There are lots of leaflets designed by Jersey midwives available to help you.

All appointments will be written on the back of your handheld "pregnancy notes". You are given these at the beginning of your pregnancy at the first midwife appointment, and they stay with you until your baby is born. Make sure to check the back page regularly to remind yourself of upcoming appointments. You might also want to ask your midwife if they can text you reminders of your next appointment.

You may find it helpful to keep a list of questions ready for your appointment. On paper or on your phone, write down any question you think of as soon as you think of it. Then, when you next see your midwife or obstetric team, you won't have to remember what you wanted to ask.

Autism

Most community midwives in Jersey run their clinics on the same day every week. For example, your midwife might always have a Tuesday clinic. You can ask to try and plan each of your appointments for around the same time of day. All appointments will be written on the back of your handheld "pregnancy notes". You are given these at the beginning of your pregnancy at the first midwife appointment, and they stay with you until your baby is born.
You can also ask for the midwife to explain in advance what will happen at the next appointment. Your pregnancy notes will be updated every time you see the midwife, and you can ask for anything discussed to be written down for you to read back in your own time.

Jersey's maternity service tries to minimise how many different midwives you see in your pregnancy. This is called "continuity of care". However, some clinics are run by more than one midwife, and midwives are of course entitled to time off and holidays.
If seeing the same midwife every time is important to you, you can discuss it with your named midwife and try to plan your appointments so that this happens. You might instead want to consider getting to know two or more of the community midwifery team, so you have a 'backup' person to see should your midwife be poorly or on leave.

Consider creating a health passport to help communicate your needs to the midwives and doctors. Your midwives and doctors are here to help, and will not judge you.

There is limited evidence to suggest how autism may affect pregnancy. However, there is some suggestion that it may be linked with higher rates of pre-eclampsia and pre-term birth.

If this concerns you, you can ask to discuss this with one of the obstetric doctors in the antenatal clinic.

Birth

Autism
Unfortunately, the continuity of care Jersey provides does not currently continue into labour care. This means you are not guaranteed to know who will look after you when you are in labour.

You are more likely to know your labour-care midwife if you have a home birth, as the community midwives are on call for these. Home births are suitable for people with low-risk pregnancies. The community midwives often run "meet the team" events for people considering home births, which could be helpful for you to attend.

If you are planning a hospital birth, or are worried about going into labour with a new midwife, you can discuss this with your midwife or obstetric team.

You might want to consider hiring a doula. This is a non-medical birth assistant who will be on-call for you and attend to support you emotionally when you give birth. You meet them whilst you are pregnant and talk about how they can advocate for you in the hospital. This means they can help communicate your needs and wishes should you be too overwhelmed to do so yourself. They will also help with gentle massage, calming words, guided meditation, information sharing and many other aspects of labour care. They do not do anything medical, including assisting the birth of your baby. Doulas can be a very calming and supportive presence, but they do charge a fee. Most people will rely on their partner, parent or a close friend to support them instead.

You can currently have two people with you to support you in labour.

You might want to visit the maternity ward during your pregnancy, so that you know what to expect when you go into labour. There are no formal 'tours' available, but you can be shown around by one of the ward midwives. Discuss this with your midwife.

If you want to feel more in control during labour, it is a good idea to attend parent preparation classes. This will help you to understand the process and know what to expect. You may also find it helpful to write down or type your birth preferences. It is a good idea to include any strong sensory likes or dislikes. For example, many midwives will massage your lower back during contractions, so if touch is something you dislike it is important to communicate this. If you have any unusual responses to pain, write these down too.

After Birth

ADHD

Some babies will need to be monitored for a few days after birth if you were taking ADHD medication during your pregnancy. This is because your baby might be dependent on the medication, and needs time to get used to not having it.

If you choose to breastfeed, you may need to change the dose or type of medication you take. Many ADHD medications pass into breastmilk, but it isn't always clear whether they affect the baby.

No matter whether you breast or bottle feed, or do a mix of the two, you may find it helpful to set an alarm for every 3 hours in the early days to remind you when baby is next due to feed, as some babies will sleep through a feeding time if not woken up.

Autism

Some autistic people worry about bonding with their baby. Some people will start to bond in pregnancy, some will start at the birth. Others will take weeks or even months after the birth to feel like they have built a bond with their baby. This is very normal, and especially common if the labour was long or there were complications. But even a quick, straightforward birth can still leave parents needing lots of time to bond. There are lots of helpful websites like Tommy's which can give you tips on how to bond with your baby.

If you choose to breastfeed, you may need to change the dose or type of medication you take if you have mental health conditions. This is because some medicines pass into the breastmilk.

Autism sometimes runs in families but this doesn’t always mean that your baby will be autistic. If you notice signs of autism in your child as they grow, speak to your health visitor or GP. You can also look at Parent Toolkits that help parents with the assessment process.

Extra Support

Brighter Futures

Brighter Futures is a local charity supporting parents, families and young people in Jersey. They provide keyworker support alongside a number of free programmes and services to help support parents and carers.

Their Brighter Storks programme features wellbeing groups, which include massage and visualisation and breathing techniques. These visualisation and breathing techniques help to calm the mind and can help to reduce stress and anxieties.

Pregnancy in Mind

Pregnancy in Mind is a preventative mental-health service designed to support parents-to-be who are at risk of, or currently experiencing, mild to moderate anxiety and depression during their pregnancy.

It is an antenatal group intervention delivered by professionals after the first trimester of pregnancy. Parents-to-be are able to attend the programme between 12 and 34 weeks gestation. Your midwife can refer you to Pregnancy in Mind.

MECSH

Having a new baby can be a difficult time for any parent. It can be harder for neurodivergent people, as babies do not regulate into routines for many months and need a very high level of care.

You might want to consider signing up for the MECSH scheme which is run by the health visitors. This means the health visitors will visit you more frequently after your baby is born, to make sure you are getting the support you need and that your baby is growing and developing well. The scheme is voluntary, and is available to people from any background or circumstance. If you would like to join the MECSH scheme, your community midwife can refer you at any point after your first routine pregnancy scan (the dating scan).

AllMatters Neurodiverse Jersey has a volunteer committee member who is also a midwife. Kate Wilson qualified as a midwife in 2013, and has worked in all areas of Jersey's maternity care including antenatal clinic, the maternity ward/labour ward, homebirths, and antenatal/postnatal community care.

Kate was diagnosed with autism in 2023 and also has several chronic medical conditions. She understands that being a neurodivergent hospital patient can be difficult.

Kate is offering neurodivergent families free 1-2-1 support sessions during their pregnancy and early newborn stage. She can talk to you about advocating for your needs, what to expect in the hospital, parent education topics, writing your birth preferences, and baby cares.

If you think you would benefit from a chat with Kate, please use the contact form on this website.

Please be aware, for insurance reasons Kate cannot provide medical midwifery care when seeing families as part of her volunteer AMNDJ role, please speak to your midwife for this.

Postnatal Depression

Neurodivergent people are more likely to develop postnatal depression (PND) than neurotypical people.

Mind Jersey created the below helpful slides to explain the difference between PND and Baby Blues, and briefly talks about getting help:

1/5

Mind also have a very helpful information leaflet about mental health in pregnancy, which you can find on this page.

Local Support Services Available

There is a wide range of professional and peer support services that you can access. These are open to you and your family before, during, and after your pregnancy. It doesn't matter if you had mental health problems before your pregnancy, or if they only started around your pregnancy.

Antenatal Clinic

Jersey's maternity service has recently hired a Perinatal Mental Health Specialist Midwife, who will be making changes to the services available. Speak to your community midwife or obstetric team, who can refer you to the Perinatal Mental Health Clinics in the hospital. These may include appointments with a Clinical Nurse Specialist, Consultant Psychiatrist, Health Visitor, Midwife or other Mental Health Practitioner.

Baby Steps

Baby Steps is a free programme of parent preparation classes. They include lots of information about mental health and coping methods for parents. Your midwife can refer you to Baby Steps after your 16th week of pregnancy.

Brighter Futures

Brighter Futures support parents to identify new tools to cope, increase their resilience and make sustainable changes that will enable them to create a brighter future for themselves and their families. They have a large schedule of programmes that you might find helpful (see here).

Hub of Hope

A directory of mental health support services in your area.

Jersey Talking Therapies (JTT)

JTT support adults over the age of 18 with free, confidential therapy services including CBT, EMDR, counselling, acceptance and commitment therapy and more. You can self-refer to them online.

The Listening Lounge

This is a free of charge service that offers a safe space to talk about how you're feeling. This can be with the Peer Team, who are people who have experienced mental health problems themselves, or with one of their trained counsellors. Call them on 866793, or visit their website to self-refer.

MECSH (Maternal Early Childhood Sustained Home-Visiting Programme)

This scheme is run by the health visitors. They will visit you more frequently after your baby is born to make sure you are getting the support you need and that your baby is growing and developing well. The scheme is voluntary, and is available to people from any background or circumstance. If you would like to join the MECSH scheme, your community midwife can refer you at any point after your first routine pregnancy scan (the dating scan). If your baby has already been born, speak to your health visitor about a referral.

Peer Support (Mind Jersey)

Mind Jersey offer sessions led by your peers. This means the people running the sessions are other parents who have experienced mental health problems around pregnancy or after birth. There is more information here about peer support. You might also want to read about the Parent Decider skills sessions they host, which help you build healthy coping methods.

Parent and Infant Psychotherapy Service (PIP)

If you're struggling to relate to, bond with or interact with your baby, PIP can help. Speak to your health visitor for referral to this service.

In an Emergency

Visit the Emergency Department if you feel you are in urgent need of mental health support. They can contact the professionals best placed to help you.

Menopause

Historically, autism and ADHD have been massively under-diagnosed in females compared to males. Whilst healthcare professionals are slowly becoming more inclusive and devising better diagnostic tools and criteria for women, trans and non-binary people, there are still a lot of unknowns. One area that is woefully under-researched is the menopause experience for neurodivergent people.

What we do know is that neurodivergent women are more at risk of suffering from increased menopausal symptoms, including hot flushes, poor sleep, increased anxiety, poor concentration, and memory lapses. This is similar to how during the menstrual cycle, increased sensitivity to hormonal fluctuations causes heightened sensory sensitivities. People can struggle more with executive function, managing their emotions, and coping with everyday life and self-care.

Menopausal symptoms are known to be caused by fluctuations in oestrogen production. Experiencing more symptoms may mean that the hormonal balance is different in neurodiverse people, however this has not been researched to date. Another possible explanation is that neurodiverse people may be more sensitive to their body during menopausal transition due to their overall increased sensory sensitivity, and thus experience menopausal symptoms more intensely.

These symptoms can be felt so intensely by some neurodivergent women that they are actually what first led that person to their autism diagnosis.

We also know that aside from menopause, neurodivergent people are more vulnerable to mental and physical ill health. This makes it very concerning that so little is known about how we experience and cope with the changes of menopause.

Menopausal neurodiverse women commonly report three main problems:

A lack of knowledge and understanding amongst professionals
Increased autistic/ADHD features, including high levels of anxiety, greater difficulties with social communication and relationships, executive functioning difficulties, and difficulties with sleep and self-care
Difficulties finding help and support.

So, how can we tackle these problems?

1) Lack of professional knowledge and understanding

Some gynaecologists, endocrinologists and psychologists are starting to take a real interest in researching the neurodiverse menopause experience. If you think there are specific areas to prioritise, you can tell one research team led by Dr Rachel Moseley (Bournemouth University) by leaving a post here.

Otherwise, you can help your healthcare workers by signposting them to professional resource websites such as the Primary Care Women's Health Forum.

2) Increased symptoms

Rock My Menopause has a fantastic page full of tips on how to manage the most common menopause symptoms. You can find it here.

They also provide a symptom tracker which can help you to explain to your GP what problems you are experiencing, and when they happen.

You may also find it helpful to confide in a trusted friend, family member or healthcare professional. Menopause is not a taboo subject and is nothing to be embarrassed about.

3) Difficulties finding help and support

Peer Support

Fortunately, one area of neurodiversity and menopause that is growing rapidly is peer support.

Check out these coping tips written by other neurodiverse people who are perimenopausal or menopausal. You can even add your own to support other people like yourself.

Local & Workplace Support

See Her Thrive - if your workplace are looking to improve menopausal support and inclusivity, they might consider working with See Her Thrive. There is even a free menopause workplace audit tool available.

JACS - provides a menopause in the workplace booklet for employees and employers

Vitality40Plus - a local company who offer some free resources and some paid-for resources and courses to support menopausal people

Research

Dr Moseley and Professor Julie Gamble-Turner have published a fantastic resources guide here. They have undertaken very interesting research into autism and menopause. They also took part in a webinar with other healthcare professionals which explored current knowledge around autistic experiences of menopause, as well as the gaps where we need to know more.

The YouTube video of the webinar is included at the bottom of this section.

Useful Websites

Balance - a library of menopause resources in written and video formats

The Diversity Project - includes information for all types of menopause, including perimenopause, postmenopause, premature and early menopause, medical menopause including surgical menopause and chemical menopause for endometriosis, PMDD or cancer, menopause-like symptoms in IVF and PCOS, gender affirmation menopause, and andropause.

Henpicked - a library of menopause resources in written, video and podcast formats.

Menopause Inclusion Collective - who aim to build a community of inclusive menopause changemakers with shared values. They provide blog posts and helpful resources.

Rock My Menopause - an activist group who raise awareness and provide a variety of resources and support.

Gynaecology

This section will cover cervical screening and contraception.

Cervical Screening

If you have a cervix and are over the age of 25, it is important to attend routine cervical screening every 3 years. Even if you are not sexually active, these screens can pick up on HPV and early signs of cervical cancer. You might have heard this screening referred to as a "smear" or a "Pap test".

Many people can find this screening difficult or uncomfortable. Your genitals are usually seen as a private area of your body, and it can feel awkward letting a stranger see them. But there is nothing to be embarrassed about. The doctor or nurse doing your screening sees lots of genitals every day, and it is no different to them than looking inside your ear or mouth. They will not judge you, or your genitals, even if you decided to dye the hair down there bright pink!

Cervical screening can be particularly difficult for neurodivergent people, especially for those with sensory issues.

If you or a ND person you care with needs cervical screening, there are ways you can prepare to make it as comfortable as possible.

Consider discussing the following with the doctor or nurse who will be doing the screening:

Any communication needs. For example, for a non-verbal person, do you need to explain to the doctor how they might communicate that the screening is hurting? Does the doctor need to use calm, quiet tones and direct, simple language or visuals?
Would it be beneficial to book a double-length appointment, to allow you time to go slowly through the screening? Or do you perhaps need to attend at a day/time when the clinic is less busy, so the waiting room is less busy and you're less likely to wait past the booked time of your appointment?
Would it be helpful to show the person an easy-read guide or video so that they know what to expect? Examples of both can be downloaded here
Is there anything you can bring to help sensory issues and comfort? For example, you are usually covered by some paper, but you may feel more comfortable with a soft blanket over your hips instead. Or you might like to bring a fidget toy to distract you
Do you take any medications that help you to remain calm, relaxed and not anxious? If so, consider if you should take a dose before the appointment
Do you or the ND person you care for have any special interests that you could tell to the doctor? They could open conversations about this to help build trust and comfort
Do you already know and trust a specific GP or nurse who you can book to see for your screening?
If you have questions about cervical screening, write them down to ask either in advance or on the day
If you would like to have someone with you to hold your hand or support you in another way, this is always okay
Plan something enjoyable for after the appointment. If it's for you, think of the self-care things that make you relaxed and happy. Maybe you will go to Brunos and get a fancy cake, or take a long, warm bath at home with a book. If you are taking your ND child or someone else you care for, let them pick what they'd like to do after. Remind them of this special thing before and during the appointment

Kate is one of our committee members. She is also a midwife, and has been diagnosed with autism. She understands that communicating your needs to healthcare professionals can be intimidating. She has put together the below brief guide that you can show to your GP or nurse to help them understand how they can support people with autism or other neurodivergence. It might help them understand what to ask you, and how to communicate with you.

You might also consider writing a health passport to help communicate your needs.

Contraception

There are lots of options for contraception that you could consider. You can read about the different kinds here. Easy-read leaflets are available here.

This section is going to talk about additional considerations neurodiverse people need to make before choosing a type of contraception.

The Combined Pill or Progesterone-Only Pill

For some neurodiverse people, the idea of remembering to take a pill at the same time every day is daunting. If you choose the combined pill, you might also have to remember when to take a break and stop taking a dose for 4-7 days.

If you want to use the combined or progesterone-only pill, consider:

Setting a daily alarm to remind you to take the pill. You must not miss a dose to ensure you are protected from pregnancy
Take it at a time when you would normally be at home: for example, before you go to bed. This means you don't need to remember to carry the pill with you when you're out and about
If you have a carer, ask them to be in charge of administering the pill every day for you

There are also some important side-effects that might be worse for the neurodiverse community:

If you struggle taking oral tablets, swallowing one every day might be an unpleasant sensory experience
Mood swings are common and might persist for the whole time you take the pill. Neurodivergent people are already more likely to struggle with mood swings, so this is more common when they take the pill
It can make periods unpredictable at first. Some people experience spotting and breakthrough bleeding, or irregular cycles. This usually settles after a few months

Caps, Diaphragms and Rings

The main downsides to a cap or diaphragm for a neurodivergent person is having to learn and remember how to use it.

It takes time and practice to learn how to place it correctly. You also have to remember when to insert it, to apply spermicide every use, and to wait 6hrs after intercourse before removing it.

It is very important to not forget that you have a diaphragm or cap inside you, as prolonged use can make you dangerously unwell with something called Toxic Shock Syndrome. You also cannot use it during your period for the same reason.

Using a vaginal ring also takes practice, though you usually leave it in place for around 21 days. You need to be confident in putting it into your vagina, and also taking it out. You need to remember when to change it, so it might be best to set an alert or reminder on the calendar. The ring can also cause mood-swings, spotting and breakout bleeding.

Condoms

Male and female condoms are the only contraceptives that can protect you from sexually-transmitted infections. This makes them a very good choice for your sexual health.

However, female condoms will take a bit of practice to get used to inserting and removing them. Male condoms also need a bit of practice to get used to putting them on.

If you forget things easily, remembering to buy condoms and to stop and use one before sex might be a problem for you.

Patch and Injection

You only have to change your patch once a week, which means less remembering-work compared to the pill. However, you do still have to remember to change it and might need to set alarm reminders.

You might find the sensation of wearing it unpleasant. It feels much like a plaster you use when you cut yourself, but it can also make your skin itchy, sore and irritated. It can also cause mood changes, spotting and breakthrough bleeding, though this tends to settle after a few months.

The injection lasts much longer, usually around 13 weeks. However, if you are very sensitive to the pain of an injection this is not going to be the right choice for you. You must remember to book and attend an appointment for your next injection before the current one wears off. If you dislike GP appointments, this can be a problem.

The injection can also cause irregular or heavy periods and mood swings, which will continue for the full length of the injection (13 weeks) and often longer after that.

Implant, IUD and IUS

The implant looks like a small matchstick and sits under the skin in your upper arm. The main benefit is that it lasts for 3 years, so you only have to remember to change it once 3 years is over.

It requires a few injections of numbing anaesthetic, and a little cut to insert. This might be unpleasant if you dislike injections or the sight of blood. You also need the injections and cut to remove and change it.

It can cause mood swings, which is usually for just the first few months. It can however make your periods irregular throughout its use.

The IUD (intrauterine device) and IUS (intrauterine system) are very similar. You might hear them being called a 'coil'. The IUD contains copper, and the IUS contains progesterone.

Both are fantastic for anyone who is worried about having to remember to take their contraception. Depending on the type used, an IUD lasts between 5-10 years before needing to be changed. An IUS lasts between 3-5 years.

However, having an IUD/IUS inserted can be unpleasant. It involves having a speculum inserted into the vagina, and some metal rods into the cervix. Some people describe this as uncomfortable, but for others it can feel very painful. It is hard to predict how it will feel for you. Some doctors offer local anaesthetic or an inhaled pain killer to make this more comfortable. Speak to your doctor to see if they can provide this for you.

Both can cause irregular periods. Some people find an IUS causes mood changes, but it is less common compared to other hormonal contraceptives. Because an IUD contains no hormones, it does not usually cause mood changes.

Natural Methods

Natural Family Planning is usually not recommended due to it being difficult to get right.

You have to keep a daily record of your fertility signals, such as your temperature and the fluids coming from your cervix. You may need to set a reminder to do this every day, and use a notebook or app to log it. It takes 3 to 6 menstrual (monthly) cycles to learn the method. The signals can also be affected by illness, stress and travel. This means they are less reliable at these times.

You need to avoid sex during your fertile days. Or, if you want to have sex during the time when you might get pregnant, you'll need to use barrier contraception, such as a condom, diaphragm or cap. This can be for up to 16 days of your cycle. You will also need to use it for the first 3-6 months whilst you learn your cycle.

It will not work without continued commitment and practice, and can be very hard work.

Female Sterilisation

Most people who opt for sterilisation have already had children, and do not want any more. However, if you are absolutely sure that you never want children, it can be an option for you.

Sterilisation is permanent, involves being put to sleep for surgery, and can sometimes fail (though this is rare). It is also a chargeable procedure in Jersey.

If you would like more information on contraception, you might find these websites helpful:

Brook

Gov.je

Yes.je

NHS - Which contraception is right for me?

Sexwise (good quick-comparison on this page)

National Autistic Society - Sex Education Guide for Parents