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Nutrition, Sensory Sensitivities, and Perimenopause: An Autistic Dietitian’s Perspective

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As an autistic dietitian, I often hear from autistic women who say their sensory sensitivities feel “louder” in midlife. Foods they used to tolerate suddenly feel unbearable, grocery stores feel too bright, and even the smell of cooking oil can turn a meal into a battle. What’s happening isn’t “all in your head.” For many of us, sensory changes intensify during perimenopause, when hormone levels — especially estrogen — fluctuate in ways that can amplify stress responses and sensory experiences (Harak et al, 2025).

How Sensory Sensitivities Affect Eating

Autistic sensory profiles vary widely, but for many of us, taste, texture, smell, or even temperature can make eating stressful. These preferences often narrow food choices, and over time, that can affect nutrient intake — especially if entire food groups (like meats, dairy, or certain vegetables) are avoided (Pérez-Cabral et al, 2024). Limited variety doesn’t just influence physical health — it can affect mood, energy, and sensory regulation. Nutrients like omega-3 fatty acids and B-vitamins support neurotransmitter balance and brain health, both of which are key for sensory processing and emotional stability (Infante et al, 2020; Długosz et al, 2025).

Food-Based Support for Sensory Well-Being

When I work with autistic clients — especially women in midlife — I focus first on real foods that feel safe and manageable, before considering supplements.


Here are some strategies that often help:

  • Start with comfort textures. If smooth or crunchy foods feel best, build balanced meals around them. Smoothies, soups, and yogurt can be nutrient-dense if blended with fruits, seeds, or soft-cooked greens. Crunchy preferences? Try roasted chickpeas, seed crackers, or crisp apples with nut butter.
  • Add omega-3s without triggering texture issues. If fish is challenging, ground flaxseed or chia mixed into oatmeal, smoothies, or soft snacks can boost alpha-linolenic acid intake.
  • Use color and variety gently. Instead of forcing new foods, pair familiar favorites with one new element in small amounts — for example, a few spinach leaves blended into a fruit smoothie or grated carrots mixed into rice.
  • Mind gentle smells. Steaming or baking instead of frying reduces strong cooking odors. Cold meals like grain bowls or overnight oats can be helpful on high-sensitivity days.

The Role of Balanced Nutrition

Even small dietary adjustments can make a meaningful difference. Research shows that diets rich in antioxidants and anti-inflammatory foods — berries, leafy greens, legumes, nuts, and seeds — may help modulate oxidative stress and inflammation, processes linked with both brain and hormonal health (Naranjo-Galvis et al, 2025; Arteaga-Henríquez et al, 2023).


Including adequate protein throughout the day also helps stabilize energy and mood, especially during hormone fluctuations. Lean meats, eggs, tofu, lentils, and Greek yogurt are good options — or, for texture-sensitive eaters, protein powders can be blended into tolerated bases like oatmeal or smoothies (Karhu et al, 2020).

It’s also worth noting that some autistic women experiment with gluten-free or casein-free diets. The evidence is mixed — some report improvements in gut comfort or mood, while others see no change (Fraguas et al, 2019; Karhu et al, 2020). The key is personal fit, not restriction for its own sake. If removing a food helps you feel better, make sure the nutrients it provided (like calcium, vitamin D, or fiber) are replaced through other sources.

Perimenopause and Hormonal Shifts

During perimenopause, fluctuating estrogen and progesterone levels influence neurotransmitters like serotonin and GABA, which play roles in mood regulation and sensory processing. These hormonal changes can heighten sensitivities and impact sleep, focus, and emotional regulation. Research suggests that eating enough protein and omega-3 fats, along with vitamins B, C, D, and calcium, can help maintain hormonal balance and support bone and cardiovascular health during this stage (Harak et al, 2025).

If you find your sensory sensitivities are sharper in the week before your period or during hot flashes, it’s not just coincidence. Hormonal changes alter how we experience light, sound, and even pain. On those days, focus on gentle, predictable meals that you don’t have to overthink — like oatmeal with seeds and berries, or eggs with avocado toast. Predictability can be calming for both the nervous system and digestion.

Supplements — When and Why

Food first, always — but there are times when supplements may be worth discussing. Deficiencies in vitamin D, B12, folate, or omega-3s are relatively common in autistic adults and may worsen fatigue or mood changes (Avram et al, 2025; Serafim et al, 2025). If blood work confirms low levels, supplementation can be helpful, but always under guidance from a healthcare provider. Some supplements, like L-carnitine or melatonin, show early promise for supporting mood or sleep in autistic adults, but the evidence is still emerging (Długosz et al, 2025).

Gentle Nutrition for Real Life

Autistic bodies often crave predictability and sensory safety, and nutrition can honor that. Instead of pushing drastic change, think small, supportive shifts that respect your sensory world and energy levels:

  • Keep a few go-to safe meals that meet your nutrient needs.
  • Eat regularly — even when appetite is low — to stabilize blood sugar and prevent meltdowns or crashes.
  • If food prep feels overwhelming, use frozen produce, canned beans, or pre-cooked proteins. Nutrition doesn’t have to be perfect; it has to be possible.
  • Stay hydrated — even mild dehydration can heighten sensory stress (Campbell & Spano, 2011). Try herbal teas or naturally flavored water if plain water feels unappealing.

As autistic women, we deserve nutrition guidance that recognizes our sensory experiences, not works against them. Our needs may not fit mainstream dietary advice — and that’s okay. Supporting our bodies through perimenopause means feeding ourselves in ways that reduce overwhelm, not add to it.

If this resonates, share it with another autistic woman navigating midlife changes. The more we talk about how sensory and hormonal health intersect, the more supportive and inclusive nutrition care can become. You can sign up for my newsletter by sending me a message below.

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This article is for informational purposes only and is not intended as medical advice. Before incorporating any of these suggestions, consult with a qualified healthcare professional. If you are seeking personalized guidance schedule a consultation with me—an registered dietitian nutritionist (RDN)—to ensure you make safe and evidence-based choices.

References

  1. Pérez-Cabral ID, Bernal-Mercado AT, Islas-Rubio AR, et al. Exploring dietary interventions in autism spectrum disorder. Foods (Basel). 2024;13(18):3010. doi:10.3390/foods13183010
  2. Naranjo-Galvis CA, Trejos-Gallego DM, Correa-Salazar C, et al. Anti-inflammatory diet and probiotic supplementation as strategies to modulate immune dysregulation in autism spectrum disorder. Nutrients. 2025;17(16):2664. doi:10.3390/nu17162664
  3. Długosz A, Wróblewski M, Błaszak B, Szulc J. The role of nutrition, oxidative stress, and trace elements in the pathophysiology of autism spectrum disorders. Int J Mol Sci. 2025;26(2):808. doi:10.3390/ijms26020808
  4. Infante M, Sears B, Rizzo AM, et al. Omega-3 PUFAs and vitamin D co-supplementation as a safe-effective therapeutic approach for core symptoms of autism spectrum disorder: case report and literature review. Nutr Neurosci. 2020;23(10):779-790. doi:10.1080/1028415X.2018.1557385
  5. Arteaga-Henríquez G, Gisbert L, Ramos-Quiroga JA. Immunoregulatory and/or anti-inflammatory agents for the management of core and associated symptoms in individuals with autism spectrum disorder: a narrative review of randomized, placebo-controlled trials. CNS Drugs. 2023;37(3):215-229. doi:10.1007/s40263-023-00993-x
  6. Karhu E, Zukerman R, Eshraghi RS, et al. Nutritional interventions for autism spectrum disorder. Nutr Rev. 2020;78(7):515-531. doi:10.1093/nutrit/nuz092
  7. Fraguas D, Díaz-Caneja CM, Pina-Camacho L, et al. Dietary interventions for autism spectrum disorder: a meta-analysis. Pediatrics. 2019;144(5):e20183218. doi:10.1542/peds.2018-3218
  8. Serafim SDS, Sant Anna LM, Rover MRM. Dietary supplements in the management of symptoms associated with autism spectrum disorder: a scoping review. Nutr Rev. 2025;nuaf085. doi:10.1093/nutrit/nuaf085
  9. Avram OE, Bratu EA, Curis C, Moroianu LA, Drima E. Modifiable nutritional biomarkers in autism spectrum disorder: a systematic review and meta-analysis of vitamin D, B12, and homocysteine exposure spanning prenatal development through late adolescence. Int J Mol Sci. 2025;26(9):4410. doi:10.3390/ijms26094410
  10. Harak SS, Shelke SP, Mali DR, Thakkar AA. Navigating nutrition through the decades: tailoring dietary strategies to women’s life stages. Nutrition (Burbank, Los Angeles County, Calif). 2025;135:112736. doi:10.1016/j.nut.2025.112736
  11. Campbell BI, Spano MA. NSCA’s Guide to Sport and Exercise Nutrition. Champaign, IL: Human Kinetics; 2011.

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