Dr Clare Bailey: Autism and why women are under the radar

I was shocked but not surprised to discover that up to 200,000 girls and women in the UK could be living with undiagnosed autism, often known at the high-functioning end as Asperger’s syndrome. It’s said to be ten times more common in men than women – and so most of the research, such as which traits to look out for, has been on men.

Difficulty communicating, rigid behaviour, narrow interests and being easily overwhelmed by sensations are typical experiences of people with autism spectrum disorder (ASD), but the ‘male’ presentation of the condition is the one we most commonly hear about. Dustin Hoffman’s character in Rain Man, with his repetitive speech and spectacular number skills, comes to mind for many of us.

Martins Rudzitis/Moment RF

Autistic females often don’t fit this picture and, because of that, have been massively overlooked. They may come across as slightly awkward, anxious – especially in social situations – and have difficulty making eye contact and maintaining friendships. They might also show subtle differences in communication, such as not understanding games or getting jokes. However, unlike men, they are more likely to study ‘normal’ behaviour and mimic it, to avoid being seen as ‘rude’. And being less likely than boys to act out, they tend to be anxious and withdrawn, so don’t get noticed.

Recent research suggests that the ratio of men to women with autism is in fact more like 3:1 or even 2:1. Francesca Happé, a leading professor at King’s College London, has warned that failure to spot the condition in women is taking a stark toll on their mental health. Almost all of the late-diagnosed women interviewed for a 2016 study said that they’d experienced one or more mental health difficulties, with anxiety, depression or eating disorders the most common. One told researchers that after ‘four to five years of depression and anxiety treatment…not once did anyone suggest I had anything other than depression’.

GPs also need to keep their radars tuned in to the possibility of ASD to make sure women and girls receive the right diagnosis and treatment. Late diagnosis can mean missed opportunities for learning social skills and making friends, as well as managing anxiety. Often having a name for it is a relief – things start to make sense.

It’s usually a relative or friend who spots the signs. The National Autistic Society says that, as each autistic person is different, there’s no test as such. There are recognisable autistic traits, but not everyone presents with all of these, which is why diagnosis is normally carried out by a multidisciplinary team, usually via GP referral. The society has a helpful free resource for newly diagnosed women and their families; go to autism.org.uk and search ‘Women and Girls’.

Memoir of an autistic mum

Diagnosed after being married twice, forging a career and raising four children, Laura James shares her experience and explores reasons for the lower diagnosis rate among women.

More cheese, please

Yevgen Romanenko/Moment RF

I love cheese – grated, stirred into sauces, scattered on salad. Once demonised for being high-fat, moderate amounts may actually be beneficial for weight loss and even diabetes. Turns out I’m in good company, as there are cheese-loving microbes in our gut. New research shows that cheese boosts beneficial bacteria such as bifidobacteria, which not only enhance a healthy gut but also reduce less welcome strains, such as bacteroides or clostridia, which are associated with intestinal infections. As for which particular cheeses our bacteria thrive on, that’s yet to be discovered. Personally, I’m hoping they are partial to a bit of emmental or goat’s cheese!

If you have a question you would like answered, email drclarebailey@you.co.uk