Menstrual Suppression for Adolescents with Developmental Disabilities

Savasi, Ingrid; Spitzer, Rachel F.; Allen, Lisa; Ornstein, Melanie

doi:10.1016/j.jpag.2007.10.008

Cited by 18 publications

(7 citation statements)

References 59 publications

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“…A small number of reports, spanning nearly 40 years, have relied upon retrospective chart review,1 previous publication summary and review,2–4 questionnaire evaluation of adult women with disabilities5 6 and problems of understanding and consent 7–9. Recent comprehensive reviews of menstruation management for adolescents who have developmental disabilities have focused on detailed management strategies, treatment dilemmas associated with the use of hormonal preparations and social management of hygiene and mood issues 3 4 10…”

Section: Introductionmentioning

confidence: 99%

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The impact of menstruation in adolescents with disabilities related to cerebral palsy

Zacharin

Savasi

Grover

2010

Archives of Disease in Childhood

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Background Information regarding menstrual difficulties for adolescents with developmental disabilities and their families is limited. Aim To assess the impact of menstruation on adolescents with developmental disabilities and their families, and to compare this to previously reported experiences of age-matched normal girls. Methods Families of girls aged 12–18 years with known disabilities, attending the Royal Children's Hospital, Melbourne, were recruited into a questionnaire based study evaluating issues of menstruation and associated problems, together with the consequent psychological, social and emotional impact on their families and carers. Information was sought regarding menstrual management strategies, outcome satisfaction and specific areas of family concern. Results 103 questionnaires were completed. The average age of participating girls was 15.11 years, mean menarchal age 12.3 years. 79 girls were postmenarchal. The severity of menstrual problems was similar to a normal population. 59 (76%) were happy with the impact of menses on their social activities. More than 50% sought menstrual advice before menarche. Advice seeking strongly correlated with disability severity (p=0.01) and impact of menses on social activities (p=0.01), which in turn were highly predictive of seeking assistance (p=0.005). Carer satisfaction with current management inversely correlated with treatment seeking behaviour (p=0.034). Conclusions Menstrual characteristics in this population are similar to those without disabilities. There is a high level of parental anxiety regarding the impact of menses, particularly when disability is severe. Medical therapies may be required but information for families is lacking. Clinicians should play a proactive and educational role with families and adolescents with disabilities.

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Section: Introductionmentioning

confidence: 99%

“…Each of these presents their own set of advantages and disadvantages, which must be considered in light of each individual's needs and medical history 3 4 9. A recent comprehensive review has provided detailed data concerning available options for menstrual management 4.…”

Section: Introductionmentioning

confidence: 99%

The impact of menstruation in adolescents with disabilities related to cerebral palsy

Zacharin

Savasi

Grover

2010

Archives of Disease in Childhood

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“…Minimising menses to achieve optimal quality of life in this setting seems reasonable. If a junior state champion swimmer also minimises her menses for optimal quality of life and to maximise her swimming achievements, then to aim for the same in the young woman with a disability does not seem unreasonable 5 …”

Section: Menses and Menstrual Managementmentioning

confidence: 99%

“…If a junior state champion swimmer also minimises her menses for optimal quality of life and to maximise her swimming achievements, then to aim for the same in the young woman with a disability does not seem unreasonable. 5 Table 1 describes the options available for reducing menstrual loss. Achieving regular lighter periods may be adequate, but achieving a marked reduction in loss either with continuous oral contraceptive pills (OCPs), 3,6 depot medroxyprogesterone acetate or the LNG IUS 7 may be preferred.…”

Section: Menses and Menstrual Managementmentioning

confidence: 99%

Gynaecological issues in adolescents with disability

Grover

2011

J Paediatrics Child Health

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Menstruation and contraception is a concern for families who have a daughter with a significant disability, either physical or developmental. Accessing information regarding options may be difficult. Maternal experiences of menses further impact on the anxiety. The onset of menses is a reminder that their daughter is at risk of sexual abuse and pregnancy. It may highlight the fact that they are at their limits of coping -without the addition of yet another problem, of managing menses. Parental and carer concern is about the practicalities of how the adolescent will manage menstruation -both the hygiene aspects of menses and also the potential pain. Additionally, information is required about the possible need for contraception and the role and importance of reproductive hormones for preventing cardiac disease and osteoporosis. Recognition that a number of other medical problems may be related to reproductive hormones -such as cyclic seizure, behavioural difficulties and osteoporosis -is important as this gives an alternative avenue for intervention. The focus of this paper will be on the gynaecological aspects of young women with significant disabilities, rather than those with mild disabilities.

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“…Management approaches to menstrual suppression have shifted over time . An increase in medical hormonal treatment options and delivery systems has led to a decrease in the need for definitive surgical management (in the form of hysterectomy), as well as legislative procedures.…”

Section: Introductionmentioning

confidence: 99%

Menstrual management in developmentally delayed adolescent females

Chuah

McRae

Matthews

et al. 2017

Aust NZ J Obst Gynaeco

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As a paediatrician, it is important to address menstrual management issues and allay caregiver concerns with appropriate advice. Our study supports the use of the COCP as sound first line management in achieving menstrual suppression. The LNG-IUS appears to be a favourable second line option. Further investigation into longer-term outcomes and potential complications of device insertion is recommended.

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Menstrual Suppression for Adolescents with Developmental Disabilities

Cited by 18 publications

References 59 publications

The impact of menstruation in adolescents with disabilities related to cerebral palsy

The impact of menstruation in adolescents with disabilities related to cerebral palsy

Gynaecological issues in adolescents with disability

Menstrual management in developmentally delayed adolescent females

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