Management of menstrual problems in adolescents with learning and physical disabilities

Authors

  • Elizabeth Jeffery MBCHb (HONS) BSC PhD,

    Foundation Year 1 Trainee
    1. Warrington and Halton Hospitals NHS Trust, Warrington Hospital, Lovely Lane, Warrington, Cheshire, UK
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  • Salma Kayani MSc DFSRH MRCOG,

    Consultant Gynaecologist
    1. Advanced Minimal Access Surgeon in Excisional Benign Gynaecology, Benenden Hospital Trust, Cranbrook, Kent, UK
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  • Anne Garden MBChB FRCOG FHEA FAcadMEd

    Consultant Gynaecologist, Head, Corresponding author
    1. Lancaster Medical School, Faraday Building, Lancaster University, Lancaster, UK
    • Warrington and Halton Hospitals NHS Trust, Warrington Hospital, Lovely Lane, Warrington, Cheshire, UK
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Correspondence: Anne Garden. Email: a.garden@lancaster.ac.uk

Abstract

Key content

  • The onset of menarche in adolescents with disabilities can cause significant disruption to their lives.
  • Menstruation has an impact on the symptom control of various medical conditions.
  • Signs and symptoms of dysmenorrhoea, menorrhagia and cyclical behavioural disturbances are frequent and distressing.
  • There are parental and carer concerns regarding menstrual management and hygiene, vulnerability to sexual abuse and pregnancy, as well as inappropriate behaviour.
  • Research on managing the menstrual problems of adolescents with disabilities is limited; consequently there is little guidance to best practice.

Learning objectives

  • To recognise the behavioural and emotional changes associated with menstruation.
  • To be aware of the pros and cons of the different management options available for adolescents with disabilities.
  • To understand the legislature and the legal issues of consent.

Ethical issues

  • The role of surgical options for management of menstruation in the adolescent girl.
  • Informed counselling includes the short and long-term effects of the disability on menstruation and vice versa, which influence decision-making.
  • The contribution of multidisciplinary team in the decision-making process involving the health and wellbeing of the adolescent.