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Management of menstrual problems difficult in disabled adolescents
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Menstrual problems are more common among adolescent patients who also have learning or physical disabilities. However, the management of this patient population is often difficult to address, according to study results.
“Managing the menstrual problems of girls with disabilities represents a challenging medical dilemma, however, not all adolescents with disabilities will encounter problems,” researcher Anne Garden, MBChB, FRCOG, FHEA, FAcadMEd, a consultant gynecologist and head of Lancaster Medical School in the United Kingdom, said in a press release.
Researchers assessed the unique nature of this patient population and reviewed and evaluated the available management options. According to their review, adolescents with disabilities are more likely to have menstrual problems that require specialized care vs. patients who are not disabled.
Some menstrual issues the researchers highlight are dysmenorrhoea, menorrhagia and cyclical behavioral disturbances. Subsequent symptoms include restlessness, aggression, hyperactivity, increased agitation and self-mutilation, according to the press release. Other areas of concern that must be considered in adolescents with disabilities include hygiene, sexual abuse and pregnancy, the researchers wrote.
“Health care professionals also play an important role in addressing concerns around the onset of menstruation, reassuring and discussing management options prior to menarche,” Garden said.
Medical options currently include combined oral contraceptive pills, combined transdermal patches, progestogen-only pill, depot medroxyprogesterone acetate, etonogestrel (Nexplanon, (Merck Sharp & Dohme Limited) and gonadotropin-releasing hormone analogues. Surgical options include levonorgestrel intrauterine system, endometrial ablation or hysterectomy.
However, many of these options fall under ethical restraints.
The researchers said a multidisciplinary team is recommended for adolescents with disabilities.
Disclosure: Garden reports being a contributor to and joint editor of Paediatric and Adolescent Gynaecology for the MRCOG and Beyond.
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