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Girls With Disabilities Often Have Unique Menstrual Problems

Update Date: Apr 19, 2013 09:40 AM EDT

Teenagers with learning and physical disabilities are more likely to have menstrual problems compared to the general populations, according to a new study.

What's more, researchers said there is no "one-size fits all" solution when managing the symptoms, according to a report published April 19 in The Obstetrician & Gynecologist (TOG).

Researchers explain that menstrual problems in girls with disabilities are often unique to the population and can cause significant disruption to their lives. Common problematic menstrual symptoms include restlessness, aggression, hyperactivity, increased agitation and self-mutilation.

What's more teen girls with disabilities are significantly more likely to have menstrual problems than the general female populations.  Past research has shown that up to 18 percent of adult women with disabilities have premenstrual syndrome compared with only 5 percent of the general female population.  For instance, women with epilepsy are more likely to have polycystic ovarian syndrome, and girls with Down's syndrome are more likely to suffer hyperprolactinaemia and irregular bleeding.

In the review, researchers discuss the advantages and limitations of both therapeutic and surgical options as management options including the combined oral contraceptive pill, the combined transdermal patch, the progestogen only pill and implanon.  The surgical options discussed in the review include endometrial ablation and hysterectomy.

Researchers said under most circumstances, menstrual problems in girls with disabilities are successfully managed by medical treatments.  They stress that surgical procedures must only be considered as last resort when symptoms and signs of menstruation are severe and medical management has failed.

"Managing the menstrual problems of girls with disabilities represents a challenging medical dilemma, however, not all adolescents with disabilities will encounter problems," researchers Anne Garden, Consultant Gynaecologist and Head of Lancaster Medical School, said in a news release.

"The decision of treatment has to rest on a multi-disciplinary team, alongside the girl and her parents or carers who should be given the opportunity to know available management options and the advantages and disadvantages of each," Garden explained. "Healthcare professionals also play an important role in addressing concerns around the onset of menstruation, reassuring and discussing management options prior to menarche."

Experts say that there has been limited research on managing menstrual problems in teens with disabilities. 

"Consequently, there is a lack of evidence of best practice to guide healthcare professionals in this area," TOG's editor-in-chief Jason Waugh said in a news release.

"This review emphasizes the need for further guidance for practitioners, as well as highlighting that care needs to be individualized," he added.

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