Trends in Menstrual Concerns and Suppression in Adolescents With Developmental Disabilities

Kirkham, Yolanda A.; Allen, Lisa; Kives, Sari; Caccia, Nicolette; Spitzer, Rachel F.; Ornstein, Melanie

doi:10.1016/j.jadohealth.2013.04.014

Cited by 65 publications

(62 citation statements)

References 26 publications

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“…1 A large Canadian study showed that parents' concerns for their adolescent daughters with intellectual disabilities include menstrual suppression, hygiene, parental burden, and menstrual symptoms. 2 The pediatrician and the medical home play a key role in anticipatory guidance with the family and teenager regarding emerging sexuality, physical changes of puberty and onset of menstruation, and the emotional and behavioral changes associated with puberty. Even before the onset of menses, the pediatrician could be asked to assist with anticipatory guidance and options for the menstrual cycle because of parental fear of menstrual periods or hormonal mood changes as well as the complex issues of sexuality, vulnerability, and fertility in the context of the disability.…”

Section: Clinical Report Guidance For the Clinician In Rendering Pedimentioning

confidence: 99%

“…Premenarchal suppression is not recommended for most teenagers with intellectual disabilities because expectant management allows for patients and families to determine whether they can cope, and suppressing menarche can result in premature closure of the epiphyses of the long bones, preventing the patient from reaching her full height potential. 2 Precocious puberty, however, should be addressed in the usual manner.…”

Section: Puberty In Adolescent Girls With Disabilitiesmentioning

confidence: 99%

“…Amenorrhea was noted at 1 year in all 21 patients who continued using the LNG-IUD. 2 As described for most patients in these series, the LNG-IUD can be inserted or removed under sedation or anesthesia, or if having another surgical procedure, could be inserted at the same time. The expulsion rate of the LNG-IUD is slightly higher in nulliparous women (approximately 3%-4%) 46 and is reported at 8% in teenagers with disabilities combining all published studies.…”

Section: Oral Progestinsmentioning

confidence: 99%

See 2 more Smart Citations

Menstrual Management for Adolescents With Disabilities

Quint¹,

O’Brien²,

Gynecology³

2016

Pediatrics

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The onset of menses for adolescents with physical or intellectual disabilities can affect their independence and add additional concerns for families at home, in schools, and in other settings. The pediatrician is the primary health care provider to explore and assist with the pubertal transition and menstrual management. Menstrual management of both normal and abnormal cycles may be requested to minimize hygiene issues, premenstrual symptoms, dysmenorrhea, heavy or irregular bleeding, contraception, and conditions exacerbated by the menstrual cycle. Several options are available for menstrual management, depending on the outcome that is desired, ranging from cycle regulation to complete amenorrhea. The use of medications or the request for surgeries to help with the menstrual cycles in teenagers with disabilities has medical, social, legal, and ethical implications. This clinical report is designed to help guide pediatricians in assisting adolescent females with intellectual and/or physical disabilities and their families in making decisions related to successfully navigating menarche and subsequent menstrual cycles.

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Section: Clinical Report Guidance For the Clinician In Rendering Pedimentioning

confidence: 99%

Section: Puberty In Adolescent Girls With Disabilitiesmentioning

confidence: 99%

Section: Oral Progestinsmentioning

confidence: 99%

See 1 more Smart Citation

Menstrual Management for Adolescents With Disabilities

Quint¹,

O’Brien²,

Gynecology³

2016

Pediatrics

View full text Add to dashboard Cite

show abstract

“…In a large Canadian study 31.7 % of parents came in to a gynecologist prior to menarche. 3 Although there is great fear and anticipation of menstrual issues, most teens with disabilities and families report doing fairly well with menstruation without intervention. 4,5 Since it is hard to predict how menses will affect a teenager's life before they start and whether intervention is indicated, pubertal events should be allowed to advance naturally.…”

Section: Anticipatory Guidancementioning

confidence: 99%

Adolescents with Special Needs: Clinical Challenges in Reproductive Health Care

Quint

2016

Journal of Pediatric and Adolescent Gynecology

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“…It offers many noncontraceptive benefits that help teens with special problems, such as reduction in the numbers and intensity of sickle cell crises 108 or menstrual suppression for those with difficulty coping due to developmental delays. 109 Concerns about bone loss with prolonged use significantly curtailed US use after the turn of the century. 110 Today clinicians often limit its use to two years, despite the fact that studies have shown return to normal bone density within two to three years after DMPA cessation of the method and that fracture rates are not increased by DMPA use.…”

mentioning

confidence: 99%

Prevention of Unintended Pregnancy Among Sexually Active Adolescents in the United States

Kakaiya¹

2016

Primary Prevention Insights

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BACKGROUND: Adolescent pregnancy and birth rates in the United States have declined dramatically from their peaks in 1991, but remain much higher than those seen in most other developed countries. METHODS: Recent results from relevant clinical trials, periodic surveys of reproductive age women, and focus group work as well as professional group recommendations in the United States are presented to provide insights into the problem of unintended teen pregnancy and suggest potential solutions. RESULTS: Dramatic changes in contraceptive technologies and practices have been implemented in the past several years to reduce the barriers young women have in accessing the most effective methods of contraception. However, new reports about how young women view their risks suggest that new strategies will be needed to motivate more sexually active young women to prevent pregnancy. CONCLUSIONS: The safety and efficacy of modern methods of contraceptives are the highest they have ever been, but if unintended pregnancy rates among teens in the United States are to be more significantly reduced, young women's attitudes about contraception and pregnancy prevention need to be better understood and remaining barriers to its access need to be reduced.

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Trends in Menstrual Concerns and Suppression in Adolescents With Developmental Disabilities

Cited by 65 publications

References 26 publications

Menstrual Management for Adolescents With Disabilities

Menstrual Management for Adolescents With Disabilities

Adolescents with Special Needs: Clinical Challenges in Reproductive Health Care

Prevention of Unintended Pregnancy Among Sexually Active Adolescents in the United States

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