Menstrual and contraceptive management in women with an intellectual disability

Abstract

OBJECTIVE: To review the clinical management of young women with intellectual disabilities with menstrual and contraceptive concerns. DESIGN: Prospective cohort study of all girls and young women with a significant intellectual disability and moderate to high support needs who presented at my gynaecology clinic for management of menstrual and contraception-related issues in the period 1990-1999. SETTING: Gynaecology clinic at the Centre for Adolescent Health, Royal Children's Hospital, Melbourne, and my private consulting rooms. OUTCOME MEASURES: The clinical management options considered most appropriate for these women, including advice, reassurance, medication (oral contraceptive pill, non-steroidal anti-inflammatory drugs, depomedroxyprogesterone acetate, hormone replacement therapy) and surgical options. RESULTS: For 2 of 107 young women, surgical approaches were required to manage their menstrual problems or contraception-related issues. For the remainder of the women, information, advice or medical management were sufficient. CONCLUSIONS: Management of the menstrual and contraceptive needs of young women with an intellectual disability is similar in most cases to the management of non-disabled women. Surgical management is required infrequently.