title: The impact of menstruation in adolescents with disabilities related to cerebral palsy.
abstract: BACKGROUND
  Information regarding menstrual difficulties for adolescents with developmental disabilities and their families is limited.
  
  
  OBJECTIVE
  To assess the impact of menstruation on adolescents with developmental disabilities and their families, and to compare this to previously reported experiences of age-matched normal girls.
  
  
  METHODS
  Families of girls aged 12-18 years with known disabilities, attending the Royal Children's Hospital, Melbourne, were recruited into a questionnaire based study evaluating issues of menstruation and associated problems, together with the consequent psychological, social and emotional impact on their families and carers. Information was sought regarding menstrual management strategies, outcome satisfaction and specific areas of family concern.
  
  
  RESULTS
  103 questionnaires were completed. The average age of participating girls was 15.11 years, mean menarchal age 12.3 years. 79 girls were postmenarchal. The severity of menstrual problems was similar to a normal population. 59 (76%) were happy with the impact of menses on their social activities. More than 50% sought menstrual advice before menarche. Advice seeking strongly correlated with disability severity (p=0.01) and impact of menses on social activities (p=0.01), which in turn were highly predictive of seeking assistance (p=0.005). Carer satisfaction with current management inversely correlated with treatment seeking behaviour (p=0.034).
  
  
  CONCLUSIONS
  Menstrual characteristics in this population are similar to those without disabilities. There is a high level of parental anxiety regarding the impact of menses, particularly when disability is severe. Medical therapies may be required but information for families is lacking. Clinicians should play a proactive and educational role with families and adolescents with disabilities.
authors.affiliation: Department of Endocrinology and Diabetes, The Royal Children's Hospital, Parkville, Melbourne, Victoria 3052, Australia. margaret.zacharin@rch.org.au
authors.forename: Margaret
authors.initials: M
authors.lastname: Zacharin
authors.forename: Ingrid
authors.initials: I
authors.lastname: Savasi
authors.forename: Sonia
authors.initials: S
authors.lastname: Grover
mesh_terms: D000293:Adolescent; D001294:Attitude to Health; D002547:Cerebral Palsy / Q000150:complications* / Q000523:psychology; D002648:Child; D002658:Developmental Disabilities / Q000209:etiology*; D004185:Disability Evaluation; D005260:Female; D006266:Health Education; D006801:Humans; D008598:Menstruation; D008599:Menstruation Disturbances / Q000150:complications* / Q000188:drug therapy; D010290:Parents / Q000523:psychology; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data