Gynecologic Issues of Adolescents with Down Syndrome, Autism, and Cerebral Palsy

Abstract 

Study Objective

The gynecologic issues of adolescents with disabilities are understudied. The purpose of this study was to identify and compare the presenting complaints, treatments, and follow-up of adolescent girls with Down syndrome (DS), autism, and cerebral palsy (CP) presenting to a specialized gynecologic clinic for women with developmental disabilities.

Setting

Outpatient gynecology clinic.

Participants

Forty four adolescents (<21 y); 13 with DS, 14 with autism, and 17 with CP who presented to the clinic from 1999 to 2006.

Interventions

None.

Main Outcome Measures

A retrospective review of the electronic medical records to collect data on age at presentation to clinic, ethnicity, menstrual history, chief complaint, treatment, and follow-up.

Results

Mean age at presentation to clinic was 15±3.5 years, and age of menarche was 12.5±2 years; age at menarche did not significantly differ between groups. The most frequent complaints were irregular bleeding (n=10) and mood/behavioral changes (n=6). Girls with autism were significantly (χ²=8.89, P=.012) more likely to present with behavioral issues than the other 2 groups. Initial management for the behavior issues in the autism group included nonsteroidal anti-inflammatory drugs (NSAID), oral contraceptives, and education.

Conclusion

The most common gynecologic complaints of adolescent girls with DS, autism, and CP centered on menstruation and mood disorders. Patients with autism were more likely to present with behavioral issues related to the onset of periods.

Key Words: Developmental disabilities, Adolescent, Menarche, Menstruation, Menstrual-related mood disorders