Gynecologic Issues of Adolescents with Down Syndrome, Autism, and Cerebral Palsy
published online 30 July 2009.
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.
University of Michigan, Departments of Obstetrics and Gynecology and Physical Medicine and Rehabilitation (CK), Ann Arbor, Michigan, USA
Address correspondence to: Claire Z. Kalpakjian, PhD, Department of Physical Medicine and Rehabilitation, 325 E. Eisenhower Blvd, Ste 300, Ann Arbor, MI 48108-5744.
ABSTRACT