Abstract
Adolescents with special needs have unique reproductive health care needs related
to their physical and cognitive issues. This review discusses some of the most common
concerns that are encountered in clinical practice, as the clinician will partner
with the adolescent and her family to guide her through the pubertal transition and
to help navigate the risks and rights of reproduction. Families often seek anticipatory
guidance before menarche on menstrual hygiene, abuse risk and sexuality and can be
reassured that most teens with special needs do very well with menstruation. The clinician
needs to evaluate the teenager’s reproductive knowledge as well her risk for abuse
and coercion and her ability to consent to sexual activity, if she requests contraception.
Menstrual management is mostly based on the impact of the menstrual cycles on the
teenager’s life and activities. The adolescents may have a decreased ability to tolerate
menses or pain, or experience changes in seizure pattern or altered mood. Hormonal
treatment is often used to assist with menstrual hygiene, cyclical mood changes or
dysmenorrhea. The goal of treatment can be complete amenorrhea, alleviate pain or
regulate and decrease menstrual flow. The unique risks and benefits of hormonal treatment
for this special population are highlighted.
Key Words
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Article info
Publication history
Published online: May 16, 2015
Footnotes
The author indicates no conflict of interest.
Identification
Copyright
© 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.
