Menstrual suppression in girls with disabilities

Area of Science:

• Reproductive Health
• Disability Studies
• Adolescent Medicine

Background:

• Pubertal transitions, especially menarche, pose challenges for girls with disabilities and their caregivers.
• Over 50% of caregivers express anxiety and seek healthcare provider guidance regarding menstrual onset.
• Nurse practitioners (NPs) are essential in providing menstrual suppression education and planning.

Purpose of the Study:

• To systematically review and evaluate current scientific literature on medical modalities for menstrual suppression in adolescent girls with disabilities.

Main Methods:

• A comprehensive electronic search was conducted across multiple databases including CINAHL, Medline, PsycINFO, and Cochrane.
• Databases searched: CINAHL, Medline, Health Sources: Nursing/Academic Edition, Psychology and Behavioral Sciences Collection, PsycINFO, Cochrane Register of Controlled Trials, and Academic Search Complete.

Main Results:

• Combined oral contraceptive pills are the most frequently used medical modality for menstrual suppression in this population.
• Depot medroxyprogesterone acetate and levonorgestrel-releasing intrauterine systems have also been recommended.
• Key concerns include the girl's and caregivers' wishes, comorbid conditions, and potential risks of suppression methods.

Conclusions:

• Open communication regarding concerns and expectations is vital for successful pubertal transitions.
• NPs should counsel on available menstrual suppression interventions, emphasizing comprehensive gynecological care.
• Further research with robust longitudinal and prospective designs is needed to guide NPs in optimizing outcomes for girls with disabilities and their caregivers.