Menstruation

Disability may affect menstruation and its management.

There has been little research on how various disabilities affect menstrual cycles and menstrual flow, and most of these have focused on spinal cord injury.

• When girls are injured before or at puberty, menstruation is the same as for girls without disabilities, and begins at about the same age.
• At the time of injury, menstrual cycles stop temporarily, but start up again within six months.
• The level or completeness of injury has no effect on menstruation.
• Menstruation may worsen spasticity.

Between 72 percent and 85 percent of women with multiple sclerosis, stroke, or other neurologic disorders have reported irregular menstrual cycles and worse symptoms related to their disabilities prior to or during menstruation.

Medications taken for multiple sclerosis and other chronic conditions may disrupt menstruation or delay the beginning of menstruation.

Women with disabilities report numerous problems with menstrual hygiene and use of menstrual products, including inadequate personal assistance to change pads and tampons often enough, skin breakdown, odor, leakage, interference with catheterization, and increased rates of vaginal and urinary tract infections.

Menstrual problems are often treated with oral contraceptives.These can reduce menstrual flow and pain associated with monthly cycles. They do, however, have side effects for women with mobility impairments that may be more serious than for women with no disabilities. We strongly recommend that you consult your healthcare provider for advice on which strategy for menstrual management is best for you.

Women with disabilities who are frustrated with menstrual management problems often seek surgical solutions such as hysterectomy or surgery on the lining of the uterus (endometrial ablation) that sometimes reduces or halts menstrual flow but may also result in infertility and delay diagnosis of cancer.