Best practices in Menstrual Health and Management for Adolescents with Disabilities Worldwide

The onset of menstruation can present significant challenges, including vulnerability, abuse risk, unintended pregnancies, difficulties with managing menstrual hygiene, abnormal uterine bleeding, painful menses, behavioral and mood changes, or changes in seizure pattern. These challenges manifest in an even greater way for individuals with disabilities and are often accompanied by significant societal repercussions. While adolescents with disabilities already are disadvantaged due to medical challenges and inaccessible environments, adding the burden of menstruation—with all its social, cultural, and medical challenges—can be overwhelming. Menstrual suppression is a way to reduce menstrual frequency, duration and intensity. It is used for a variety of reasons, including to improve quality of life for those who experience significant negative impacts or restrictions in activities due to their menses. Adolescents with disabilities may seek menstrual suppression for help with irregular or heavy bleeding, dysmenorrhea, behavioral changes, or personal hygiene. While this is one way to improve quality of life surrounding menstruation, improved policies and health education globally are also needed to combat the menstrual health barriers faced by this population. The purpose of this review is to summarize best practices in menstrual health and management for adolescents with disabilities worldwide.