Menstrual and contraceptive issues among young women with developmental delay: a retrospective review of cases at the Hospital for Sick Children, Toronto.

OBJECTIVES: To define the clinical characteristics of, and management options offered to, young women with developmental delay referred to The Hospital for Sick Children gynecology clinic in Toronto for menstrual suppression and contraception. To review the primary caregiver concerns and preferences with regards to menstruation and contraception.
METHODS: A retrospective chart review of hospital records of young women with developmental delay referred to the gynecology clinic at The Hospital for Sick Children, Toronto from 1998 to 2003.
RESULTS: A total of 72 charts were reviewed from clinic visits between 1998 to 2003. Ages range from 8 to 17 years with an unknown cause of their cognitive disability in 44% and medium to high support needs in the majority. Forty-three percent were still premenarcheal when first brought to the gynecology clinic by their families or caregivers. The main reason for consult was menstrual-related in 90%, with concerns related to hygiene and problems coping.
CONCLUSIONS: Caregivers often approach physicians for menstrual suppression prior to menarche with a primary concern of personal hygiene. Medical suppression of menstruation can be successfully achieved. Depo-Provera was the most commonly prescribed and accepted method of menstrual suppression within our population.