Taking control of periods, cycles and conditions.1
Adolescents with chronic conditions are as likely as other adolescents to become sexually active and are significantly more likely to experience sexual abuse.
Menstruation in those with physical and mental disabilities can cause significant distress and disruption. Menstruation can exacerbate pre-existing chronic conditions (e.g. seizures around period time).
Specific issues are:
- Desired outcome (amenorrhoea or pregnancy avoidance or both).
- BMI of patient and mobility (if overweight then thrombosis – if underweight then osteoporosis with Depoprovera.
- Drug interactions (a pragmatic approach may be needed – reduced contraceptive efficacy due to enzyme inducers may be less important if a method is being used for menstrual control rather than contraception. Enzyme-inducing medication can affect all oral forms and possibly implants.
- Ability to swallow and absorption.
- Mental capacity and consent issues.
- Difficulty recognising or communicating side-effects.
- Compliance.
