Women’s health in people with developmental disability

For delayed or precocious puberty in a person with developmental disability, see Pubertal disorders.

Sexually transmitted infections (STIs) are commonly overlooked in this group. Screen for STIs as per Australian guidelines. Reproductive health screening procedures (eg mammograms, vaginal examinations, Papanicolaou [Pap] smears) are the same as for all women. Reassurance, explanation and use of appropriate educational aids before a procedure may be helpful to support people with developmental disability who find examinations difficult, see also Physical examination and investigations. Sedation or anaesthesia for routine vaginal examinations is not common practice in Australia. If a woman finds the examination distressing or difficult, the benefit of a Pap smear needs to be weighed against this.

For advice on menstrual management or contraception, see Menstrual management and contraception in females with developmental disability. For general advice on sexual health (eg safe sex practices) for females with developmental disability, see Sexuality in people with developmental disability. The role of the general practitioner (GP) in supporting people with developmental disability who would like to start a family is discussed here. Considerations related to pregnancy in a female with developmental disability are discussed here.

Menopause can occur earlier in women with developmental disability than in the general population, and symptoms may not be reported or recognised. The likelihood of early menopause is increased in women with fragile X syndrome and Down syndrome. GPs should include menopausal symptoms in the woman’s annual comprehensive health assessment. For advice on managing early menopause, see Premature ovarian insufficiency and early menopause.

The risk for cardiovascular disease and osteoporosis increases in postmenopausal women. This risk is often even higher in women with developmental disability, because they have multiple risk factors.

For detailed discussion of menopause, see Overview of menopause.