Supporting females with developmental disability with menstrual management and contraception

Females with developmental disability face the same issues of fertility and menstrual management as other females, and should be similarly assessed and offered the same options and approaches.

Ask females with developmental disability if they have a preferred practitioner (eg someone of the same gender) they would like to see about menstruation management or contraception.

To support a female with developmental disability to make decisions about menstrual management and contraception, it is essential to:

• understand the scope and severity of their disability, including physical, cognitive and communication difficulties (see also Communicating with people with developmental disability)
• assess their level of self-care skills
• understand their activities and the living environment
• prioritise the interests of the female over others (eg carers, parents).

Parents and carers are naturally concerned about reproductive health issues, including vulnerability, risk of abuse, mood and seizure pattern changes, and menstrual hygiene, and may have difficulty making decisions.

All options for menstrual suppression and contraception in females with developmental disability have the potential for misuse in females who cannot give informed consent. A multidisciplinary approach to consider the most appropriate and least restrictive option may be required. See also Least restrictive alternative.