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Onset of menses can present unique challenges for adolescents with intellectual or physical disabilities. The Committee on Adolescence of the American Academy of Pediatrics has issued a clinical report to help pediatricians address these concerns. Key points include:
Menstrual suppression should only be initiated after a through discussion with the adolescent (unless precluded by severe intellectual disability) and her family, taking into account clinical factors and social context (e.g., hygiene issues, school placement). Goals for treatment should be clearly defined.
Achieving complete amenorrhea is difficult; scheduled withdrawal bleeds may be easier to manage than unscheduled breakthrough bleeding.
Combined oral contraceptive (COC) pills a…