809 - Understanding Menstruation in Individuals with Cerebral Palsy: A Topical Review

Friday, February 20, 2026

5:00 PM - 6:30 PM AST

Presenting Author(s)

ER

Emma Raffman, BS

Medical Student
Northwestern University Feinberg School of Medicine
Chicago, Illinois, United States
AL

Alyssa Levitt, BA

Medical Student
Northwestern University Feinberg School of Medicine
Chicago, Illinois, United States

Corresponding Author(s)

PJ

Prakash Jayabalan, MD, PhD

Physician Scientist/Associate Professor
Shirley Ryan AbilityLab/Northwestern University
Chicago, Illinois, United States

Submitter(s)

ER

Emma Raffman, BS

Northwestern University Feinberg School of Medicine
Chicago, Illinois, United States

Objectives: Menstrual care in individuals with disabilities is often overlooked, with minimal data specific to cerebral palsy (CP), the most common motor disability in childhood. CP presents physical and cognitive challenges that may affect menstrual experiences, including hygiene, symptom management, and treatment choices. However, information on menarche, cycle features, and symptom burden in CP remains sparse, limiting tailored clinical guidance. Menstrual management involves unique considerations such as accessibility, comorbidities, and medication interactions, alongside cultural and caregiver influences. This review synthesizes existing literature on menstrual presentation, management, and attitudes in CP to identify gaps and guide care.

Design: A PubMed search using terms for CP and menstrual health identified 22 articles; 9 met criteria, and 4 more were added through references, totaling 13 studies. Eligible studies included ≥33% CP participants or stratified results by disability type. Two reviewers independently screened all articles. Data on menstrual characteristics, hygiene, suppression strategies, and caregiver attitudes were narratively synthesized due to small, heterogeneous samples.

Results: Thirteen studies revealed four domains: menstrual characteristics, hygiene, suppression, and attitudes. Menarche occurred around ages 12–14. Cycles were usually regular, lasting 3–7 days. Dysmenorrhea was common but sometimes perceived differently, possibly due to altered pain sensitivity. Pads were the primary hygiene product, though challenges included discomfort, infection risk, and school-based care barriers. Suppression use varied; oral contraceptives were common but required caution regarding bone density and thrombosis. Caregiver attitudes reflected cultural norms, reproductive concerns, and caregiving burden, with widespread desire for anticipatory guidance.

Conclusions: While menstrual patterns in CP resemble those of neurotypical peers, functional limitations, comorbidities, and psychosocial factors affect management. Physiatrists play a critical role in optimizing hygiene, evaluating suppression options, and facilitating anticipatory guidance. Evidence gaps remain regarding safe and appropriate menstrual care strategies. Future research should prioritize CP-specific, culturally sensitive guidelines to enhance autonomy and quality of life.