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    Special needs girl menstral cycle
    Speedo72 posted:
    My step daughter is 12 years old, has cerebral palsy and mild form of autism. She had at least 4 menstrual cycles approximately 6 months ago and hasn't had one since. Her step mother (a nurse) says that this is normal for a special needs child. She is very physically active but has started to gain weight. Her mother and I are very concerned that her father may have given her a "deprovera" shot so they wouldn't have to be inconvenienced by her menstrual cycle. My question is, is it normal for a special needs child to have such a seemingly abnormal menstrual cycle?
    J_Harrison_Hohner responded:
    Dear speedo: I could find no published data which linked CP to menstrual irregularities. Here is one of the citations on social-sexual issues from the National Library of Medicine site: Clin Rehabil. 2006 Dec;20(12):1023-31. Social and sexual relationships of adolescents and young adults with cerebral palsy: a review.Wiegerink DJ, Roebroeck ME, Donkervoort M, Stam HJ, Cohen-Kettenis PT. Department of Rehabilitation Medicine, Erasmus MC, University Medical Center and Rijndam Rehabilitation Center, 3000 CA Rotterdam, The Netherlands. OBJECTIVE: To investigate possible barriers to successful social and sexual relationships in adolescents and young adults of normal intelligence with cerebral palsy. DESIGN: A literature review based on a PubMed and PsycINFO search for the period 1990-2003. Included were studies focusing on one or more of the outcome parameters (i.e. social, intimate and sexual relationships) or on associated factors that described relationships with the outcome parameters. RESULTS: Fourteen papers were selected. Two studies investigated exclusively people with cerebral palsy whereas 12 concerned people with a congenital disability and/or physical disabilities, including people with cerebral palsy. All studies addressed adolescents or adults of normal intelligence. A. Social and sexual relationships: In social relationships adolescents and young adults with cerebral palsy were less active than their age mates, and dating was often delayed and less frequent. Adolescents with congenital disabilities indicated that sexuality is an important aspect of their lives, but they experienced difficulties developing a sexual relationship. B. Associated factors: Psychological maladjustment, insufficient self-efficacy and low sexual self-esteem may impair the development of social and sexual relationships. Overprotection in raising children with cerebral palsy and the negative attitudes of other people may have a negative influence on the self-efficacy of people with cerebral palsy. CONCLUSION: The reviewed studies suggest many factors that may influence the development of social and sexual relationships in adolescents and young adults with cerebral palsy. However, evidence was found only for the personal factors self-efficacy and sexual self-esteem and their interrelationships with the parents' way of raising their children and successful experiences in social situations. In her specific case, her age could be part of the explanation. In newly menstruating girls it can take up to 18 months for regular ovulations and regular menses to appear. If a woman gains a great deal of weight, that can also impede regular ovulations. Lastly, while DepoProvera shots can sound like an ideal way to end the "fuss" of periods in fact a woman can also experience erratic, unpredictable bleeding on the Depo shot. Your daughter has two step mothers and a biological mother involved in her care so I would urge you all to consult with a GYN so every Mom can give input and receive the same information about what to expect for her menstruation (and contraception if that is a worry) needs. In Support, Jane

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