Menstrual Hygiene

January 2022 | Katie Frank, PhD, OTR/L and Hannah Graham, MD - Adult Down Syndrome Center

One topic that comes up frequently at the Adult Down Syndrome Center is menstrual hygiene. Women with Down syndrome and their caregivers often ask us about strategies to make periods easier or even to make periods stop all together. While some women with Down syndrome we see have difficulty managing period hygiene, many women with Down syndrome are able to become completely independent in managing period hygiene with some guidance and practice.

While there are treatments available to make periods less frequent or stop altogether, we typically do not recommend those treatments unless there is another medical indication for them. For example, if a woman has heavy periods causing anemia, we might discuss hormonal treatments to make periods lighter. However, we prefer to avoid these medication options for patients unless they are necessary. Hormonal treatments (like birth control pills) can have side effects (such as blood clots or weight gain) which sometimes affect individuals with Down syndrome more than individuals without Down syndrome. We prefer to start with some modification or adaptation strategies to make period hygiene more manageable.

Many women with Down syndrome who we see at our clinic do well with:

Period underwear (period panties). There are a variety of brands including Thinx and Knix among others. We share additional information in this post on period underwear from our Resource Library.
Visual supports. Visual supports can aid in independence with menstrual hygiene. These can be stories that talk about menstruation, when to change a pad, and how to change a pad. Visuals can also include actual pads with red marker or food coloring to help someone learn when to change a pad. Links to several visual supports related to menstrual hygiene are provided below.
Practice. Practice makes perfect! Just like every other skill that has been learned, practice using menstrual hygiene products helps gain independence. Practice can also be used in conjunction with visual supports.
Using a period bag. A period bag can be brought with to the bathroom so an individual is always prepared. The bag can include any necessary supplies for menstrual hygiene such as extra sanitary napkins, wipes, an extra pair of period underwear, the visual support, etc.
Reminders. Reminders to perform menstrual hygiene management at certain times of the day (e.g., at mealtimes) or every time the person uses the restroom removes the uncertainty of whether a menstrual hygiene product should be changed.
Using different pads. If fine motor deficits make it harder to manage sanitary napkins with wings, consider using extra-long pads without wings. There are also reusable sanitary pads that are like period underwear.