Growth, sexual development and menstrual issues among girls with cerebral palsy - A cross sectional study in a tertiary care centre

Introduction: There is paucity of literature and research on puberty among girls with cerebral palsy especially from India. Knowledge of sexual development and menstrual issues can guide towards better care for these girls. Objective: To study the onset of sexual development and patterns of menstrual issues among girls with cerebral palsy who attended cerebral palsy clinic. Methods: A cross sectional study of 93 girls with cerebral palsy(GMFCS levels-I toV), aged 5-19 years, attending the cerebral palsy clinic at a tertiary care hospital, was conducted. Data was obtained by interviewing the parents of the girls with cerebral palsy using a semi structured questionnaire followed by examination of the girls. Results: Mean age of the girls in the study was 11.27 +/- 4.46 yrs. The average height of the girls with cerebral palsy were found to be lesser than the published standards. 36(38.7%) girls had attained menstruation. Average age of menarche was 12.54 +/- 1.37yrs. There was one case of delayed puberty. 75% of the girls had regular cycles while 47.2% had dysmenorrhoea. 69.4% used sanitary pads and mothers changed the pads in 38.8% of the girls. 58.3% of them had signs of vaginal infection while 25% of them showed signs of premenstrual syndrome. Conclusion: Girls with cerebral palsy required extra support from their care-givers during the menstrual cycles. Usage of sanitary pads was not widely prevalent with signs of vaginal infection. Breast development was delayed but pubic hair development was found earlier among the study participants.