{"componentChunkName":"component---src-components-article-page-article-page-gatsby-container-tsx","path":"/articles/cycle-a-z/menstruating-while-disabled","result":{"data":{"articleNode":{"id":"4bA3LkvBoIG046ciwAmYQC","title":"Disabled people have periods, too","subtitle":"Disabled women and people with cycles face barriers to period care","seoMetaTitle":"Menstruating and disabilities ","seoMetaDescription":"How might your disability affect your period? What kind of strategies can help make your period more comfortable?","openGraphTitle":"Strategies for managing your period while disabled","openGraphDescription":"Disabled people have a right to a dignified and comfortable period. Find out what barriers they might face.","slug":"cycle-a-z/menstruating-while-disabled","artCredits":"Illustration: Marta Pucci & Emma Günther","publishDate":"2022-01-05T00:00+01:00","updatedAt":"2023-12-01T10:11:03.068Z","createdAt":"2018-02-12T15:21:11.853Z","locale":"en","authors":[{"id":"4dgkAFxktyoUQhGxdNA1W7","name":"Kathryn Stone","headline":"Freelance Writer/Disability Consultant","slug":"kathryn-stone","twitter":null,"locale":"en","profileImage":{"id":"4UOHVLJ9WzcgH7S6Cpn7G9","description":"Kathryn Stone's profile photo","file":{"contentType":"image/jpeg","url":"//images.ctfassets.net/juauvlea4rbf/4UOHVLJ9WzcgH7S6Cpn7G9/069bb1db51d7e78fe555104b9348fca0/headshot.jpg"},"gatsbyImageData":{"images":{"sources":[{"srcSet":"https://images.ctfassets.net/juauvlea4rbf/4UOHVLJ9WzcgH7S6Cpn7G9/069bb1db51d7e78fe555104b9348fca0/headshot.jpg?w=160&h=135&q=50&fm=webp 160w,\nhttps://images.ctfassets.net/juauvlea4rbf/4UOHVLJ9WzcgH7S6Cpn7G9/069bb1db51d7e78fe555104b9348fca0/headshot.jpg?w=319&h=270&q=50&fm=webp 319w,\nhttps://images.ctfassets.net/juauvlea4rbf/4UOHVLJ9WzcgH7S6Cpn7G9/069bb1db51d7e78fe555104b9348fca0/headshot.jpg?w=638&h=539&q=50&fm=webp 638w","sizes":"(min-width: 638px) 638px, 100vw","type":"image/webp"}],"fallback":{"src":"https://images.ctfassets.net/juauvlea4rbf/4UOHVLJ9WzcgH7S6Cpn7G9/069bb1db51d7e78fe555104b9348fca0/headshot.jpg?w=638&h=539&fl=progressive&q=50&fm=jpg","srcSet":"https://images.ctfassets.net/juauvlea4rbf/4UOHVLJ9WzcgH7S6Cpn7G9/069bb1db51d7e78fe555104b9348fca0/headshot.jpg?w=160&h=135&fl=progressive&q=50&fm=jpg 160w,\nhttps://images.ctfassets.net/juauvlea4rbf/4UOHVLJ9WzcgH7S6Cpn7G9/069bb1db51d7e78fe555104b9348fca0/headshot.jpg?w=319&h=270&fl=progressive&q=50&fm=jpg 319w,\nhttps://images.ctfassets.net/juauvlea4rbf/4UOHVLJ9WzcgH7S6Cpn7G9/069bb1db51d7e78fe555104b9348fca0/headshot.jpg?w=638&h=539&fl=progressive&q=50&fm=jpg 638w","sizes":"(min-width: 638px) 638px, 100vw"}},"layout":"constrained","backgroundColor":"#f8f8f8","width":638,"height":539}}}],"reviewers":[{"id":"3MIvCjqek8V0jWipRHBRIB","name":"Sarah Toler, DNP, CNM","headline":"Science Writer","slug":"sarah-toler-dnp","twitter":null,"locale":"en","profileImage":{"id":"5aMwJD1FI92OLlydMMjWHg","description":"Science Writer at Clue","file":{"contentType":"image/jpeg","url":"//images.ctfassets.net/juauvlea4rbf/5aMwJD1FI92OLlydMMjWHg/14c0ab7d316f83800646617b6eb496b4/Sarah_Toler_profile_pic.jpeg"},"gatsbyImageData":{"images":{"sources":[{"srcSet":"https://images.ctfassets.net/juauvlea4rbf/5aMwJD1FI92OLlydMMjWHg/14c0ab7d316f83800646617b6eb496b4/Sarah_Toler_profile_pic.jpeg?w=225&h=225&q=50&fm=webp 225w,\nhttps://images.ctfassets.net/juauvlea4rbf/5aMwJD1FI92OLlydMMjWHg/14c0ab7d316f83800646617b6eb496b4/Sarah_Toler_profile_pic.jpeg?w=450&h=450&q=50&fm=webp 450w,\nhttps://images.ctfassets.net/juauvlea4rbf/5aMwJD1FI92OLlydMMjWHg/14c0ab7d316f83800646617b6eb496b4/Sarah_Toler_profile_pic.jpeg?w=900&h=900&q=50&fm=webp 900w","sizes":"(min-width: 900px) 900px, 100vw","type":"image/webp"}],"fallback":{"src":"https://images.ctfassets.net/juauvlea4rbf/5aMwJD1FI92OLlydMMjWHg/14c0ab7d316f83800646617b6eb496b4/Sarah_Toler_profile_pic.jpeg?w=900&h=900&fl=progressive&q=50&fm=jpg","srcSet":"https://images.ctfassets.net/juauvlea4rbf/5aMwJD1FI92OLlydMMjWHg/14c0ab7d316f83800646617b6eb496b4/Sarah_Toler_profile_pic.jpeg?w=225&h=225&fl=progressive&q=50&fm=jpg 225w,\nhttps://images.ctfassets.net/juauvlea4rbf/5aMwJD1FI92OLlydMMjWHg/14c0ab7d316f83800646617b6eb496b4/Sarah_Toler_profile_pic.jpeg?w=450&h=450&fl=progressive&q=50&fm=jpg 450w,\nhttps://images.ctfassets.net/juauvlea4rbf/5aMwJD1FI92OLlydMMjWHg/14c0ab7d316f83800646617b6eb496b4/Sarah_Toler_profile_pic.jpeg?w=900&h=900&fl=progressive&q=50&fm=jpg 900w","sizes":"(min-width: 900px) 900px, 100vw"}},"layout":"constrained","backgroundColor":"#a8a8a8","width":900,"height":900}}}],"editors":null,"featuredImage":{"description":"There is a person in a wheelchair, a person with a prosthetic leg, a person with an amputated arm, and a blind person with a white cane.","file":{"contentType":"image/svg+xml","url":"//images.ctfassets.net/juauvlea4rbf/2C0gRWZ7nW0ASoY0IWyAGS/5a0977368f00c1f5921e81c7f14a9bde/contenful.svg"},"gatsbyImageData":null},"openGraphImage":{"description":"A woman in a wheelchair, a woman with a prosthetic leg, a woman with one arm, and a visually impaired woman with a walking cane.","file":{"url":"//images.ctfassets.net/juauvlea4rbf/6l9O6GCKl2SWiwwUaaummw/215a0d53d2eaf9af769ac5579e1a503b/fb.png"}},"sectionDivider":null,"featuredVideoURL":null,"category":{"id":"28dzA11rn1llRluDIyUhKB","slug":"issues-and-conditions","title":"Issues & Conditions","color":"#144181","description":{"description":"Articles about Issues & Conditions."},"parentCategory":null,"locale":"en"},"body":{"body":"Women and people with cycles can face barriers to adequate healthcare, and having a disability can add another layer of difficulty.\n\nSome people with disabilities face challenges in managing their health. Disabled people who menstruate often encounter obstacles in accessing sufficient support and services, which can put them at risk for more health problems.\n\nFor the purposes of this article, we’ll define disabilities according to the [World Health Organization](http://www.who.int/topics/disabilities/en/) (WHO): “disabilities is an umbrella term, covering impairments, activity limitations, and participation restrictions.”\n\nHaving a disability can mean impediments to cognition, body function, and/or structure. It can also entail difficulties doing specific activities, or being in a life situation that affects functioning and/or mobility.\n\nSome situations and environments are better equipped for people with disabilities than others. The WHO emphasizes that a disability is “the interaction between a person with health condition and personal/environmental factors”—like being in a wheelchair and facing inaccessible public transportation. Care and facilities for disabled people varies widely from country to country and region by region.\n\nSome difficulties that are specific to both having a cycle and a disability are: handling tampons, pads, or [menstrual cups](https://helloclue.com/articles/culture/how-to-use-a-menstrual-cup \"How to use a menstrual cup\") (collection methods), menstrual awareness, and managing menstrual-related pain.\n\n## Managing periods while physically disabled\nThere’s a wide spectrum of physical disabilities, and individual abilities vary. Some examples of physical disabilities include cerebral palsy, multiple-sclerosis, limb amputation, visual impairment, and spinal cord injury.\n\nManaging menstruation can be challenging for some people with limited hand function. Inserting and removing a tampon or menstrual cup may not be simple, or possible at all for some people.\n\nLauren Slattery, a Clue Ambassador, shared her experience:\n\n“I have cerebral palsy, and use tampons with no issue. I just got a menstrual cup though and I’m worried about insertion and removal, since my muscular ability isn’t the best.”\n\nThe menstrual cup is becoming a more popular collection method for people who menstruate, as it’s reusable, sustainable, and can be worn for up to 12 hours. That means less waste, fewer trips to the bathroom, and money saved. But menstrual cups can be challenging to insert and remove—they need to be gripped and folded.\n\nMenstrual cups come in many kinds and sizes, with different “stems”—the bit at the bottom of the cup you grab to help pull it out. Some people can insert and remove a menstrual cup with one hand. The effectiveness of a cup will depend on an individual’s ability, and the way the cup is built.\n\nJane Hartman Adamé, a woman with Ehlers-Danlos Syndrome, has designed the [Keela Cup](https://www.kickstarter.com/projects/366403924/keela-cup) in an effort to make using a menstrual cup easier. Adamé’s inclusive menstrual cup has an adjustable pull-string stem and a soft base for an easy grip.\n\nTampons can come with or without applicators. Effectively inserting and removing a tampon (with or without an applicator) also depends on individual ability. \n\nPeriod-proof underwear (like Thinx), pads, and disposable underwear are collection methods to consider—especially for people who don’t feel sensation below the waist, and can’t detect leaks. \n\nSome people with visual impairments might mistake their period for vaginal discharge, especially if their cycles are irregular.* People with irregular cycles may not be able to predict as effectively when they will be getting their next period. Bodily symptoms of premenstrual syndrome—such as cramps, breast tenderness, or emotional changes—may also help to indicate to the person that the start of their period is approaching. Some people may have trouble telling if a pad or tampon needs to be changed.\n\n## Managing periods while intellectually disabled\nAn [intellectual disability](http://aaidd.org/intellectual-disability/definition/faqs-on-intellectual-disability#.WiaLLLQ-fUI), according to the American Association on Intellectual and Developmental Disabilities, is characterized by limited intellectual functioning—learning, reasoning, problem solving—and behavior that affects daily skills. Some examples of intellectual disabilities include traumatic brain injuries (TBI) and Down syndrome.\n\nSome people with intellectual disabilities have trouble understanding what goes on in their bodies (1). It’s important that intellectually disabled people have solid support and education to help them understand their biology. Check out the The Raising Children Network’s [guide](http://raisingchildren.net.au/articles/autism_spectrum_disorder_periods.html) to teaching people with autism about menstruation.\n\nDepending on cognitive ability, tampons and menstrual cups may not be the best collection methods, as they require keeping track of time and might be forgotten. Period-proof underwear, pads, and disposable underwear are worth trying. \n\nThe American College of Gynecology and Obstetrics (ACOG) has a [guide](https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Adolescent-Health-Care/Menstrual-Manipulation-for-Adolescents-With-Physical-and-Developmental-Disabilities) to menstrual manipulation for people with disabilities. If menstruation is too challenging for a disabled person, menstrual manipulation can help alleviate issues through suppressing periods, or reducing the amount and days of menstrual flow. The goal should be to maintain the person’s rights and choices, while avoiding harm, and working within the scope of the patient's understanding of their reproductive health and cycle (3).\n\nSometimes in extreme cases, intellectually disabled people and/or their parent(s) or guardian(s) may consider medical procedures (stunting growth, hysterectomy, and/or sterilization) (2). These procedures are only considered after other reasonable alternatives have been pursued and are not recommended by ACOG (3). It’s important to remember that these operations do come with risks, and that these decisions are not made lightly (3). \n\nSome parent(s) or guardian(s) of people with severe intellectual disabilities say that procedures that suppress menstruation are meant to improve the quality of life of their dependents who can’t process or tolerate menstruation-related symptoms (2). \n\n__If a person can’t consent to an optional medical procedure, it’s generally considered a human rights violation.__ A person with a severe intellectual disability (who has impaired capacity to consent) usually has a Person Responsible to make decisions about their health in their best interests (B). For more on this topic, check out a [guide](https://vkc.mc.vanderbilt.edu/etoolkit/general-issues/informed-consent/) to informed consent in adults with intellectual disabilities by the Vanderbilt Kennedy Center, as well as this [guide](http://www.intellectualdisability.info/how-to-guides/articles/consent-and-people-with-intellectual-disabilities-the-basics) by the University of Hertforshire.\n\nPeople's abilities vary. What’s beneficial for some people may not be useful for others. Some people may consider using hormonal birth control to reduce menstrual cycle symptoms or to skip periods.\n\nDo you have a disability and a cycle, or care for somebody with a disability and a cycle? How do you help manage menstrual health and disabilities? \n\n[Track menstrual cycle symptoms in Clue.](https://app.adjust.com/ejcbve)\n\n*A Clue user with visual impairments wrote in to tell us that she has no trouble distinguishing her period from other fluids, and that the suggestion that people with impairments cannot tell the difference is offensive. She also wrote that in her experience, a more appropriate problem would be knowing when a pad or tampon needs to be changed, so we have added that additional information. The info presented in the section on visual impairments is anecdotal, and we’re grateful for feedback and to hear about your experiences. Send us your thoughts at hi@helloclue.com. \n\n*__Edit__: February 27,2018\nWe received thoughtful feedback from a user who suggested we not list autism as an intellectual disability, as it is manifested in broad and varied ways in individuals. We decided to take it out of the list of intellectual disabilities here.*"},"bodyRichText":{"raw":"{\"data\":{},\"content\":[{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"Top things to know:\",\"nodeType\":\"text\"},{\"data\":{},\"marks\":[{\"type\":\"bold\"}],\"value\":\" \",\"nodeType\":\"text\"}],\"nodeType\":\"heading-2\"},{\"data\":{},\"content\":[{\"data\":{},\"content\":[{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"Most disabled women and people with cycles have periods\",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"}],\"nodeType\":\"list-item\"},{\"data\":{},\"content\":[{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"Disabled women and people with cycles face barriers like inaccessible bathrooms, shame and stigma, and affording period products \",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"}],\"nodeType\":\"list-item\"},{\"data\":{},\"content\":[{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"New period products designed for disabled people, including period-tracking apps like Clue, can improve their experience\",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"}],\"nodeType\":\"list-item\"}],\"nodeType\":\"unordered-list\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"The ways in which women and people with cycles experience menstruation varies from person to person. When we think about these experiences and how periods make people feel, we often think of non-disabled people, and don’t consider the period experiences of disabled people. \",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"Most disabled women and people with cycles have functioning reproductive systems. They experience the same or similar cycle changes as non-disabled  people. But there’s one big difference — having a period can be physically and emotionally difficult  for disabled people because of the barriers they face, like lack of access to bathrooms or sinks, and restricted or no access to period products or pain relief. \",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{\"target\":{\"sys\":{\"id\":\"QheqTDlYb8kreBmnWIPD9\",\"type\":\"Link\",\"linkType\":\"Entry\"}}},\"content\":[],\"nodeType\":\"embedded-entry-block\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"\",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{},\"content\":[{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"Raising awareness about disability and periods can help reduce stigma and encourage disabled people and caregivers to seek help if they need it. \",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"}],\"nodeType\":\"blockquote\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"This article will explain how resources, information, and period products are usually not designed with disabled people in mind and how eliminating menstrual taboos will help disabled people have better periods. \",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"When talking about disability, some people choose to use “identity first” language, in which the disability is mentioned first (1). This way of speaking uses terms like “deaf person,” or “autistic person,” rather than “a person who is deaf,” or “a person who is autistic.” Clue has decided to follow the lead of disabled communities who use identity first language. We use it on  our website and in this article because it allows people to embrace their disabled identity and celebrate membership within a wider group . \",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"Another way of talking about disability is to use “‘person first”’ language (1). Some people prefer to use “‘person first” language when talking about their disability since “person with a disability” puts the person before their diagnosis. \",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[{\"type\":\"bold\"}],\"value\":\"What does “disabled” mean?\",\"nodeType\":\"text\"}],\"nodeType\":\"heading-2\"},{\"data\":{\"target\":{\"sys\":{\"id\":\"6go956hv4F9qz6PolzzhXG\",\"type\":\"Link\",\"linkType\":\"Entry\"}}},\"content\":[],\"nodeType\":\"embedded-entry-block\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"You might get different definitions of the word, “disabled,”  depending on whom you ask. This is because there are different “models” to describe disability. Clue’s values align with what’s called “the social model of disability.” \",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"The social model of disability states that a person with an impairment is disabled by their environment and society, rather than by the impairment itself (2). For example, a person using a wheelchair is disabled by buildings that don’t have wheelchair access. The lack of access makes them unable to enter the building, not the fact they are using a wheelchair. \",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"The social model of disability calls attention to barriers in society that disable people. Other disabling barriers might include flashing lights that trigger epilepsy, the absence of sign-language interpreters for deaf people, or school attendance policies for people with chronic fatigue.\",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"This model also acknowledges that an impairment can have a significant impact on the person’s life. Living with chronic pain can make it difficult to move through day-to-day life and symptoms such as post-exertional malaise can make it difficult to participate in various activities, however accessible they may be. \",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[{\"type\":\"bold\"}],\"value\":\"Challenges faced by disabled women and people with periods\",\"nodeType\":\"text\"}],\"nodeType\":\"heading-2\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"Within the disabled community, experiences of menstruation can vary. However, there are also some similar challenges that disabled women and people with cycles face: \",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[{\"type\":\"bold\"},{\"type\":\"italic\"}],\"value\":\"1. Lack of accessible bathrooms for disabled people\",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"Many bathrooms are inaccessible to wheelchair users. Because of this, they may change their period products outside of bathroom stalls or in places without privacy or running water (3). In areas where water supplies are limited, disabled people may have to reuse menstrual products or be unable to wash their hands, increasing risk of infection (4). \",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[{\"type\":\"bold\"},{\"type\":\"italic\"}],\"value\":\"2. Lack of period education for disabled people\",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"Global cultural taboos often lead to people with cycles not being educated enough about periods. Where people do receive education about menstruation, it is rarely written for disabled people. This might be due to a prevalent myth that disabled people have different reproductive systems and do not menstruate (5). \",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{\"target\":{\"sys\":{\"id\":\"7oWBt03KKeGHwCzCQAyLqK\",\"type\":\"Link\",\"linkType\":\"Entry\"}}},\"content\":[],\"nodeType\":\"embedded-entry-block\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"Menstrual education for disabled people can also be difficult to understand or access. This might look like a lack of sign language interpreters for the deaf and hard of hearing, sex educators who are not trained in working with disabled people, or educational materials that are not written clearly enough for intellectually disabled people (3, 5). Some disabled people who rely on family or carers might also be disadvantaged if their carers are not educated about periods  (3, 5). \",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"Menstruation can be stressful and difficult for both a disabled person and their guardian. Cultural messages that disabled people should not be parents or sexual beings can complicate how guardians view the disabled people they care for (6). Some guardians do not see the benefits of disabled people having periods and may request a sterilization procedure (7). This happens most commonly to people with intellectual disabilities (7). \",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"Sterilization is unethical when the disabled person does not consent to the procedure. The European Disability Forum, an organization fighting for disability rights, denounces the sterilization of people with disabilities (8) since  it  goes against their human rights.\",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[{\"type\":\"bold\"},{\"type\":\"italic\"}],\"value\":\"3. Shame and stigma around disability and periods\",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"Most non-disabled people take the \",\"nodeType\":\"text\"},{\"data\":{\"target\":{\"sys\":{\"id\":\"3WjYTmJ96UmuYK2MciCyU0\",\"type\":\"Link\",\"linkType\":\"Entry\"}}},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"ability to change a tampon\",\"nodeType\":\"text\"}],\"nodeType\":\"entry-hyperlink\"},{\"data\":{},\"marks\":[],\"value\":\" for granted. A disabled person on the other hand might not be able to do this on their own. People of all abilities often struggle to ask for help, but asking for help around your period is  awkward or embarrassing for many. Studies suggest that disabled people may change their period products less frequently than recommended or avoid using certain products like menstrual cups that might be viewed as difficult to use (9,). \",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[{\"type\":\"bold\"},{\"type\":\"italic\"}],\"value\":\"4. Practical problems for disabled people\",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"Disabled people face barriers to having a comfortable and dignified period. Period products are rarely made with disabled people in mind. They can be hard to use for people with limited mobility, stiff muscles, pain conditions, or sensory issues. \",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"Pads can cause sensory-related issues for some people with autism because the feel and touch causes discomfort. Inserting tampons or menstrual cups requires the use of the arms, hands, and fingers, and is not always a viable option for some disabled people.  \",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"It can also be difficult to use period products in combination with other medical equipment. Wheelchair users are often sitting all day; a position that can cause pads to slip. People using urinary catheters may struggle using certain products that do not absorb catheter leaks (4,). \",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"Some chronic conditions may  flare up during the late luteal phase and during menstruation. This may be because inflammation might be reduced during the early and mid-luteal phases (10). An increase in hormone-like substances like prostaglandins can be a cause of inflammation (10). Migraines, seizures, and symptoms of epilepsy or Ehlers Danlos syndrome are often more frequent during menstruation (11, 12, 13).\",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[{\"type\":\"bold\"},{\"type\":\"italic\"}],\"value\":\"5. Period costs for disabled people\",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"An estimated 500 million women and people with cycles globally live in \",\"nodeType\":\"text\"},{\"data\":{},\"marks\":[{\"type\":\"italic\"}],\"value\":\"period poverty, \",\"nodeType\":\"text\"},{\"data\":{},\"marks\":[],\"value\":\"which means they cannot afford reproductive healthcare and safe period products (14). Disabled people are statistically more likely to live in poverty or on low incomes. This can lead to lack of access to period needs like water and period products — a situation that can increase discrimination against disabled women and girls (4). Period products aren’t cheap, and many people who cannot afford them turn to items like bark, paper, or cloth to absorb menstrual blood (15). \",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"Some disabled people may have additional costs related to pain management, medication, therapies, and surgeries. Managing these expenses on a low income can make average period products even less affordable. Finding more specialized or convenient period products designed for disabled people can be too expensive for people with low income. \",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[{\"type\":\"bold\"}],\"value\":\"How can disabled people manage their periods?\",\"nodeType\":\"text\"}],\"nodeType\":\"heading-2\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"Businesses are beginning to consider disabled people as new period products are developed. You might find different strategies helpful, depending on your disability:\",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{},\"content\":[{\"data\":{},\"content\":[{\"data\":{},\"content\":[{\"data\":{},\"marks\":[{\"type\":\"bold\"},{\"type\":\"italic\"}],\"value\":\"Cycle tracking for disabled people\",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"}],\"nodeType\":\"list-item\"}],\"nodeType\":\"ordered-list\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"Tracking your cycle can help you predict your period. Period tracking apps like Clue make this simple. Tracking is useful to help disabled people better understand their disability in relation to their cycle, understand their period itself, and to help them plan around it. For some people with epilepsy, seizures can be linked to the menstrual cycle (12), so tracking can help them be more aware of the risk. \",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[{\"type\":\"bold\"},{\"type\":\"italic\"}],\"value\":\"2. Innovative period products for disabled people\",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"The development of new period products is helping  disabled women and people with periods. Menstrual cups can be left in for around 12 hours, hold more period blood than tampons, and have a lower risk of toxic shock syndrome, meaning they can safely be changed less frequently (15). The \",\"nodeType\":\"text\"},{\"data\":{\"uri\":\"https://flexfits.com/products/flex-cup\"},\"content\":[{\"data\":{},\"marks\":[{\"type\":\"underline\"}],\"value\":\"Flex Cup\",\"nodeType\":\"text\"}],\"nodeType\":\"hyperlink\"},{\"data\":{},\"marks\":[],\"value\":\", was designed specifically with disabled people in mind and features a pull-tab to remove it more easily. \",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"Period underwear provides a comfortable alternative to disposable pads. They can be helpful for people with sensitivities to disposable pads, or they can provide extra support in case of leaking caused by tampons or cups. Modi-bodi, a brand selling period underwear, recently released the \",\"nodeType\":\"text\"},{\"data\":{},\"marks\":[{\"type\":\"underline\"}],\"value\":\"luxe collection.\",\"nodeType\":\"text\"},{\"data\":{},\"marks\":[],\"value\":\" This collection includes underwear with clasps on either side, making them more accessible for some disabled people.\",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[{\"type\":\"bold\"},{\"type\":\"italic\"}],\"value\":\"3. Seeking healthcare as a disabled person\",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"Disabled and concerned about your period?  Check in with a healthcare provider. They can diagnose, manage, and treat reproductive health conditions. Advocating for yourself with healthcare providers can be easier if you have your needs written down before you arrive. \",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[{\"type\":\"bold\"},{\"type\":\"italic\"}],\"value\":\"4. Education about disabilities and periods\",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"Online disabled communities are revolutionizing education for disabled people with cycles and the people who care for them. These communities provide useful, accessible resources on social media platforms. These active support groups offer a space to get useful tips and ask sensitive questions. Many disabled people share their experiences on platforms like Instagram and YouTube. Since the people in these spaces are disabled themselves, they know first-hand about periods and disability. Some examples of strong voices in these spaces include \",\"nodeType\":\"text\"},{\"data\":{\"uri\":\"http://www.youtube.com/watch?v=gcYRpOIUElU&ab_channel=MollyBurke\"},\"content\":[{\"data\":{},\"marks\":[{\"type\":\"underline\"}],\"value\":\"Molly Burke\",\"nodeType\":\"text\"}],\"nodeType\":\"hyperlink\"},{\"data\":{},\"marks\":[],\"value\":\", \",\"nodeType\":\"text\"},{\"data\":{\"uri\":\"https://www.robynsteward.com/\"},\"content\":[{\"data\":{},\"marks\":[{\"type\":\"underline\"}],\"value\":\"Robyn Steward\",\"nodeType\":\"text\"}],\"nodeType\":\"hyperlink\"},{\"data\":{},\"marks\":[],\"value\":\", and \",\"nodeType\":\"text\"},{\"data\":{\"uri\":\"https://www.melissablakeblog.com/2018/01/getting-your-period-in-a-wheelchair.html\"},\"content\":[{\"data\":{},\"marks\":[{\"type\":\"underline\"}],\"value\":\"Melissa Blake\",\"nodeType\":\"text\"}],\"nodeType\":\"hyperlink\"},{\"data\":{},\"marks\":[],\"value\":\".  \",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"Disability-focused websites, like the \",\"nodeType\":\"text\"},{\"data\":{\"uri\":\"https://www.mssociety.org.uk/about-ms/what-ms/women-and-ms/periods-contraception-and-ms#periods\"},\"content\":[{\"data\":{},\"marks\":[{\"type\":\"underline\"}],\"value\":\"MS Society UK\",\"nodeType\":\"text\"}],\"nodeType\":\"hyperlink\"},{\"data\":{},\"marks\":[],\"value\":\", are another resource, full of information about how people with specific disabilities manage periods. Websites like \",\"nodeType\":\"text\"},{\"data\":{\"uri\":\"https://themighty.com/topic/disability/\"},\"content\":[{\"data\":{},\"marks\":[{\"type\":\"underline\"}],\"value\":\"The Mighty\",\"nodeType\":\"text\"}],\"nodeType\":\"hyperlink\"},{\"data\":{},\"marks\":[],\"value\":\", or blog posts hosted by different period-related brands, like \",\"nodeType\":\"text\"},{\"data\":{\"uri\":\"https://wuka.co.uk/blogs/periods-a-z/learningdifficultiesandperiods?_pos=3&_sid=1ed6a905c&_ss=r\"},\"content\":[{\"data\":{},\"marks\":[{\"type\":\"underline\"}],\"value\":\"Wuka\",\"nodeType\":\"text\"}],\"nodeType\":\"hyperlink\"},{\"data\":{},\"marks\":[],\"value\":\", are also available  educational resources. \",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"Some small global initiatives provide menstrual and sexual health education to people with intellectual disabilities. In the UK, the \",\"nodeType\":\"text\"},{\"data\":{\"uri\":\"https://www.josephineandjackproject.co.uk\"},\"content\":[{\"data\":{},\"marks\":[{\"type\":\"underline\"}],\"value\":\"Josephine and Jack\",\"nodeType\":\"text\"}],\"nodeType\":\"hyperlink\"},{\"data\":{},\"marks\":[],\"value\":\" project use anatomical dolls to educate disabled people, and similar tools are used in the \",\"nodeType\":\"text\"},{\"data\":{\"uri\":\"https://washmatters.wateraid.org/publications/bishesta-campaign-menstrual-health-hygiene\"},\"content\":[{\"data\":{},\"marks\":[{\"type\":\"underline\"}],\"value\":\"Bishesta campaign\",\"nodeType\":\"text\"}],\"nodeType\":\"hyperlink\"},{\"data\":{},\"marks\":[],\"value\":\" in Nepal.  \",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[{\"type\":\"bold\"}],\"value\":\"How can periods be more inclusive?\",\"nodeType\":\"text\"}],\"nodeType\":\"heading-2\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"Disabled women and people with cycles face barriers to successfully managing their periods. Changing attitudes toward both disability and periods can improve the lives of disabled people with cycles globally. In some ways, period experiences may have improved for some disabled people over the last few years. Menstruation taboos are changing, products are created with disabled people in mind, and useful resources are available online. Ultimately, this trend can only be good news for disabled people who menstruate.\",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"For non-disabled people who want to make menstruation more inclusive, you can ask your employer to provide a range of menstrual products at work so there are options for all your coworkers. If you are organizing an event, make sure sinks and bathrooms are accessible to as many abilities as possible. There is still a lot of work to be done to reduce barriers for people with disabilities. As a non-disabled person, you can use your position to uplift disabled voices, so that the people who experience impairments themselves can tell you what changes need to be made. \",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"\",\"nodeType\":\"text\"},{\"data\":{\"uri\":\"https://helloclue.com/\"},\"content\":[{\"data\":{},\"marks\":[{\"type\":\"underline\"}],\"value\":\"Download Clue\",\"nodeType\":\"text\"}],\"nodeType\":\"hyperlink\"},{\"data\":{},\"marks\":[],\"value\":\" to know when your period is coming so you can be prepared. \",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{\"target\":{\"sys\":{\"id\":\"5FzJsm5n8dmDvSQkri33DC\",\"type\":\"Link\",\"linkType\":\"Entry\"}}},\"content\":[],\"nodeType\":\"embedded-entry-block\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[{\"type\":\"italic\"}],\"value\":\"An earlier version of this article was originally published February 12, 2018.\",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"}],\"nodeType\":\"document\"}","references":[{"__typename":"ContentfulAppDownloadWidget","contentful_id":"QheqTDlYb8kreBmnWIPD9","message":"Are your periods irregular? 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Keep up with us by subscribing to our monthly menstrual health newsletter."}}],"assets":null}]},"references":{"references":"1. National Center on Disability and Journalism. Journalists should learn to carefully traverse a variety of disability terminology [Internet]. 2021 [cited 23 December 2021]. Available from: https://ncdj.org/2016/01/journalists-should-learn-to-carefully-traverse-a-variety-of-disability-terminology/\n2. Goering S. Rethinking disability: the social model of disability and chronic disease. Curr Rev Musculoskelet Med. 2015;8(2):134-138.\n3. Wilbur J, Torondel B, Hameed S, Mahon T, Kuper H. Systematic review of menstrual hygiene management requirements, its barriers and strategies for disabled people. PLoS One. 2019;14(2):e0210974.\n4. House S, Mahon T, Cavill S. Menstrual hygiene matters: a resource for improving menstrual hygiene around the world. Reprod Health Matters. 2013 May 1;21(41):257-9.\n5. UNICEF. Guidance Note: Menstrual health and hygeine for girls and women with disabilities. [Internet]. 2020 [cited 23 December 2021]. Available from: https://www.unicef.org/media/98881/file/MHH-Disabilities-Guidance-Note-ENG.pdf\n6. Groce N, Izutsu T, Reier S, Rinehart W, Temple B. Promoting sexual and reproductive health for persons with disabilities [Internet]. Geneva: World Health Organization; 2009 [cited 23 December 2021]. Available from: https://apps.who.int/iris/bitstream/handle/10665/44207/9789241598682_eng.pdf\n7. Márquez-González H, Valdez-Martinez E, Bedolla M. Hysterectomy for the management of menstrual hygiene in women with intellectual disability. A systematic review focusing on standards and ethical considerations for developing countries. Front  Public Health. 2018 Nov 28;6:338.\n8. European Disability Forum and CERMI Women’s Foundation. Ending forced sterilisation of women and girls with disabilities [Internet]. 2021 [cited 23 December 2021]. Available from: https://www.edf-feph.org/content/uploads/2020/12/edf_forced-sterilisation_8-accessible_6.pdf\n9. Wilbur J, Kayastha S, Mahon T, Torondel B, Hameed S, Sigdel A et al. Qualitative study exploring the barriers to menstrual hygiene management faced by adolescents and young people with a disability, and their carers in the Kavrepalanchok district, Nepal. BMC Public Health. 2021;21(1).\n10.  Alvergne A, Tabor VH. Is female health cyclical? Evolutionary perspectives on menstruation. Trends Ecol Evol. 2018 Jun 1;33(6):399-414.\n11. Hernandez AM, Dietrich JE. Gynecologic management of pediatric and adolescent patients with Ehlers-Danlos Syndrome. J Ped Adol Gynecol. 2020 Jun 1;33(3):291-5.\n12. Herzog AG. Catamenial epilepsy: definition, prevalence pathophysiology and treatment. Seizure. 2008 Mar 1;17(2):151-9.\n13. Martin VT, Lipton RB. Epidemiology and biology of menstrual migraine. Headache: The Journal of Head and Face Pain. 2008 Nov;48:S124-30.\n14. The World Bank. Menstrual hygiene management enables women and girls to reach their full potential. 2018. https://www.worldbank.org/en/news/feature/2018/05/25/menstrual-hygiene-management. Accessed 29 Jan 2020.\n15. Van Eijk AM, Zulaika G, Lenchner M, Mason L, Sivakami M, Nyothach E, Unger H, Laserson K, Phillips-Howard PA. Menstrual cup use, leakage, acceptability, safety, and availability: a systematic review and meta-analysis. 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