Women with disabilities: Hormones and bone health

Women with disabilities, particularly those with intellectual difficulties, have very particular needs  in regards to their hormones and bone strength. Many of these women are distressed by their periods or by the requirement for additional care it requires. To prevent this distress, many women use hormonal treatments to prevent their periods from occurring. Unfortunately, long term use of hormonal treatments can be damaging to bone strength. For most women this is not problematic, however combined with the use of other medications, wheelchair use, an absence of weight bearing exercise and institutionalization can be disastrous for bone strength and result in osteoporosis and fractures.

Osteoporosis in this setting can be even more problematic as fractures occur more frequently and, particularly if a woman does not have verbal skills, can sometimes go weeks before being detected.

As their needs in these areas are so specialized, it is usually outside of the area of expertise of most of the medical professionals they are exposed too. In an attempt to assist the situation, the Keogh Institute has been running a women’s health clinic devoted to the needs of women with disability since 1992.  Clients from nursing homes or group homes alongside their carers come in to see us once a month on Thursdays, as do women with disabilities who live in the community.

Although we feel that we have seen a clinical improvement in the women we have seen.  We feel that everybody deserves strong evidence for their treatment and so are conducting our second clinical research project to determine if our management has lead to a decrease in osteoporosis and fracture rates.