Women's health
Women's health
Women’s Health issues for those living with spinal cord injury
Spinal cord injury can affect women at any age, from birth to old age, and they will experience the same women’s health issues as non-disabled women but these may be experienced slightly differently depending on the degree and level of injury.
With the appropriate time, help and advice, women living with a spinal cord injury can manage their periods, enjoy sex, access contraception, have successful pregnancies and navigate women’s health screening and the menopause.
These factsheets are to help raise the issues and explain specific problems for women with spinal cord injury – do seek help from your GP, your clinical support team, your local hospital and you can always ask for advice from the clinical specialists at the SIA.
CONTACT SIA CLINCIAL SPECIALISTS
Every woman has an individual experience of what sensory perception she has, depending on the level and completeness of the injury, and women with an injury above T6 may experience autonomic dysreflexia. These factsheets attempt to differentiate how this may affect the experience of certain women’s health problems – such as pain with periods and childbirth.
There will be a difference in perception depending on whether the injury is partial or complete. Even when there is a complete cord injury – pain may be noticed in different ways which is very individual and you will probably be aware of how your body may react.
Level of injury and experience of gynaecological and pregnancy symptoms
T6 and above
- You may experience autonomic dysreflexia to varying degrees in response to painful stimuli and this may include: with your periods, from a full bladder and rectum, pain from pelvic infection, from an intrauterine contraceptive device (IUCD), vaginal examination and procedures such as a cervical smear, endometrial sample and from labour. The dysreflexia can be managed by reducing the pain from the cause (such as pain killers for painful periods, an epidural anaesthetic in labour) and by your usual management of autonomic dysreflexia.
T10 and above to T6
- If your injury is complete, you may not experience any pain from your periods or other gynaecological issues as described above. The pain during labour is unlikely to be felt. Pain may be experienced by an increase in spasms or referred to another part of your body.
Below T10
- You will feel pain from periods, which may be heightened post injury, or pelvic infection and labour pains.
FACTSHEETS:
PERIOD: MANAGEMENT AND PROBLEMS
- Managing your period is not something we generally talk about in society. It is therefore not always addressed as openly as it should be following a spinal cord injury, and some women will feel very concerned about how they are going to cope with managing their periods. Hopefully the information in this resource will reassure you that it is possible and show you that there are different options you can try, to find the right one for you.
- Making the choice on which type of contraception to use can be very difficult but it is important that it is used if you are having sex and at all ages – from when periods start to 2 years after they finish (menopause) if you are under 50 years old or for 1 year after periods finish if you are 50 years and older.
- After a spinal cord injury, you may initially find difficulties in having sex but should be able to get advice from the rehabilitation team. Fertility declines for women with age – reducing after the age of 35 and more rapidly after 40 years old. This needs to be factored into decisions about when to try to get pregnant, particularly if it is around the time of a spinal cord injury (SCI).
COMING SOON:
pregnancypost partum practical tipsmenopause
sexualitypelvic Floor healthOsteoporosis
Authors and editors
- Felicity Ashworth is a retired obstetrician and gynaecologist, worked at Buckinghamshire Health Care NHS Trust and ran a gynae clinic in the National Spinal Injuries Centre for 25 years, as well as leading the obstetric service for women living with spinal cord injury
- Debbie Green is a specialist spinal cord injury nurse with a particular interest in the health needs of women with spinal cord injury. Debbie has a degree in Women’s Health and has been working with people who have acquired spinal cord injury for over 35 years.
OTHER INFORMATION
Breast screening
- Women in the UK are invited for a breast screening appointment when they turn 50. But SCI people who can’t hold themselves up may not be able to have a mammogram. If this is the case for you, regular breast examinations are vitally important. Ask your partner, GP or someone you trust for help with this.
Cervical smear tests
- Routine smear tests can sometimes be challenging for SCI people because of poor access. Not every GP surgery has a wheelchair hoist to transfer you onto an examination table, for example. Speak with your GP to find out whether they can carry out the screening in your home or ask your local SCI centre about having a test there.
Being a mum
- People with SCI can still get pregnant and go on to have healthy children. With the right information, we can prepare for pregnancy and plan how to adapt bowel and bladder routines while managing the increased risk of pressure ulcers that come with weight gain.
- Think about whether you may need to have someone living with you to help when the baby arrives. Your local authority has a duty to consider what support you need as a parent. Occupational therapists can also help with equipment to help you with being a mum, and the charity Remap designs and adapts equipment for disabled people for free.
However nervous you feel when confronted with a tiny baby to care for, it’s important not to allow people to do too much for you. The baby must get used to the way you do things and handle them, however unconventional that might be.
Women’s Health campaign
Women with spinal cord injury face significant challenges in accessing the healthcare they need. Despite advancements in medical care and policy commitments to equality, too many women with disabilities continue to be excluded from mainstream health services, left navigating a system that fails to recognise and meet their unique needs.
Accessibility – please note we are currently working to ensure that all of our factsheets and other documents are accessible to everyone. If you are unable to access any materials please contact [email protected] for assistance.