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Summer 99 Table of Contents
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Preparing Your Daughter for Her Menstrual Cycle

By Robbie Blaha, Teacher Trainer and Kate Moss, Family Support Specialist, TSBVI, Texas Deafblind Outreach

This article first appeared in the April 1992 edition of P.S. NEWS!!!

When a child begins to experience the physical and emotional changes that puberty brings, many parents feel unprepared to support their child through these changes. Helping their child learn to take care of her physical needs and, at the same time coping with behaviors that can occur, is a challenge. Parents of children with deaf-blindness do not escape this significant milestone in their child's life, and they too feel unprepared. Robbie Blaha, Teacher Trainer for Texas Deafblind Outreach at Texas School for the Blind and Visually Impaired, offers several suggestions for helping young women with deafblindness become more independent in menstruation management.

It is important to note that some of the suggestions may seem unnecessary for your daughter depending on her toileting skills and her understanding of social factors such as modesty and appropriate public behaviors. As you read the information that follows, consider your daughter's skill levels. You may want to make modifications in her instruction. If you are not sure how to modify these suggestions, you might want to contact a parent of an older child, your classroom teacher, or Robbie.

1. Provide instruction prior to your daughter's first period.

By starting in advance of the menses, parents and staff will have the opportunity to prepare the young woman in a positive manner. Let her become familiar with the pad by wearing one for specific lengths of time on a daily basis. This will allow her to learn about the pad without experiencing the added discomfort of being in her period for the first time. A young woman's period may bring some physical and emotional discomfort. Dealing with the unusual sensation of a pad may be unacceptable to her, and she may react by pulling off the pad repeatedly when it is first introduced. Should this happen, it will be less stressful for everyone if you are dealing with a dry pad in a private place.

Take time to let your daughter try out different pads and select the one that is most comfortable for her. Start with the smallest size available, such as panty liners, and build gradually to the thicker pads. It is better to change pads more frequently and use a thinner more comfortable variety than to engage in a power struggle with a young woman. Give your daughter time to practice the new skills involved in changing a pad (e.g. taking the paper strip off the back of the pad, attaching the pad to undergarments, disposing of the pad after it has been used, etc.). If you present these new skills only while your daughter is menstruating, she may not have enough opportunities in those few days each month to learn independence in the routine.

Educational staff teaching menstruation management should visit with the young woman's parents before beginning instruction. The parents have a lot of information about their child. They also have great concern about their daughter's progress and need to understand how instruction in this area will be carried out. Menstruation is a very intimate subject; parents need to be reassured that their daughter will receive support and understanding as she goes through an experience that can be trying for any young woman.

2. Stay matter-of-fact when teaching menstruation management.

It is important to be positive, organized and relaxed. Address menstruation management as if you were teaching tooth brushing and hand washing. Be careful not to teach negative behaviors with this particular hygiene activity. If changing pads offends you or if you view training your child as a waste of time, your daughter may receive a negative message about the activity. Consider the situation of a caregiver hurriedly changing the sanitary napkin. The young woman reaches down to touch the pad. Her hand is pushed away abruptly several times. The caregiver's behavior upsets her, leading to a combative situation about the pad. Several exchanges of this nature across the day could set up a pattern of behavior that may be very difficult to change. Sometimes this can evolve into pulling at the pad, smearing menses, or other inappropriate behaviors. For young women who are already demonstrating noncompliant behaviors there is a risk for learning more serious behaviors.

While people in our culture may ignore someone who lays down on the floor at the mall, they probably will be less understanding, deeply offended or frightened by a young woman pulling off her sanitary napkin in a public place. Once learned, these kinds of behaviors are very difficult to redirect; so it is better to avoid their development in the first place. Even if inappropriate behaviors do not develop, treating a young woman abruptly while changing pads can make her feel that she has done something wrong. This is not fair to her and certainly not beneficial in developing a good self-concept about her body.

3. Help reduce your daughter's confusion.

Sometimes individuals confuse their period with a toileting accident and become distressed. They may keep insisting they need to use the restroom. If your daughter feels the need to go to the bathroom more often, let her. You can use this opportunity to practice changing the pad. Let your reassuring manner tell her that she is doing the right thing. Praise her success and be proud of her independence.

Another area of confusion is related to pad disposal. Your daughter may want to flush it down the commode like toilet paper. Take special care to guide her, hand-over-hand if necessary, to dispose of the pad in the proper container near the commode. You may want to consider purchasing a small trash receptacle with a lid that is used exclusively for this purpose. Schools may choose to purchase the type of wall containers that are found in most public restrooms to help make the environment as typical of other public restrooms as possible.

Parents should remember to practice these skills exclusively in the bathroom. If your daughter experiences pad changing in other places at home, she may assume it is appropriate to remove the pad in other places that may not be acceptable. Help her to understand that taking off her sanitary pad is appropriate behavior only in the privacy of the bathroom.

4. Handle menstrual problems in a proactive manner.

Before your daughter has her first period, make an appointment to talk with your family doctor or nurse about premenstrual stress syndrome. You should also discuss the need for a gynecological examination and start planning a way to assist your daughter in going through that examination. Don't assume this examination is not really necessary. Women with deafblindness are subject to the same health risks in this area as their peers who are nondisabled. It is also important to keep a record of her periods to detect irregularities that may warrant medical attention. Also, following a round of antibiotics, have your daughter checked for yeast infections which can cause discomfort, especially during her period.

Your doctor may suggest giving your daughter aspirin or a Tylenol-like product for the first several days of her period. This can help make her more comfortable, and may head off problems if her communication level prevents her from letting you know she has cramps. You may also want to change her daily routine, especially at school. For example, if she usually likes to jump on a trampoline, but keeps getting off during the first day of her period, give her other activity choices that are not physically taxing.

5. Don't expect the day to go as usual.

If your daughter or one of your students is in her period, just expect to get less done and know that your schedule may have to be adjusted. It is almost impossible to maintain the number of activities in a typical day and still find time to teach the critical skills of menstruation management. If you as a caregiver are too rushed, you will do most of the work yourself. When that happens an opportunity to gain independence has been lost.

It helps to actually schedule this hygiene activity into the day. For example, put a pad in a small makeup bag, place it in your child's room or student's calendar box, and have her be responsible for carrying it to and from the bathroom. If she uses a weekly or multi-weekly calendar, schedule her periods on the calendar. Help her to anticipate her period by going to buy pads at a grocery store. Talk about her upcoming period with her as you review the calendar together. If she does not use this type of calendar, use the bag with the pad as a topic of conversation during her usual hygiene activities. Make thing easier for yourself by always having extra pads, latex gloves, and a change of clothing on hand. You can help her pack these items into a backpack for outings or trips to and from school. The better prepared she is for her period, the easier it will be on her and you.

6. When problems occur, try to see the activity from your daughter's perspective.

If she refuses to participate in the activity, consider whether this is a pattern of behavior she exhibits in other situations. Don't put any more emphasis on this activity than you would other types of hygiene activities. If you do, you may set yourself up for a power struggle.

You might understand the cause for her unwillingness to participate by noting other activities she does not like. Are their similarities between those activities and the menstruation management routine? For example, does she dislike touching tape or other adhesive surfaces? Does she have a preference for certain textures against her skin? Does she show some aversion to handling other things that are damp?

Consider the activity's design. Is she experiencing the same sequence of events every time she changes pads? Check with other caregivers that help her with this activity. If they are having the same problems you might help each other in finding solutions. If they are not having problems, you may want to adopt their approach.

7. Share knowledge of your child and the way you do things at home with the educational staff or other caregivers.

Probably the most important thing you can do to help your daughter become independent is to communicate with all of those individuals who will assist her in this activity throughout her day. If a particular type of pad is used because she finds it the most comfortable, be sure your teacher knows so it can also be used at school. If a medication for premenstrual discomfort is recommended by your physician, talk to the teacher and school nurse about the policy for administering the medication at school. Don't assume that a note from you will guarantee that the medication can be given in a school setting. If you know her period is about to start, send a note to the teacher so she is aware of behaviors that may result from this impending event. Work together to build strategies for supporting your daughter during this time. Most importantly, make sure school personnel are committed to making this experience a valuable learning opportunity for your daughter. Don't be shy about asking for their help. They may have experienced this many times before in their teaching career, while it may be your first time.

If you would like more information on this subject or would like to talk directly with Robbie about concerns you have in this area, please call or write to her at (512) 206-9232, Texas School for the Blind and Visually Impaired, Outreach Department, 1100 West 45th Street, Austin, Texas 78756; or send e-mail to her at blaha_r@tsbvi.edu

Another resource on this topic is: Fredericks, H.D. Bud, et. al., The Teaching Research Curriculum for Handicapped Adolescents and Adults _ Personal Hygiene. 1980.

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