After a spinal cord injury, the body can go into shock in many ways. For women, normal female occurrences such as their menstrual cycle can be dramatically affected – more than someone without a SCI might initially realise.
The data gaps for women’s health in the general population are significantly big, so it’s not difficult to imagine just how scarcer the data is for women living with a spinal cord injury. Even in 2021, we are lacking data and it’s nothing new. Women aren’t misunderstood, they are ‘under’ understood. With such lack of discussion, it’s difficult to imagine how services will be developed to truly meet the important needs of women with SCI.
Blood and bladder? Mess.
An average woman tends to feel fatigue around the time of the month. Women with SCI experience exhaustion daily – so, with the added tiredness during that time, you can only imagine the double negative effect it has on those suffering with a SCI.
Tetraplegics lack hand dexterity to manage tampons, but pads can chaffe and cause skin breakdowns. Periods can trigger autonomic dysreflexia, increase spasms around the time of the month, increase bladder accidents and bowel accidents throughout.
‘‘I use tampons after a shower to prevent mess whilst transferring but it can be worrying having someone else insert it, without feeling it normally.’’
A lot of women feel they have no choice but to take the pill continuously instead of the additional care support and dealing with the obstacles that come with their period, but not everyone can tolerate the pill, let alone when it’s being retaken continuously.
With side effects such as weight gain, loss of libido, (on top of SCI libido woes), mood swings… the list is endless. Since a woman with SCI is probably used to an already sedentary state, the added restlessness on top of that is a cause for concern. Not only that, but dealing with trauma and mood swings at the same time surely isn’t a great balance. Some even consider ablations and hysterectomies if AS is bad. That’s not a decision taken lightly.
*Ankylosing spondylitis (AS) is a long-term condition in which the spine and other areas of the body become inflamed.
Bladder incontinence is life-altering
Most women with a spinal cord injury will experience bladder dysfunction known as neurogenic bladder, meaning they have a decreased ability to control their bladder at any time. Depending on the person’s particular needs, there are a few options to help support emptying the bladder. Some women may decide to independently use intermittent catheterisation or wear incontinence pads. Others may need surgical intervention.
Considerations
Period pants are great for tetraplegics and paraplegics, especially in circumstances where they can’t get to a bathroom for more than 8 hours, such as a long-haul flight with no access to the on-flight toilets and no way of changing a tampon or period pad. These pants come in a range of absorbances and would most likely need several pairs for the week.
There is a lot to consider when it comes to periods and women with SCI, especially the vulnerability aspect. Having someone perform a very private, and to some, quite embarrassing process for you can be nerve wracking to say the least.
Even those who are capable of doing it independently, the consideration of increased washing for a week once a month compared to SCI men and the increased cost of incontinence pads due to more leaking needs addressing. Women with SCI will need much more support the time their period rolls around – and these are all costly claims to think about.
Cervical screenings and STI testing
Thankfully, most paraplegics won’t encounter many issues in accessing facilities during a cervical screening or STI testing environment. Tetraplegics, unfortunately, may encounter issues with hoists and beds. Some women will also experience spasms, which can make screenings more difficult to conduct.
‘’My GP didn’t have a bed that lowered. I couldn’t transfer so I had to be referred to a sexual health clinic.’’
It all depends on whether someone is a para or tetra and can even depend on the area they live – checking if the client’s area has these facilities is essential. If not, claiming for home visits and testing or extra travel costs to access further afield facilities should be encouraged.
‘’Pelvic exams are very difficult unless I have someone lift me on the table, or the doctor does the exam on the couch in the room instead of the exam table.’’
Considerations
Sometimes when limited options are available and there are no real answers or solutions, it all comes down to thinking outside of the box. Small considerations such as checking with the doctors if padded options exist is a good start. These are great to wear beforehand to prevent pain and protect sores.
Women’s health is a human right and should be taken seriously, we really need to consider how to make women with SCI live more comfortably, whether it be easing costs with claims, finding solutions or simply providing real, accurate data for emotional support.
A law firm with a difference.
Aspire Law is a specialist law firm, working for people with SCI. We help and support everyone affected by spinal cord injury, and believe in the importance of women’s health. Get in touch and give us a call on 0800 030 20 40 if you require legal support.
