{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T02:55:09Z","timestamp":1790477709048,"version":"4.1.0"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:00:00Z","timestamp":1777939200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Adolescent girls with Intellectual disability (ID) are amongst the most vulnerable and underserved populations with special menstrual health needs. The prevalence of menstrual difficulties and premenstrual symptoms among people with ID often goes unrecognized, is poorly communicated and poorly managed which in turn contributes to functional limitations, increased caregiver burden and reduced quality of life. There is a lack of evidence from India regarding multidimensional PMS patterns and integrated supportive care approaches for girls with ID.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess menstrual health difficulties and premenstrual symptom patterns among adolescent girls with intellectual disability and to describe multidisciplinary supportive care recommendations within a salutogenic public health framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional school-based survey was conducted among 52 adolescent girls with mild to moderate ID aged 10\u201319 years in selected special schools of Puducherry. Menstrual history and hygiene practices were assessed by a gynecologist, and premenstrual symptoms across psychological, physical, and behavioral domains were evaluated using a caregiver-reported PMS screening tool over three consecutive cycles. Symptom clustering was performed by multidisciplinary experts. Exploratory inferential analysis was conducted using appropriate statistical tests to examine associations between level of intellectual disability and key menstrual health variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Dysmenorrhea was reported by 94.2% of participants with severe pain of 67.3%. Nearly half of them experienced menstrual irregularities, and over 90% needed partial to complete caregiver assistance in menstrual hygiene. Premenstrual symptoms were common across the domains: mood variability, irritability, pain, aggression, hypersomnia, and school absenteeism. Exploratory analysis showed no significant differences in symptom domain scores across levels of intellectual disability; however, hygiene dependence was significantly higher among adolescents with moderate intellectual disability. All participants exhibited overlapping symptom clusters-warranting integrated multidisciplinary recommendations. Routine supportive care gynecological, psychiatric, and yoga-based strategies were given. Emphasis was also laid on non-pharmacological management, behavior regulation, and body-mind coping.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Adolescent girls with ID face a high burden of menstrual and premenstrual difficulties across physical, psychological, and behavioral domains. A salutogenic, multidisciplinary approach to gynecological care, together with behavioral support and yoga-based interventions, provided a culturally feasible framework for addressing menstrual health needs within special-school settings. For longitudinal effectiveness, such integrated strategies need to be evaluated.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1771244","type":"journal-article","created":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T05:32:03Z","timestamp":1777959123000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["A cross-sectional study on menstrual health difficulties and premenstrual symptomatology in adolescent girls with intellectual disability: a salutogenic public health perspective"],"prefix":"10.3389","volume":"14","author":[{"given":"Anlin","family":"Jenisha","sequence":"first","affiliation":[{"name":"Department of Community Medicine, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth University","place":["Puducherry, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arun","family":"Sugumaran","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth University","place":["Puducherry, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meena","family":"Ramanathan","sequence":"additional","affiliation":[{"name":"School of Yoga Therapy, Institute of Salutogenesis and Complementary Medicine, Sri Balaji Vidyapeeth University","place":["Puducherry, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lalithambigai","family":"Chellamuthu","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, Vinayaka Mission's Medical College, Vinayaka Missions Research Foundation, Deemed to be University (VMRF-DU)","place":["Karaikal, Puducherry, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiruthika","family":"Asokan","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth University","place":["Puducherry, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahityaa","family":"Narayanaswamy","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth University","place":["Puducherry, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,5]]},"reference":[{"key":"B1","unstructured":"Washington\n          AAIDD\n          Definition of Intellectual Disability\n          \n          2024"},{"key":"B2","doi-asserted-by":"publisher","first-page":"416","DOI":"10.4103\/ijcm.IJCM_433_20","article-title":"Challenges faced by primary caretakers of adolescent girls with intellectual disability during their menstrual cycle in Puducherry: a mixed method study","volume":"46","author":"Karthikayini","year":"2021","journal-title":"Indian J Community Med."},{"key":"B3","doi-asserted-by":"publisher","first-page":"317","DOI":"10.3362\/1756-3488.17-00012","article-title":"Lost in transition: menstrual experiences of intellectually disabled school-going adolescents in Delhi, India","volume":"36","author":"Thapa","year":"2017","journal-title":"Waterlines"},{"key":"B4","doi-asserted-by":"publisher","first-page":"9795681","DOI":"10.1155\/2018\/9795681","article-title":"Management of menstrual disorder in adolescent girls with intellectual disabilities: a blessing or a curse?","volume":"2018","author":"Nurkhairulnisa","year":"2018","journal-title":"Obstet Gynecol Int."},{"key":"B5","unstructured":"New Delhi\n          UNFPA\n          Menstrual Health and Hygiene Management for Persons With Disabilities\n          \n          2022"},{"key":"B6","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1111\/tog.12008","article-title":"Management of menstrual problems in adolescents with learning and physical disabilities","volume":"15","author":"Jeffery","year":"2013","journal-title":"Obstet Gynaecol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"e20160295","DOI":"10.1542\/peds.2016-0295","article-title":"Menstrual management for adolescents with disabilities","volume":"138","author":"Quint","year":"2016","journal-title":"Pediatrics"},{"key":"B8","doi-asserted-by":"publisher","first-page":"800","DOI":"10.1016\/j.ridd.2010.02.004","article-title":"Age at menarche and premenstrual syndrome in adolescent girls with intellectual disability in Bosnia and Herzegovina","volume":"31","author":"Ibralic","year":"2010","journal-title":"Res Dev Disabil."},{"key":"B9","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1016\/j.jpag.2023.02.005","article-title":"Assessing the menstrual cycle and related problems in adolescents with a genetic syndrome associated with intellectual disability","volume":"36","author":"\u00c7inar","year":"2023","journal-title":"J Pediatr Adolesc Gynecol."},{"key":"B10","first-page":"25","article-title":"Challenges and coping strategies adopted for effective menstrual hygiene management among intellectually disabled adolescents and their caregivers: a qualitative study","volume":"9","author":"Armah-Ansah","year":"2023","journal-title":"J Disabil Stud."},{"key":"B11","doi-asserted-by":"publisher","first-page":"471","DOI":"10.1186\/s12905-025-04029-y","article-title":"A qualitative study on the experiences of caregivers on menstrual management of adolescent girls with developmental disabilities in selected special schools of Karveer Taluka, Maharashtra","volume":"25","author":"Bhosale","year":"2025","journal-title":"BMC Womens Health"},{"key":"B12","doi-asserted-by":"publisher","first-page":"4147","DOI":"10.53555\/kuey.v30i1.7820","article-title":"Dilemmas being encountered by primary caregivers in handling the hygiene of menstruating girls with intellectual disability: an exploratory study","volume":"30","author":"Fatima","year":"2024","journal-title":"Educ Adm Theory Pract."},{"key":"B13","volume-title":"Unraveling the Mystery of Health: How People Manage Stress and Stay Well","author":"Antonovsky","year":"1987"},{"key":"B14","doi-asserted-by":"crossref","DOI":"10.1007\/978-3-319-04600-6_4","article-title":"Aaron Antonovsky's development of salutogenesis, 1979 to 1994","volume-title":"The Handbook of Salutogenesis.","author":"Vinje","year":"2017"},{"key":"B15","doi-asserted-by":"publisher","first-page":"1107669","DOI":"10.3389\/fpain.2023.1107669","article-title":"Management of dysmenorrhea through yoga: a narrative review","volume":"4","author":"Kanchibhotla","year":"2023","journal-title":"Front Pain Res."},{"key":"B16","unstructured":"Effectiveness of yoga on primary dysmenorrhea among adolescent girls at selected schools\n          \n          231\n          6\n          \n            \n              Vasantha\n              S\n            \n          \n          Int J Nurs Educ Res\n          2\n          2014"},{"key":"B17","doi-asserted-by":"publisher","first-page":"S497","DOI":"10.4103\/ijcm.ijcm_555_24","article-title":"Effects of pilates and yoga on pain intensity, absenteeism, quality of life, and sleep quality among primary dysmenorrhea school students","volume":"50","author":"Juzer","year":"2025","journal-title":"Indian J Community Med."},{"key":"B18","doi-asserted-by":"publisher","first-page":"571","DOI":"10.1016\/j.jpag.2015.10.016","article-title":"Prevalence of menstrual problems among adolescent school girls in rural Tamil Nadu","volume":"29","author":"Ravi","year":"2016","journal-title":"J Pediatr Adolesc Gynecol."},{"key":"B19","unstructured":"Bhavanani\n              AB\n            \n            \n              Ramanathan\n              M\n            \n            \n              Dayanidy\n              G\n            \n          \n          Innovative Aspects of the CYTER in Pondicherry, India\n          \n          2020"},{"key":"B20","unstructured":"Premenstrual syndrome and premenstrual dysphoric disorder in individuals with intellectual disability\n          \n          29\n          30\n          \n            \n              Silka\n              VR\n            \n            \n              Hurley\n              A\n            \n          \n          Ment Health Asp Dev Disabil.\n          8\n          2005"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1","DOI":"10.4236\/jbm.2015.31001","article-title":"The prevalence and symptoms of premenstrual syndrome under examination","volume":"3","author":"Naeimi","year":"2015","journal-title":"J Biosci Med."},{"key":"B22","doi-asserted-by":"publisher","first-page":"1278","DOI":"10.1111\/1471-0528.18187","article-title":"Dysmenorrhea and adolescent mental health: a school-based cross-sectional study","volume":"132","author":"Gambadauro","year":"2025","journal-title":"BJOG"},{"key":"B23","doi-asserted-by":"publisher","first-page":"54","DOI":"10.18773\/austprescr.2016.024","article-title":"Menstrual issues for women with intellectual disability","volume":"39","author":"Tracy","year":"2016","journal-title":"Aust Prescr."},{"key":"B24","unstructured":"Menstrual concerns in an adolescent with disabilities\n          \n          823\n          31\n          \n            \n              Klein\n              DA\n            \n            \n              Gawrys\n              BL\n            \n            \n              Sylvester\n              JE\n            \n          \n          Am Fam Physician\n          92\n          2015"},{"key":"B25","unstructured":"UNICEF\n          Guidance Note: Menstrual Health and Hygiene for Girls and Women With Disabilities\n          \n          2021"},{"key":"B26","doi-asserted-by":"publisher","first-page":"123","DOI":"10.20529\/IJME.2021.081","article-title":"Does India's menstrual hygiene management scheme exclude the disabled?","volume":"7","author":"Dutta","year":"2022","journal-title":"Indian J Med Ethics"},{"key":"B27","doi-asserted-by":"publisher","first-page":"1","DOI":"10.47509\/SCDI.2025.v05i01.05","article-title":"Menstrual health and hygiene management during COVID-19: a qualitative study of adolescent girls with intellectual disability","volume":"1","author":"Mishra","year":"2025","journal-title":"J Contemp South Asia."},{"key":"B28","unstructured":"Royal\n              Children's Hospital Melbourne\n            \n          \n          Melbourne\n          RCH\n          Clinical Practice Guideline: Menstrual Management in Adolescents With Disabilities\n          \n          2023"},{"key":"B29","doi-asserted-by":"publisher","first-page":"143","DOI":"10.33790\/jphip1100143","article-title":"The affecting factors of premenstrual syndrome in female college students with disabilities","volume":"3","author":"Lan","year":"2019","journal-title":"J Public Health Issues Pract"},{"key":"B30","volume-title":"Effects of Yoga on Menstrual Symptoms, Pain, Sleep Quality, and Aerobic Endurance in Young Women With Primary Dysmenorrhea: A Randomized Controlled Trial","author":"Ulu\u015fahin","year":"2025"},{"key":"B31","doi-asserted-by":"publisher","first-page":"590","DOI":"10.12688\/f1000research.111219.1","article-title":"Meditation and yoga impact on dysmenorrhea (MY-ID): a study protocol","volume":"11","author":"Nayak","year":"2022","journal-title":"F1000Res"},{"key":"B32","volume-title":"IBM SPSS Statistics for Windows, Version 27.0","author":"IBM","year":"2020"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1771244\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T05:32:06Z","timestamp":1777959126000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1771244\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,5]]},"references-count":32,"alternative-id":["10.3389\/fpubh.2026.1771244"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1771244","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,5]]},"article-number":"1771244"}}