‘There is no one to help–It’s always me’: challenges and coping strategies in menstrual hygiene management of adolescent girls with moderate intellectual disability–mothers’ perspectives

Abstract

This study aimed to explore the difficulties experienced by mothers in managing menstrual hygiene for adolescent girls with moderate intellectual disability and the coping strategies they develop. The sample consisted of 16 mothers of girls aged 12-18 attending special education and rehabilitation centers, selected through maximum diversity sampling. Data were collected via semi-structured interviews and analyzed using thematic analysis. Five main themes emerged: (1) recognizing menstruation and initiating management, (2) challenges in maintaining menstrual hygiene, (3) coping with physiological, emotional, and behavioural changes, (4) lack of social support and caregiving burden on mothers, and (5) development of individual coping strategies. Mothers reported significant difficulties with sanitary pad use, hygiene skills, managing leakage, and addressing behavioural changes. They also highlighted limited social support and the responsibility of care being largely placed on them. Despite these challenges, mothers developed practical strategies such as establishing routines, using repetitive instruction, making environmental adjustments, and applying individualized solutions. The findings emphasize the need for structured training programs for mothers, greater involvement of school and healthcare professionals, and the establishment of multidisciplinary support systems to improve menstrual hygiene management for adolescents with intellectual disabilities.