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Menstruating in a wheelchair, how does that work?

3 min read
Cycle Care

Imagine that an accident causes you to become paralyzed up to your chest. Even your fingers and partially your arms. How in the world do you handle your period?

Pascalle (56) doesn’t have to imagine that, as the above became her reality 23 years ago. She candidly tells us about how the most intimate part of her body became the concern of whichever visiting nurse is clocked in. ‘It feels humiliating. I haven’t gotten used to it after all these years.’

You end up in a wheelchair. Then there are thousands of millions of things you can no longer do yourself. In Pascalle’s case, it for example means calling your neighbors for help when you want to open a bottle of wine. Or to pick up something that’s fallen onto the ground. Even inserting a tampon has become impossible, but that’s not the sort of thing you’d like to call on your neighbor for. For years, Pascalle was dependent on at-home carers for the insertion of her period products. They’d come by every morning to help her get dressed. Had the visiting nurse just left when her menstruation began? Then she was out of luck, and would have to put up with waiting until the evening, all without being changed.

‘I was 28. After my pregnancy, I went to France for a long weekend with my then-partner and a couple of good friends. There I made a dash, tripped, and just about broke my neck. To be exact, the c5 vertebra was shifted, which caused me to have a spinal cord injury. I am paralyzed from the chest down, but am lucky enough to still feel everything. In the revalidation center, I had to relearn literally everything. For example, I can’t squeeze with my hands, so when I want to grab something I have to use a different technique. As of now, I can do many things myself, and am lucky enough that I used to exercise a lot, which has made me agile and flexible. Because of that, I can -besides getting dressed- get through the day fully independently. 

‘I’m unable to insert a tampon myself, because my fingers are paralyzed’

But I’m unable to insert a tampon myself, because my fingers are paralyzed. I found that to be one of the most difficult things to depend on others for. I can’t just get up from my chair, but have to hoist myself out of bed, undress, change the tampon, and get dressed again. I can’t do that without help, because in my arms only my biceps still work. Even with help, it costs me about an hour, as well as a lot of energy. It’s different for each person in a wheelchair, but in my case it’s actually not doable to get out of my wheelchair during the day.

Besides, I didn’t like having someone different insert my tampon each time. They’re all very kind people who do a fantastic job, and they assured me that they’re used to doing such tasks. I get that, but I could never get used to it. I’m not prudish, but I am fond of my privacy. I still wrap a towel around myself when the at-home carer helps me get dressed after showering. Because I can still feel, I’d also notice whenever I’d leak. Sometimes the tampon wasn’t inserted properly, and I’d only notice when the carer had already left. At that point, I couldn’t do anything about it. Eventually, I decided to get a contraceptive injection. A great solution for me, because now my menstruation no longer happens.

‘Sitting on a pad all day eventually begins to hurt’

I have always used tampons, even before I ended up in a wheelchair. 23 years ago, pads were still very popular. But those are very inconvenient when you’re in a wheelchair, because, especially during the heavy flow days, they need to be changed every two hours. Besides, it’s not nice to sit on a pad all day, since they eventually begin to hurt. At the time, no information was given in the revalidation center about what options were available besides pads and tampons, and I myself was concerned with completely different things. Only later did I realize that it would’ve been nice if any attention had been given to it in the revalidation center. Perhaps then I would’ve begun contraceptive injections earlier or tried a menstrual cup.’

Cycle has approached multiple revalidation centers in the Netherlands for comment (among others de Hoogstraat, Reade, Nederlandse Vereniging van Revalidatieartsen team Spinal Cord Injuries, and the section Child Revalidation Care). At the time of publication of this article, they have not yet responded. Nikki van Hooij, occupational therapist at the medical specialist revalidation center Revant (a large Dutch revalidation center) says: ‘There is no dedicated program for the topic of menstruation. It is discussed with the nursing staff or other carers if a client specifically asks for it. We haven’t yet thought about how to regularly change a tampon if you can’t do it yourself. That’s a good question.’

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