Part II: Clinical Practice Guidelines for Adolescents and Young Adults With Down Syndrome: 12-21 Years

Susan Van Cleve, MSN, RN, CPNP; Sheila Cannon, MEd; William I. Cohen, MD


J Pediatr Health Care. 2006;20(3):198-205. 

In This Article

Puberty and Sexuality in Adolescents With DS

Secondary sex characteristics develop in females with DS in the same sequence as in typical children (Pueschel, 1997); their age of onset for menstruation is 12 years, 6 months (Scola and Pueschel, 1992). Scola and Pueschel found that almost all of the women with DS in their study ovulated and had regular menstrual cycles. Pregnancy can occur in women with DS; their offspring have a 50% risk of having DS in any single conception. To prevent unintended pregnancy, young women with DS should receive contraceptive counseling and, if appropriate, contraceptive interventions.

Pueschel, Orson, Boylan, and Pezzullo (1985) investigated the development of primary and secondary sex characteristics as well as the levels of specific pituitary and testicular hormones in males with DS. They found that the pubic hair and size of genitalia did not differ significantly from that of typical adolescents. A few males with DS have fathered children (Sheridan et al., 1989), but their overall fertility rates are thought to be quite low.


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