PIP: Family planning practitioners tend to be unaware of the reproductive health needs of disabled people. In many developing countries, disabled women are not taken for routine gynecologic examinations because it is assumed they will not have children. Even in developed countries, women with paralysis, impaired motor function, and other obvious physical disabilities are rarely offered counseling on sexuality or contraception. With proper education and counseling, disabled men and women may finally be in a position to make a truly informed decision about their reproductive lives. The selection of a contraceptive method for a disabled woman depends on consideration of factors such as the quality of circulation, abnormal clotting, the degree of physical sensation, manual dexterity, possible interactions with other medications, the effect of contraceptives on the disease process, problems with menstrual hygiene, and depression. For example, oral contraceptives are contraindicated in women with impaired circulation, a history of cerebrovascular accident, and immobility of the extremities. Methods than increase menstrual bleeding (e.g., copper IUDs) can cause hygiene problems for women with compromised manual dexterity. Although use of a barrier method may be difficult for women with poor coordination or upper-extremity disabilities, sexually transmitted disease (STD) prevention is especially important for women with pelvic sensory impairments that could allow STD symptoms to go unrecognized. Also in need of assessment in patients with physical disabilities are the impact of the disability on sexual expression and the possibility that sexual abuse is occurring.