Start with low dose monophasic pills. Trial for at least three months. Paying careful attention to withdrawal bleeds. If still heavy, move to a higher dose pill or reduce frequency of bleeds. Menstrual suppression with Depo-Provera may be necessary if all else fails.
Hormonal treatments result in reversible contraception.
This must be acknowledged and discussed. Contrary to popular belief women with an intellectual disability can be reliable pill takers although some may require the support of their carers. Removes the need for hysterectomy. Does not guarantee total amenorrhoea. Cannot be relied on as a form of contraception.