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Miss Ahmed is a 29 year old female who you have seen a few times with heavy periods. During your last consultation you took a detailed history, examination and requested a Full Blood Count (FBC). The FBC has returned normal and you feel she likely has dysfunctional uterine bleeding. Miss Ahmed has been managing her pain with Paracetamol which is not fully effective. Despite using tampons and pads she is still having leaks and is finding it challenging. She also has Coeliac disease and Eczema but is otherwise fit and well. She is a non-smoker and does not drink alcohol. Miss Ahmed is not currently sexually active and not keen on having a coil fitted.

What is the most appropriate treatment?

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