GYNECOLOGICAL CARE FOR WOMEN WITH INTELLECTUAL DISABILITY

Optimal gynaecological care for women with intellectual disability is complex. Many of these women suffer unique problems with regard to men strual hygiene, sexuality, contraception and susceptibility to Sexual abuse. Complex medical, ethical, social and legal issues must be caref ully considered to address these problems. We discuss the ''gynaecolog ical'' management of intellectually disabled women, with particular re ference to contraception and menstrual suppression. We advocate endome trial ablation as an alternative to hysterectomy for women with intrac table menstrual problems. Some ethical issues are reviewed which must be addressed to determine which approach is in the patient's ''best in terest'' and adopts the ''least restrictive option''. Finally, we pres ent Federal and State laws governing informed consent for medical proc edures for women and children with intellectual disabilities.