Dr Miriam Shah
06 April 2019
Dear Dr Shah
Re: Ms Olivia Hawthorne, aged 40
Ms Olivia Hawthorne, who has difficulty in removing of intra uterine device, is being referred for further investigations and appropriate management from your facility.
In terms of her medical background, Ms Hawthome has had menorrhagia and dysmenorrhea since 2009, for which she was treated with Cerazette. Despite offering treatment frequent visits was recorded for discontinue of contraceptives prior to each pregnancy. She has history of G3P2. She has been treated in 2018 with vaginal thrush and Canestan for five days; hence, condition was improved.
On 02 April 2019, Ms Hawthome presented with the previous symptoms along with significant increase of hairiness and greasiness of skin. Additionally, menstrual spotting for the last three months was noted. Therefore; removal of intrauterine device was prescribed. On the subsequent visit, failure attempt was made because, unable of locate strings due to misplace or fallen out.
Base on the aforementioned circumstances, your willingness to evaluate the requirement for further investigations such as ultrasound would be extremely beneficial to Ms Hawthome's condition.
If any additional information is required, please do not hesitate to approach me.