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QQ-3354. Ms Olivia Hawthorne - Nursing – Nycy Mathew – Menorrhagia and Dysmenorrhea


Dr Miriam Shah

Consultant Obstetrician

Royal Hospital


Dear Dr Shah,

Re: Ms Olivia Hawthorne ,DOB: 01 April 1979

I am referring Ms Howthorne, who has been diagnosed with menorrhagia and dysmenorrhoea, requires removal of intrauterine device and appropriate investigations at your service.

Ms Howthorne, a yoga teacher, is married and has two children. She has had iron deficiency anemia, for which she is on ferrous sulphate 200 mg daily. She had menorrhagia and dysmenorrhoea in 2009 and treated with cerazette.

Ms Howthorne presented on 10 April 2015 with the complainants of menorrhagia ;therefore, IUD Minerva coil was inserted. On 02 April 2019, she re- presented with the complaints of menstrual spotting for the past three months,increased hair growth,greasiness of the skin,along with menorrhagia and dysmenorrhoea. Canestan five times daily has been commenced as well as removal of IUD has been advised.

On today's visit, although the removal of intrauterine device was attempted for 15 minutes, owing to the inability to locate the strings,it was unsuccessful whereas, Ms Howthorne is unable to recall the location of previously inserted strings. Possibility of shifting or fallen out of the intrauterine device is suspected.

It would be profoundly beneficial if you could take over Ms Hawthorne and perform ultrasound and other necessary evaluations in order to manage her condition.

In case, any additional information is required, please do not hesitate to contact me.

Yours sincerely,

Registered Nurse


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