{"paper_id":"d6523cc1-f02e-4ca7-9527-19ce4b56aa5a","body_text":"A Case of Recurrent Menorrhagia Caused by Severe Hypothyroidism in a Rural Kenyan Hospital: Clues from Madarosis, Milphosis, and Woltman's Sign\nAuthors/Creators\nDescription\nAbstract: The typical causes of premenstrual abnormal uterine bleeding (e.g., menorrhagia) are gynecologic and include pregnancy-related bleeding (e.g., abortion and ectopic pregnancy), fibroids, adenomyosis, endometrial hyperplasia, cervical and uterine cancers, etc., and medical causes like coagulation disorders. Hypothyroidism must be considered a cause of menorrhagia, especially in women on thyroid hormone replacement therapy (who are non-compliant) due to its suppressive effects on ovulation with subsequent estrogen-induced breakthrough bleeding, coupled with hypocoagulation and fibrinolysis. This case study from rural Kenya highlights how non-adherence to lifelong thyroxine replacement therapy led to profound hypothyroidism with classical physical findings and caused severe recurrent menorrhagia, which subsequently resolved with compliant treatment.\nKeywords: menorrhagia, abnormal uterine bleeding, hypothyroidism, thyroxine, madarosis, milphosis, delayed tendon reflex, myxedema, Kenya.\nTitle: A Case of Recurrent Menorrhagia Caused by Severe Hypothyroidism in a Rural Kenyan Hospital: Clues from Madarosis, Milphosis, and Woltman’s Sign\nAuthor: Vonwicks C. Onyango, Ali J. Kariuki, Boniface Mutiso, Boniface M. Kioko, William C. Fryda\nInternational Journal of Novel Research in Healthcare and Nursing\nISSN 2394-7330\nVol. 11, Issue 2, May 2024 - August 2024\nPage No: 151-156\nNovelty Journals\nWebsite: www.noveltyjournals.com\nPublished Date: 18-June-2024\nDOI: https://doi.org/10.5281/zenodo.12073500\nPaper Download Link (Source)\nhttps://www.noveltyjournals.com/upload/paper/A%20Case%20of%20Recurrent%20Menorrhagia-18062024-1.pdf\nFiles\nA Case of Recurrent Menorrhagia-18062024-1.pdf\nFiles\n(441.6 kB)\n| Name | Size | Download all |\n|---|---|---|\n|\nmd5:2fcbe2dccaf8c7bba9f6bd549ac8288d\n|\n441.6 kB | Preview Download |","source_license":"CC0","license_restricted":false}