Abnormal menstruation

Availability

North South North West Statewide

Pre-referral work-up

History

Minimum of three months unless continuous bleeding.

All referrals should comply with referral standards and include in particular:

  • Duration of condition – primary or secondary condition
  • Age of menarche
  • Gynaecological and obstetric history
  • Treatment – present and past and efficacy of treatments
  • Symptoms – pain, fatigue and effects on work, study etc
  • Family history – haematolgical disorders
  • Examination findings – genital tract abnormalities

Tests

  • Pap smear
  • Pelvic ultrasound
  • FBE and iron studies if prolonged or heavy bleeding
  • Pregnancy test – if acute

Interim/GP management

To refer a patient with this condition, please see the Gynaecology clinic page for the full referral process and templates.

Consider use of hormonal treatments such as OCP, a hormonal intrauterine contraceptive device (IUCD) or a hormonal implant if no contra-indications. Consider use of NSAIDs such as Mefenamic acid.

In the THS Southern Region women suitable for outpatient hysteroscopy may be referred directly by their GP without the need for a Gynaecology Clinic appointment  - see referral pathway.

For more information please see the Tasmanian Health Pathways website.

Emergency

Uncontrolled heavy bleeding

Urgent / category 1

Anaemia with Hb <80 g/l

Age >37

Pelvic mass

Abnormal smear

Routine / category 3

  • Resistant to treatment

Red flags are clinical indicators of possible serious underlying conditions requiring further medical intervention. They may or may not indicate an emergency.

Emergency:

Proceed to Emergency Department (ED).
LGH ED Reception  – Phone: (03) 6777 6405  Fax: (03) 6777 5201
MCH ED* – Phone: (03) 6478 5120  Fax: (03) 6441 5923
NWRH ED* – Phone: (03) 6493 6351 Fax: (03) 6464 1926
RHH ED Reception – Phone: (03) 6166 6100  Fax: (03) 6173 0489

Advice for medical practitioners can be given by the Medical Officer In Charge (MOIC) - see HealthPathways Tasmania for contact information.
*MCH and NWRH MOICs request GPs call them prior to referring a patient to ensure the patient is being sent appropriately to a safe destination.

Urgent:

Urgent referrals should be accompanied by a phone call to the Consultant/Registrar to organise urgent review and the referral must be faxed.

We will endeavour to see these patients within four weeks, or sooner if clinically indicated.

Semi-urgent:

Routine:

Will be seen in turn.