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, Implanon or Mirena 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). Please contact ED Medical Officer in Charge:
LGH ED – Phone: (03) 6777 6405  Fax: (03) 6777 5201
MCH ED – Phone: (03) 6478 5120  Fax: (03) 6441 5923
NWRH ED – Phone: (03) 6493 6340 Fax: (03) 6464 1926
RHH ED - Phone: (03) 6166 6100  Fax: (03) 6173 0489

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.