Please ensure your referral includes all the following whether negative or positive. This will ensure that that the patient is correctly prioritised by secondary care and allow more clinic time to discuss treatment options (an ereferral is being developed which will assist you with the referral process).
Bleeding history-clots / flooding / cycle length
Medications - past Tamoxifen or unopposed oestrogen use
Family history of endometrial or bowel cancer
History of bleeding disorder
Speculum examination - view the cervix and take smear if due or if concern
Full blood count
Consider TSH (use clinical judgement)
Consider coagulation screen (3-5% of menorrhagia patients have a coagulation disorder)
Take swabs if considered clinically necessary or if a Mirena is to be considered
Cervical smear if due/considered necessary
Primary care referral for USS may be requested only if there is a palpable mass (>12/40 size uterus). For other cases the USS will either be carried out by the gynaecologist at the OP appointment, or in selected cases the gynaecologist will refer the patient to radiology.
Note female hormone testing is not routinely required
If pharmaceutical treatment is required while a clinic appointment is being arranged either Tranexamic acid, a NSAID drug or a progestorone can be used. AVOID oestrogen containing preparations until pathology is ruled out.
Disclaimer: This site is intended to be flexible and frequently updated. While every effort has been made to ensure accuracy, all information should be verified.