Obstetrics and Gynaecology  |  Menorrhagia Pathway - Red Flags

Obstetrics and Gynaecology

Menorrhagia Pathway - Red Flags

The Red Flags identify those patient that require Specialist assessment to rule out pre-cancerous endometrial hyperplasia and endometrial cancer (rare).  These patients are 'at-risk' (as opposed to high risk).  If the patient meets any one of the criteria below, they should be referred.





Age>35 with one or more of the following:

  • Nulliparity
  • Infertility
  • Known Polycystic Ovary Syndrome (PCOS)
  • Use of either Tamoxifen or unopposed oestrogens

IMB/PCB; if either of these symptoms is present ensure smear is up to date  and refer on according to the MoM Midland PCB/IMB pathway.

First degree relative with endometrial or bowel  cancer <60 years old (Lynch syndrome)


Age >35 AND Weight>90kg or BMI>30

Clinically palpable abnormal pelvic mass

Note those with a vulval lump or ulceration or those with an abnormal cervix should be considered high risk for vulval or cervical cancer and should be referred to Gynae OPD 


Hb<80 g/L


Last updated : Friday, August 21, 2015
Next review date : Saturday, August 20,2016

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.