Condition:
- postmenopausal bleeding on HRT : REFER directly for hysteroscopy / as per PMB guidelines
Referrals for women with a complex medical history:
(Please include the following with referral)
- Breast Cancer: relevant correspondence regarding diagnosis, most recent mammogram/ screening.
- Abnormal LFTs: recent liver function results and any relevant correspondence regarding diagnosis
- Epilepsy: current medications, information re. seizure control, contraceptive history
- Estrogen -dependent cancers: correspondence regarding diagnosis and information about treatment/ surgery etc.
- Migraine: please outline if there is a history of aura/ catamenial migraine
- VTE: spontaneous/ precipitated, contraceptive history, current risk factors for VTE. Information regarding anticoagulation
- Family history of breast cancer: outline family members and any information about diagnosis. Recent mammogram/ screening results.
- Ischemic Heart Disease/ Stroke: information regarding diagnosis, documentation regarding most recent cardiac investigations, recent BP and lipids, smoking status
- Premature Ovarian Insufficiency: >4 months of amenorrhoea, with no other cause. Bloodwork; 2 x FSH levels taken > 6 weeks apart, LH, estradiol, prolactin level, TFTs,
For all referrals:
– Please note referral to the Rotunda Menopause Clinic is by GP only through Healthlink.
– Please include a list of current medications, outline any previous HRT and hormonal contraceptive history, most recent BP, record of most recent screening (eg mammogram, cervical smear, DEXA) and any pelvic ultrasound/ imaging results
Complex Menopause Referral Criteria:
Past or current medical history of:
- Current or past history of cancer (particularly breast or other gynaecological cancers)
- Abnormal liver function
- Venous thromboembolism/ Factor V Leiden
- Cardiovascular disease / Vascular disease
- Cerebrovascular accident
- Epilepsy
- Premature Ovarian Insufficiency/ surgical or medical menopause
- Immunological diseases
- Significant Family history of breast / ovarian or endometrial cancer
- Patients with a history of BRCA diagnosis