Post-menopausal bleeding

Post-menopausal bleeding — referral criteria for Gynaecology services.

Eligibility

At least one must be met for the patient to be eligible for referral.

Clinically suspected or confirmed post-menopausal bleeding with initial primary-care work-up completed

Red flags

Indicate urgent (Category 1) referral or emergency assessment.

Uncontrolled vaginal bleeding, or if the person is haemodynamically unstable

Routine referral criteria

Determine Category 2 or 3 urgency.

Post-menopausal bleeding with a thickened endometrium (greater than 4 millimetres measured on transvaginal pelvic ultrasound)

Post-menopausal bleeding with polyp confirmed by imaging

Post-menopausal bleeding in a person taking tamoxifen

Usually managed in primary care

Single episode of bleeding with an endometrium (less than 4 millimetres measured on transvaginal pelvic ultrasound), with negative cervical screening results