Menstrual Clinic referrals

Heavy menstrual bleeding (HMB) is excessive menstrual blood loss which interferes with a woman's physical, emotional and social quality of life.

To avoid repeated visits to the hospital and lengthy waiting times for investigations, women over 40 with heavy or irregular vaginal bleeding referred to the Menstrual Clinic are able to have a scan, see a consultant, undergo a hysteroscopy if necessary and receive the results and plan of care immediately, all in a two hour appointment.

Please note that sometimes it is not possible to have the scan on the same day and you may need a second appointment. This service is led by Gynaecology Consultant Mr Vic Rai and his team.

Recently developed local and national guidelines determine the best ways women with these problems can be treated.

The full guideline can be accessed on the Oxfordshire Clinical Commissioning Group intranet (internal link for those with NHS access only):

• OCCG intranet: HMB guidelines

Referral to secondary care is recommended:

• if USS/examination shows abnormalities (use locality-based USS where available)
• if patient falls into 2 Week Wait cancer referral pathway criteria
• for women over 40 years with:
  • irregular bleeding
  • recent onset of menorrhagia, or
  • if the patient cannot tolerate or does not wish to use the pharmaceutical method of treatment, and wishes to explore possible surgical intervention
• for women under 40 years with:
  • persistent irregular bleeding not responding to pharmacological treatment
  • persistent heavy bleeding not responding to pharmacological treatment
  • recent onset of menorrhagia.

Please refer directly to General Gynaecology Clinic via Choose & Book.

Links

• Gynaecology patient leaflets
• NICE Clinical Guideline No. 44: Heavy Menstrual Bleeding (HMB) (pdf)
  
• NICE heavy menstrual bleeding quick reference guide (2007)
• NICE referral advice - a guide to appropriate referral from general to specialist services (pdf)
• NICE referral guidelines for suspected cancer
• Local funding policies (Lavender Statements) - Oxford Clinical Commissioning Group