Referral to emergency

If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergent medical advice if in a remote region.

  • nil

For clinical advice, please telephone the relevant metropolitan Local Health Network switchboard and ask to speak to the relevant specialty service.

Central Adelaide Local Health Network

Northern Adelaide Local Health Network

Southern Adelaide Local Health Network

Women's and Children's Health Network


Triage categories

Category 1 (appointment clinically indicated within 30 days)

  • nil

Category 2 (appointment clinically indicated within 90 days)

  • nil

Category 3 (appointment clinically indicated within 365 days)

  • people with a physical and/or developmental disability or a complex medical condition with either of the following:
    • commenced menses and require assistance with menstrual management
    • pre-menarche: for discussion of menstrual management options

For more on outpatient referrals, see the general referral information.

All referrals for people less than 16 years of age, or those less than 18 years with intellectual disabilities, complex medical conditions, primary amenorrhea, pubertal delay, or Mullerian anomalies are to be sent to Women’s and Children’s Hospital (WCH).

Central Adelaide Local Health Network only accept referrals for people greater than 18 years of age.

Due to limitations in infrastructure and resources, the WCH cannot accommodate referrals for individuals with a body mass index (BMI) equal to or greater than 45, as well as individuals over the age of 69 years of age.

Essential referral information

Completion required before first appointment to ensure patients are ready for care. Please indicate in the referral if the patient is unable to access mandatory tests or investigations as they incur a cost or are unavailable locally.

  • identifies as Aboriginal and/or Torres Strait Islander
  • for adult patients, relevant social history, including identifying if you feel your patient is from a vulnerable population and/or requires a third party to receive correspondence on their behalf
  • for paediatric patients, identify within your referral if you feel your patient is from a vulnerable population, under guardianship/out-of-home care arrangements and/or requires a third party to receive correspondence on their behalf
  • interpreter requirements
  • past medical/surgical/psychosocial history
  • current medications and allergies
  • menstrual history:
    • menarche
    • cycle, day/months
    • days of bleeding
    • blood loss e.g. change of pads or tampons per day/hours
    • previously trialled treatments
  • quality of life concerns including:
    • missed school/extracurricular activities
    • impact on family and support workers
    • behavioural changes or aggression
    • exacerbation of medical conditions e.g. increase in seizure activity
  • height/weight
  • BMI
  • growth chart trends
  • blood pressure
  • relevant physical examination findings

Clinical management advice

Initiating discussions about puberty and menstruation before menarche is the most beneficial approach.

Adolescents with disabilities or complex medical conditions may encounter extra difficulties and risks related to menstruation and pregnancy. These contributing risk factors may include:

  • physical health risks - depending on the nature of their disability or medical condition, adolescents may have pre-existing health issues that can complicate menstruation. In addition, hormonal changes during menstruation may worsen underlying medical problems.
  • medication interactions - some adolescents with disabilities or complex medical conditions may be taking medications that can have negative effects on menstruation. It is crucial to understand the potential risks and ensure appropriate management.
  • communication and understanding - adolescents with cognitive or intellectual disabilities may face challenges in comprehending reproductive health, menstruation, or sexual education. Providing adequate support and resources is vital to enable informed decision-making and understanding.
  • emotional and social factors - adolescents with disabilities or complex medical conditions, along with their families, may confront additional challenges regarding emotional well-being, social support, and coping with the physical demands of menstruation. In addition, hormonal changes during menstruation can worsen underlying behavioural problems.

Consulting specialist clinicians who work with people with disabilities, or complex medical conditions is essential for evaluating risks and providing appropriate management plans to address specific concerns related to menstruation management.

Clinical resources

Consumer resources