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.

  • symptomatic imperforate hymen

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

Women's and Children's Health Network

Category 1 (appointment clinically indicated within 30 days)

  • nil

Category 2 (appointment clinically indicated within 90 days)

  • primary amenorrhoea

Category 3 (appointment clinically indicated within 365 days)

  • nil

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).

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
  • 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
  • sexual and contraception history
  • current medications and allergies
  • presenting symptoms including:
    • Tanner staging -pubertal development
    • breast and pubic hair development
    • cyclical abdominal pain including frequency and severity
    • headache/visual disturbances/galactorrhoea
    • significant weight/dietary/exercise changes
  • height/weight
  • BMI
  • blood pressure trends
  • abdominal examination findings
  • pelvic examination if sexually active


  • follicle stimulating hormone (FSH)
  • luteinizing hormone (LH)
  • oestradiol
  • thyroid stimulating hormone (TSH) 
  • prolactin
  • beta-human chorionic gonadotropin (ßhCG) with permission
  • trans abdominal pelvic ultrasound

Acne and/or hirsutism

  • testosterone
  • free androgen index
  • sex hormone binding globulin (SHBG)
  • dehydroepiandrosterone sulphate (DHEAS)

Clinical management advice

Primary amenorrhoea is defined as no period by the age of 16 years, in the presence of normal secondary sexual characteristics, breast pubic hair development is normal, or no period by the age of 13 years with absent development of secondary sexual characteristics.

Clinical resources

Consumer resources