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

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)

  • suspected/confirmed polycystic ovarian syndrome (PCOS)

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/obstetric/psychosocial history
  • current medications and allergies
  • onset, duration and course of presenting symptoms e.g. hirsutism or acne
  • menstrual history:
    • cycle, day/months
    • days of bleeding
    • blood loss e.g. change of pads or tampons per day/hours
    • previously trialled treatments
  • height/weight
  • BMI
  • abdominal examination findings
  • pelvic examination if sexually active
  • an up-to-date cervical screening test as per the cervical screening guidelines if older than 25 years of age
  • trans-vaginal ultrasound if sexually active
  • relevant imaging and reports including location, company, and accession number

Pathology

  • complete blood examination (CBE)
  • ferritin (iron deficiency)
  • human chorionic gonadotropin (ßhCG)
  • day 2 to 6 bloods if possible
    • follicle stimulating hormone (FSH)
    • luteinizing hormone (LH)
    • oestradiol
  • testosterone
  • free androgen index (FAI)
  • sex hormone binding globulin
  • prolactin
  • thyroid stimulating hormone (TSH)

Clinical management advice

For any of the following symptoms, please refer directly to endocrinology:

  • concerning features of virilisation (masculine physical characteristics)
  • male-pattern baldness
  • deepening of voice
  • clitoromegaly
  • abnormal glucose metabolism
  • cardiovascular disease
  • non-alcoholic fatty liver disease

Polycystic ovary syndrome (PCOS) is a common condition, present in 12 to 21% of women in their reproductive years. A diagnosis of PCOS can be made if 2 of the 3 following criteria are met:

  • excess androgen, clinical or biochemical and/or
  • menstrual disturbance, oligomenorrhoea/amenorrhoea and/or
  • polycystic appearance of ovaries on ultrasound

Irregular periods are defined as:

  • greater than 1 year post menarche: cycles greater than 90 days
  • between 1 to 3 years post menarche: cycles less than 21 or greater than 45 days
  • greater than 3 years post menarche: cycles less than 21 or greater than 35 days

Clinical resources

Consumer resources