When to refer to a menopause specialist
| Indication | What to include in your letter |
|---|---|
| Abnormal bleeding | USS with endometrial thickness±cervical smear report, consider fast-track cancer referral |
| Multiple treatment failure (3+) | List types and detail problems |
| VTE (confirmed) | Detail confirmation (e.g. circumstances, anticoagulation, thrombophilia screen, USS, venogram, V/Q scan) |
| Premature menopause | Reason for ovarian failure, FSH, TFTs, BMD, auto-antibody screen |
| Osteoporosis | BMD confirmed by DEXA if possible with T and Z scores, detail any non-traumatic fracture |
| Previous or high risk of hormone-dependent cancer | Details of disease, stage, treatment, family history |
BMD, bone mineral density; DEXA, dual-energy X-ray absorptiometry; FSH, follicle-stimulating hormone; TFT, thyroid function test; V/Q, ventilation/perfusion; VTE, venous thromboembolism; USS, ultrasound scan.