The Women's has one referral pathway. We prioritise access for women who live in our local area (i.e. we are their closest hospital) and for women who have complex or high risk health needs.
The following gynaecological problems may require the tertiary level expertise of the Women’s:
- Molar pregnancy surveillance and registry (for gestational trophoblastic disease)
- Diethylstilboestrol (DES) exposure (for surveillance)
- Gynaecological cancers
- Fibroid management requiring Magnetic Resonance-guided Focused Ultrasound
- Menopause symptoms after cancer
- Infertility requiring Reproductive Services
Links to referral requirements and Fast Fax Templates can be found at the end of this page.
Care for general gynaecology issues
Women who require care for general gynaecology problems should be referred to their local hospital with a women’s health service. Guidance in assessing, managing and referring some problems can be found on the HealthPathways Melbourne website.
The problems in the list below generally do not require tertiary level expertise:
- Cervical dysplasia and polyps
- Heavy or Irregular Menses
- Intermenstrual or Post Coital Bleeding
- Post Menopausal Bleeding
- Pelvic pain
- Dyspareunia
- Menopause
- Prolapse
- Incontinence
- Vulval itch
- Vulval pain / skin problems
- Breast pain/lumps
Women who have a general gynaecology problem but also have complex needs and/or co-morbidities may be accepted for care at the Women's. This will be determined by clinical triage upon receipt of a referral.
According to the state-wide referral criteria, the Women’s is unlikely to accept women referred for:
- Reversal of tubal ligation
- Where cervical screening shows:
- human papillomavirus is not detected
- there is unsatisfactory liquid-based cytology or human papillomavirus testing
- possible, or confirmed, low-grade squamous intraepithelial lesions where human papillomavirus is not detected.
For women who are low risk, and cervical screening 12 months apart shows two consecutive non 16/18 HPV with low grade cytology changes or better, even when the pathology recommendation is for colposcopy, women will not be accepted for colposcopy. It is recommended a third test is undertaken by their GP in 12 months – read more here.
Referral requirements
Comprehensive information is required for us to appropriately triage your referral and to allocate women to a clinic and contact them. Insufficient information will delay triage. Templates can be found at the end of this page.
Your referral must include the essential information below:
- Name
- Address
- Date of birth
- Phone (preferably mobile)
- Medicare number (Health insurance details if no Medicare number provided)
- Referrer details: practice address and provider number
- Country of Birth
- Aboriginal or Torres Strait Islander status
- Interpreter and language required
- Disabilities and special needs (e.g. mobility)
- Clinical information:
- Diagnosis or provisional diagnosis, if known
- Co-Morbidities
- BMI
- Relevant physical examination findings
- Relevant Medical history
- Relevant Psychiatric, Genetic and Family history
- Management to date and response to treatment.
Issues with fax referrals
Referrals should be faxed to the Women’s Fast Fax: (03) 8345 3036.
If faxing is not an option for your clinic, or you have problems with fax referrals not being received, please email our GP Liaison Unit for assistance. Please do not include your referral in this email. Email: GP.liaison@thewomens.org.au
List of conditions that require specific investigations
For some clinical conditions, we require a comprehensive referral including the specific investigations listed below:
- Contraception
Consider: cervical screen, STI screen - Dysplasia/abnormal cervical screening test
Cervical screening - Endometriosis, Dysmenorrhoea, Pelvic pain
Pelvic ultrasound, cervical screen
Consider: STI screen, - Fibroid
Pelvic ultrasound
If associated heavy menstrual bleeding include FBE, Ferritin - Menopause
Consider hormonal tests (FSH and estradiol) if menopause is not clear on history
Consider: cervical screen - Molar pregnancy
Tumour HCG - Ovarian and other adnexal pathology
Pelvic ultrasound
If suspected malignancy or post-menopausal ovarian cyst, Cancer antigen 125 (CA 125) - Heavy menstrual bleeding
Pelvic ultrasound, FBE, Ferritin
Consider: TFT, cervical screen - Intermenstrual or post coital bleeding
Most recent cervical screen, Pelvic ultrasound
Consider: STI screen - Polycystic Ovarian Syndrome (PCOS)
Pelvic ultrasound
Hormonal tests: βhCG (to rule out pregnancy), Oestradiol, Prolactin, LH, FSH, TSH, 17 hydroxyprogesterone, SHBG, biochemical androgens 3 months after cessation of oral contraceptive pill (free androgen index , free testosterone, DHEAS) - Polyp (cervical or uterine)
Cervical screen, Pelvic ultrasound - Post-menopausal bleeding
Pelvic ultrasound, STI screen, cervical screen - Pregnancy choices
Pelvic ultrasound, Quantitative serum HCG, Blood group and antibodies
Consider: STI screen, cervical screen - Vulvo vaginal:
• Vulval and vaginal pain
• Chronic vulvovaginal candidiasis
• Pruritus vulvae/vulval itch
Failure to respond to treatment after 3 months High vaginal swab micro and culture
Consider: STI screen