For patients who have post-menopausal bleeding and are not on HRT, please see link to PMB No HRT page
MM & RC 22/1/26
How to refer:
1.For patients with unscheduled bleeding on HRT:
Refer to Radiology for Unscheduled Bleeding on HRT USS Sci-Gateway > ELCH/LB/RIE/SJH > Clinical Radiology > LI Unscheduled Bleeding on HRT
If the USS report is reported as non-reassuring, the Primary Care Clinician to refer patient to Gynaecology
Sci-Gateway > RIE > Gynaecology > LI PMB Abnormal Ultrasound
There are 2 situations, as below, where patients who are, or have recently been, on HRT should be referred for a PMB USS (not an Unscheduled Bleeding on HRT USS):
- Ongoing unscheduled bleeding after a total of 12 months of HRT despite troubleshooting actions
- Ongoing bleeding at 6 weeks since stopping HRT
2.For patients with ongoing unscheduled bleeding after a total of 12 months of HRT despite troubleshooting actions:
USOC Referral Gynaecology Sci-gateway > RIE > Gynaecology > LI Basic sign referral (select priority USOC) and simultaneous referral to Radiology for PMB USS Sci-Gateway > ELCH/LB/RIE/SJH > Clinical Radiology > LI PMB (No HRT)
3.For patients with ongoing bleeding at 6 weeks since stopping HRT
USOC Referral Gynaecology Sci-gateway > RIE > Gynaecology > LI Basic sign referral (select priority USOC) and simultaneous referral to Radiology for PMB USS Sci-Gateway > ELCH/LB/RIE/SJH > Clinical Radiology > LI PMB (No HRT)
4.For suspected vulval, vaginal, cervical malignancy:
USOC Referral Gynaecology Sci-Gateway > RIE> Gynaecology> LI Basic sign referral (select priority USOC)
