April 2025
All menopause referrals and advice queries should be directed to the Menopause Clinic at Chalmers via Sci Gateway. Check out the updated info on lab investigations for peri/menopause and the assessment of contraceptive needs here: https://apps.nhslothian.scot/refhelp/guidelines/sexualreprohealth/menopause/fsh-testing-for-menopausecontraception/
Please use the risk calculator for unexplained throat symptoms. This has been reliably validated using Scottish evidence: http://www.orlhealth.com/risk-calculator-2.html and includes all the red flags. More details on referral criteria & FOSSIT management here: https://apps.nhslothian.scot/refhelp/guidelines/entadult/throat/feelingofsomethingstuckinthethroatfossit/
The easiest and most reliable way to risk-assess for persistent hoarseness is to use the validated Head and Neck Cancer Risk Calculator. The emphasis for suspecting cancer is on constant hoarseness and considering risk factors. Detailed guidance here: https://apps.nhslothian.scot/refhelp/guidelines/entadult/throat/hoarseness/
Patient with Intermenstrual bleeding (IMB)? Please check RefHelp to see which investigations to do prior to referral – FBC, pregnancy test, chlamydia pelvic US to avoid delays in the patient pathway. Detailed guidance here: https://apps.nhslothian.scot/refhelp/guidelines/gynaecology/abnormaluterinebleeding/intermenstrualbleedingirregularvaginalbleeding/
Post menopausal bleeding (PMB) in women without previous h/o of abnormal bleeding & who are on HRT should be allowed 6 months for it to settle prior to referral for US scan. If bleeding is >12 months ago this is a new episode of PMB. https://apps.nhslothian.scot/refhelp/guidelines/gynaecology/postmenopausalbleeding/
New Page on Paediatric Endocrinology & Diabetes covering guidance and management for all endocrine conditions except Type 1 Diabetes which is managed by the RYCYP Diabetes team. More info about the service & referral criteria here: https://apps.nhslothian.scot/refhelp/guidelines/paediatrics/paediatric-endocrinology-diabetes/
Sleep disordered breathing encompasses a wide range of breathing abnormalities during sleep. Please see RefHelp for detailed referral guidelines, tips for primary care management, and useful resources: https://apps.nhslothian.scot/refhelp/guidelines/respiratory/sleep-medicine/sleep-disordered-breathing/
Detailed information regarding diagnosis, management, and referral criteria for distinct types of parasomnias now on RefHelp: https://apps.nhslothian.scot/refhelp/guidelines/respiratory/sleep-medicine/parasomnias/
