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Everyone must stay at home to help stop the spread of coronavirus. Advice for clinicians on COVID-19 (coronavirus) is here. If you are a member of the public looking for health advice, visit the NHS website or North Yorkshire Public Health. And if you are looking for the latest travel information, and advice about the government response to the outbreak, go to the website.

Last updated: 30 March, 2020 15:59pm

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Polymenorrhea – Information for GPs


Frequent bleeding with shorting of menstrual cycle (eg < K- 5/21) for more than 3 cycles

Red flag symptoms

  • Persistent Intermenstrual bleeding (IMB) if >45 or other risk factors for endometrial cancer (eg obesity, PCOS unopposed estrogen, tamoxifen)
  • Age over 45 is a relative indication for early referral


Under age 45

Consider hormonal profile: TFTs, FBC

Offer hormonal therapy (any of):

  1. COCP 3m minimum
  2. Cyclical Norethisterone/ Provera days 5-24, for three cycles
  3. Depo Provera
  4. Mirena- at least 6m trial

If enlarged uterus on examination: Routine USS, if normal- under 14w size- consider Mirena

Investigations prior to referral

  • Chlamydia screening
  • High Vaginal Swab
  • Pelvic USS
  • Nb DON’T perform a cervical smear if outside the screening programme

Information to include in referral letter

  • Describe problem (cycle, quantity e.g. pad usage, duration) and effect of quality of life
  • FBC and USS results
  • Current contraception
  • Smear history (including last smear & result) the patient will still be seen without this but if you can retrieve it automatically it speeds up the appointment
  • Treatment options please include which tried and whether effective

Desirable information

  • Indication of parity
  • Expectations of referral
  • Exclusions of pathology & reassurance
  • Endometrial ablation/TCRE
  • Hysterectomy

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