Premenstrual Syndrome (PMS) /Premenstrual dysphoric disorder (PMDD)

ADULT

  • If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or follow local emergency care protocols or seek emergent medical advice if in a remote region.

    • Suicidal ideation or acute concern for mental health
Minimum Referral Criteria
Category 1
(appointment within 30 calendar days)
  • Severe premenstrual dysphoric disorder (PMDD) with risk of self-harm or severe functional impairment impacting safety

    • NB: Referral to a Persistent pain service may be considered if chronic pelvic pain coexists and remains uncontrolled.
Category 2
(appointment within 90 calendar days)
  • Severe PMS/PMDD symptoms unresponsive to initial medical management (e.g., SSRIs, hormonal treatments) and causing significant impact on daily functioning, including work, relationships, or school
  • Co-existing psychiatric disorders that exacerbate PMDD symptoms, requiring close gynaecologic and mental health management
  • Moderate to severe PMS/PMDD with substantial impact on quality of life, affecting daily activities and relationships but without immediate safety concerns
  • Symptoms persisting despite trial of first-line treatments (e.g., lifestyle modifications, basic hormonal therapies)
  • Worsening symptoms requiring review for alternative treatments (e.g., second-line hormone therapy, SSRIs) or multidisciplinary input

    • NB: Referral to a persistent pain service may be considered if symptoms are accompanied by chronic pelvic pain that has not responded to initial treatments.
Category 3
(appointment within 365 calendar days)
  • Mild PMS/PMDD symptoms that do not significantly impair daily functioning but require specialist advice or management adjustments

Please insert the below information and minimum referral criteria into referral

1. Reason for request Indicate on the referral

  • To establish a diagnosis
  • For treatment or intervention
  • For advice and management
  • For specialist to take over management
  • Reassurance for GP/second opinion
  • For a specified test/investigation the GP can't order, or the patient can't afford or access
  • Reassurance for the patient/family
  • For other reason (e.g. rapidly accelerating disease progression)
  • Clinical judgement indicates a referral for specialist review is necessary

2. Essential referral information Referral will be returned without this

  • Medical management to date and/or therapies previously tried
  • Mental health assessment, including any diagnosed psychiatric conditions or current use of psychiatric medications, and history of mental health support if relevant.
  • Screening for suicidal ideation or other severe psychological symptoms, particularly in cases of PMDD.

3. Additional referral information Useful for processing the referral

  • Family history of PMS/PMDD or other menstrual disorders.
    Any relevant medical history
    If chronic pelvic pain is present, describe its relationship with the menstrual cycle, severity, and impact on quality of life*

    *This information would help decide if a concurrent referral to a persistent pain service is necessary

4. Request

  • Patient's Demographic Details

    • Full name (including aliases)
    • Date of birth
    • Residential and postal address
    • Telephone contact number/s – home, mobile and alternative
    • Medicare number (where eligible)
    • Name of the parent or caregiver (if appropriate)
    • Preferred language and interpreter requirements
    • Identifies as Aboriginal and/or Torres Strait Islander

    Referring Practitioner Details

    • Full name
    • Full address
    • Contact details – telephone, fax, email
    • Provider number
    • Date of referral
    • Signature

    Relevant clinical information about the condition

    • Presenting symptoms (evolution and duration)
    • Physical findings
    • Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
    • Body mass index (BMI)
    • Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
    • Current medications and dosages
    • Drug allergies
    • Alcohol, tobacco and other drugs use

    Reason for request

    • To establish a diagnosis
    • For treatment or intervention
    • For advice and management
    • For specialist to take over management
    • Reassurance for GP/second opinion
    • For a specified test/investigation the GP can't order, or the patient can't afford or access
    • Reassurance for the patient/family
    • For other reason (e.g. rapidly accelerating disease progression)
    • Clinical judgement indicates a referral for specialist review is necessary

    Clinical modifiers

    • Impact on employment
    • Impact on education
    • Impact on home
    • Impact on activities of daily living
    • Impact on ability to care for others
    • Impact on personal frailty or safety
    • Identifies as Aboriginal and/or Torres Strait Islander

    Other relevant information

    • Willingness to have surgery (where surgery is a likely intervention)
    • Choice to be treated as a public or private patient
    • Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)

  • If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or follow local emergency care protocols or seek emergent medical advice if in a remote region.

    • Please note that where appropriate and where available, the referral may be streamed to an associated public allied health and/or nursing service. Such a service may be an interim service prior to seeing the public medical specialist or, if appropriate, may negate the need to see the public medical specialist.
    • A change in patient circumstance (such as condition deteriorating, or becoming pregnant) may affect the urgency categorisation and should be communicated as soon as possible.
    • Please indicate in the referral if the patient is unable to access  mandatory tests or investigations as they incur a cost or are unavailable locally.

Last updated: 29 January 2025

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