Menopause management

​​​​​​​​​Emergency

If any of the following are suspected, seek emergency medical advice or refer the patient to the emergency department (via ambulance if necessary)

  • ​Nil

When public outpatient services are not routinely provided

  • Endometrial hyperplasia in perimenopausal or menopausal patient aged > 40 years
    Note: refer to general gynaecology state-wide referral criteria
  • Osteoporosis where this is the primary concern
    Note: latest osteoporosis management guidelines can be applied in general practice with referral to endocrinologist using endocrinology state-wide referral criteria (if specialist input is required) or osteoporosis refracture prevention service (if minimal trauma fracture present)
  • Primary menopausal care or advice (unless socioeconomic barriers, such as cultural and financial complexities, are present)
    Note: refer to Practitioner's Toolkit for the Management of the Menopause (Monash Toolkit) for more information
  • Provision of menopausal hormonal implants
  • Symptoms of menopause in a patient aged > 40 years who has not had any trial of treatment and where there are no contraindications to treatment​​

Criteria to access public outpatient services

CategoryCriteria
Category 1
Recommended to be seen within 30 calendar days.
  • Nil

​Category 2
Recommended to be seen within 90 calendar days.

  • ​​Onset of menopause in a patient aged < 40 years with suspected or known Premature Ovarian Insufficiency (POI)
    Note: consider urgent referral to fertility services for patients wishing to conceive
  • ​Recent (i.e. within the last 12 months) or anticipated medically or surgically induced menopause (e.g. cancer treatment, risk-reducing surgery) ​

Category 3
Recommended to be seen within 365 calendar days.

  • ​> 10 years since onset of menopause, or aged ≥ 60 years, and still experiencing significant menopausal symptoms 
  • Aged ≥ 40 years experiencing menopausal symptoms, with any of the following features: 
    • active liver disease with abnormal liver function tests
      Note: excluding fatty liver disease
    • established cardiovascular or cerebrovascular disease
    • genetic risk of malignancies
    • migraine with aura
    • personal history of cancer
    • porphyria or systemic lupus erythematosus (SLE)
    • socioeconomic barriers to care
    • thrombo-embolic disease, history of venous thromboembolism (VTE) or thrombophilia (including hereditary thrombophilia)
  • ​Persistent adverse effects of menopause therapy
  • Persistent physical or psychological symptoms of menopause with no improvement 8 weeks after initiating therapy
    Note: consider concurrent referral to a mental health clinician for psychological symptoms of menopause, if appropriate
​
Note: refer to the Menopause Care Clin​ician Toolkit for tools and resources to diagnose, refer and provide care for women with severe and complex menopause

Information to include within a referral

Required

  • Reason for referral
  • Details of the presenting condition, including menstrual history, menopausal symptoms and their duration, impact on quality of life
  • Patient health summary (such as relevant medical history, relevant investigations, current medications and dosages, immunisations, allergies and/or adverse reactions), including specifically
    • ​Details of menopause therapy history and follow up provided
    • Histopathology result where available (if history of cancer)

    • Abnormal pathology result (if relevant) 

If available

  • ​​​​Menopause score (e.g. MENQOL, Modified Green Scale/AMS Symptom Score Card)
  • Cervical screening results

  • Mammogram results​

Important info​rmation for referring health professionals

If there is a change to a patient’s condition while waiting for their appointment, referring health professionals may further investigate and manage the situation, or send an updated referral to the outpatient service. Where there are significant concerns about a patient's condition, referring health professionals may check HealthPathways for urgent/same day advice or contact the relevant clinical team.​

Current as at: Monday 23 March 2026
Contact page owner: System Purchasing