Polycystic Ovarian Syndrome (PCOS)

This condition is treated in the Gynaecology clinic.

Emergency Referral Criteria

Criteria for Emergency include: 

• Ectopic pregnancy 
• Ruptured haemorrhagic ovarian cyst 
• Ovarian torsion 
• Acute/severe pelvic pain 
• Significant or uncontrolled vaginal bleeding 
• Severe infection 
• Abscess intra pelvis or PID 
• Bartholin's abscess/acute painful enlargement of a Bartholin's gland/cyst 
• Acute trauma including vulva/vaginal lacerations, haematoma and/or penetrating injuries 
• Post-operative complications within 6 weeks including wound infection, wound breakdown, vaginal bleeding/discharge, retained products of conception post-op, abdominal pain 
• Urinary retention 
• Acute urinary obstruction 
• Any molar pregnancy 
• Inevitable and/or incomplete miscarriage 
• Hyperemesis gravidarum 
• Ascites, secondary to known underlying gynaecological oncology 

If you, or someone else, are experiencing a serious and life-threatening injury or illness call triple zero (000) immediately or go to the nearest Emergency Department.

Learn more about when to access emergency care and non-emergency care options if the injury or illness is not serious or life-threatening.

Statewide Referral Criteria (SRC)

Criteria for referral to public hospital specialist clinic services

? Red flags are clinical indicators of possible serious underlying conditions requiring further medical intervention. They may or may not indicate an emergency.

Urgent (Category 1)

• Patient with Polycystic Ovarian syndrome with Abnormal endometrium on ultrasound (i.e. irregular/focal lesion or thickened – over 12mm) 
• Patient with Polycystic Ovarian Syndrome with Abnormal menstrual bleeding (including oligomenorrhoea) 

Semi-urgent (Category 2)

• Nil category 2 criteria

Routine (Category 3)

• Diagnosis of polycystic ovary syndrome as per Rotterdam criteria RACGP - Polycystic ovary syndrome with two of the following three criteria required:
  • Polycystic ovaries on ultrasound (either 20 or more follicles per ovary or increased ovarian size (greater than 10 cc) 
  • Oligo/anovulation 
  • Hyperandrogenism 
  • Clinical (hirsutism or less commonly male pattern alopecia) or biochemical (raised FAI/ free androgen index or free testosterone)  

Information to be included in the referral

(Referral may be returned without this)

Essential supporting information

Pathology

• HbA1c 
• Follicle Stimulating Hormone Day 2-6 (off Hormone therapy medication) 
• LH Day 2-6 (off Hormone Therapy medication) 
• Estradiol (E2) Day 2-6 (off Hormone Therapy Medication) 
• Luteal phase progesterone 
• Prolactin  
• TSH (Thyroid Stimulating Hormone) 
• Lipid profile 
• Fasting blood glucose results  

Only if hirsute:   

• Testosterone 
• Sex Hormone Binding Globulin  
• Free androgen index 
• 17 hydroxyprogesterone 
• DHEAS (Dehydroepiandrosterone sulphate) 

Imaging

• Pelvic Ultrasound  
• Transvaginal pelvic USS should be done when indicated.  

Note: If delay obtaining a USS may impact critical care this should be clearly indicated in the referral, however the scan should still be booked. Phone discussion on a case by case basis may be needed. 

Investigations/other

• Any relevant

Additional information

• General referral information
• Weight/BMI

Interim/GP management

To refer a patient with this condition, please see the Gynaecology clinic page for the full referral process and templates.

For more information please see the HealthPathways Tasmania website.

Additional resources

View all clinic availability