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Referral Criteria
The POI Clinic is a referral only clinic. Patients require referral by a medical practitioner. If you are the referring provider, please see patient referral criteria below.
Criteria
- The patient should have two levels of FSH greater than 25 IU/L.
- The patient should have oligomenorrhea or amenorrhea presenting for over 3-4 months.
- The patient may or may not have symptoms of menopause.
- The patient should have a negative pregnancy test.
- The patient should be under the age of 40. If the patient is 40-45, please refer to the menopause clinic.
- The patient may be referred if there are concerns about POI without amenorrhea given the patient’s medical history (e.g. previous cancer treatments, past surgery, or following bone marrow transplant).
- Patients with galactossemia may be referred.
Please include in the referral the following:
- Copy of CPP
- Relevant lab work and other investigations
- Most recent pap test, if done
- Relevant clinical questions you would like us to address
Referral Form
Download this form to refer a patient to our clinic.
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