About the SOGC Established in 1944, The Society of Obstetricians and Gynaecologists of Canada (SOGC) is one of North America’s oldest national organizations devoted to the specialty of obstetrics and gynaecology. The mission of the SOGC is to promote optimal women’s health through leadership, collaboration, education, research and advocacy in the practice of obstetrics and gynaecology.
2006 Menopause Consensus Report The Society welcomes all specialists in obstetrics and gynaecology, general practitioners, researchers, nurses, midwives and other healthcare providers in Canada and internationally. English and French are the official languages of the SOGC.
The Society of Obstetricians and Gynaecologists of Canada (SOGC) published the first Menopause Consensus Report in 1994, and has published two updates since then, most recently in 2002.
An expert consensus panel, composed of endocrinologists, gynaecologists, public health and family physicians, a cardiologist and a psychiatrist, reviewed all pertinent evidence published in peer-reviewed journals since the last consensus update in 2002. The publications were rated according to the level of evidence, and the panel reached its conclusions through face-to-face meetings, exchange of information via e-mail and teleconferences.
The objective of the panel was to provide guidelines for healthcare providers about the management of natural menopause in symptomatic healthy women as well as in women presenting with vasomotor symptoms, urogenital, sexual, and mood and memory concerns and on specific medical considerations, as well as cardiovascular and cancer issues. All other forms of premature ovarian failure represent special considerations outside the scope of this document.
Defining & Understanding Menopause
Natural menopause is quite specifically defined and is confirmed when a woman has not had a menstrual period for a 12-month period.1 Although menopause itself is defined by this specific timing, many people think of menopause as a longer period of transition.
- Perimenopause – leading up to menopause, the body begins to produce smaller amounts of female hormones (estrogen and progesterone). Changing hormone levels from month to month can mean the ovaries may release an egg some months, but not others; periods may become lighter or heavier, or farther apart or closer together or may even be missed on occasion. The average age of perimenopause is 45.1 years – but it can start anytime between ages 39 and 51, and can last between two and eight years (the average being five).
- Menopause – is “reached” when a woman, due to declining ovarian activity, has her last menstrual period. In the case of natural menopause it is known only in retrospect, and is confirmed after 12 months have passed without a period. Surgical menopause, or menopause induced by chemotherapy or radiation is the last menstrual period before the surgery, or event that led to the loss of ovarian function. Menopause is the loss of ovarian function, not the absence of periods. A woman who has no periods because of, for example a hysterectomy, is not menopausal so long as she continues to have ovarian activity.
- Postmenopause – is the time that begins when a woman has reached menopause. When a woman is postmenopausal, she has some additional long-term age-related health considerations such as the development of osteoporosis and cardiovascular disease.3 As a woman reaches the menopause stages of life, it is a good opportunity to assess overall health and lifestyle choices to address potential long-term health issues.
Content
Introduction
Pillar 1: Lifestyle and Wellness
Pillar 2: Symptomatic Treatment
Pillar 3: Urogenital/Sexual Health
Pillar 4: Cancer
Pillar 5: Osteoporosis Treatment
Appendix I: Key Recommendations from the 2006 Menopause Consensus Report
Appendix II: About Hormone Therapy References
Downlaod
Menopause Handbook
