SOGC CLINICAL PRACTICE GUIDELINEManaging Menopause
Section snippets
Recommendations for Patients
- 1.
Women aged 51 to 70 should consume 7 servings of vegetables and fruits, 6 of grain products, 3 of milk and alternatives, and 2 of meat and alternatives daily. (III-A)
- 2.
A diet low in sodium and simple sugars, with substitution of unsaturated fats for saturated and trans fats, as well as increased consumption of fruits, vegetables, and fibre, is recommended. (I-A)
- 3.
Routine vitamin D supplementation and calcium intake for all Canadian adults year round is recommended. (I-A)
- 4.
Achieving and maintaining a
Summary Statements
- 1.
Determinants of sexual function involve central and peripheral mechanisms. (II-2)
- 2.
Both testosterone and estrogen have effects on sexual function. (I)
- 3.
The serum testosterone level is not a useful marker for the diagnosis of sexual dysfunction. (II-1)
- 4.
Estrogen’s primary action is on maintenance of vaginal and vulvar health. (II-2)
Recommendations
- 1.
Vulvovaginal atrophy should be addressed in all middle-aged women who complain of sexual dysfunction. (I-A)
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Serum androgen measurements should not be used in the assessment
Summary Statements
- 1.
Taking a brief sexual history is part of the evaluation of the menopausal woman. (III)
- 2.
Female dysfunction can be categorized into desire, arousal, pain, and orgasm problems. These categories often overlap. (II-2)
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Low desire with distress is most common in mid-life women. (II-2)
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Vaginal atrophy occurs in 50% of women within 3 years of menopause and is a common cause of sexual pain in menopausal women. (II-1)
- 5.
Sexual pain results in a cascade of detrimental sexual symptoms. (II-1)
- 6.
The treatment of
Summary Statements
- 1.
Sexual dysfunction is common in depressed patients and those taking selective serotonin reuptake inhibitors. (I)
- 2.
Premature loss of ovarian function may be attended by sexual dysfunction related to loss of both ovarian estrogen and androgen production at a time of life when sexual activity is normally heightened. (II-1)
- 3.
Survivors of breast cancer using aromatase inhibitors have more sexual dysfunction due to vulvovaginal atrophy than do women using tamoxifen or control subjects. (II-1)
Recommendations
- 1.
Patients
References (0)
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This clinical practice guideline has been prepared by the Menopause and Osteoporosis Working Group, reviewed by the Clinical Practice Gynaecology and Family Physician Advisory Committees, and approved by the Executive and Council of the Society of Obstetricians and Gynaecologists of Canada.
The literature searches and bibliographic support for this guideline were undertaken by Becky Skidmore, Medical Research Analyst, Society of Obstetricians and Gynaecologists of Canada.
Acknowledgement: Claudio N. Soares, MD, PhD, Toronto ON
Disclosure statements have been received from all contributors.
This document reflects emerging clinical and scientific advances on the date issued and is subject to change. The information should not be construed as dictating an exclusive course of treatment or procedure to be followed. Local institutions can dictate amendments to these opinions. They should be well documented if modified at the local level. None of these contents may be reproduced in any form without prior written permission of the SOGC