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Menopause

A Canadian clinical summary of menopause, with source-attributed priorities and explicit jurisdiction boundaries.

JurisdictionCanada
Source check2026-08-20
Clinical reviewiatroX editorial team 路 Clinical editorial review 路 reviewed 2026-08-20 路 due 2027-08-20
AudienceHealthcare professionals practising in Canada
This is an iatroX educational summary of named Canada sources, not an official guideline. It does not replace the complete source documents, local policy, specialist advice or clinical judgement. The evidence source is pan-Canadian, but formularies, funded access, referral routes, public-health directions and service availability remain provincial or territorial.

Source and scope

This summary is bounded to the recommendations, population and decisions covered by Guideline No. 422a: Menopause: Vasomotor Symptoms, Prescription Therapeutic Agents, Complementary and Alternative Medicine, Nutrition, and Lifestyle. Apply it with the current provincial or territorial pathway where implementation differs.
sources for this section:SOGC 422a

Source-attributed clinical priorities

  • Make a clinical assessment of the menopause transition, symptom burden, bleeding pattern, contraception needs and long-term health risks.
  • Individualize menopausal hormone therapy by symptoms, uterus status, contraindications, timing, route, risk and patient preference.
  • Offer evidence-based nonhormonal options when hormone therapy is contraindicated or unwanted and reassess benefit and risk periodically.
  • Diagnose uncomplicated menopause clinically in the usual age group and reserve laboratory testing for uncertainty or atypical timing.
sources for this section:SOGC 422a

Practical assessment and management workflow

1
Clarify vasomotor, sleep, mood, genitourinary, sexual, bleeding and functional concerns.
2
Review pregnancy possibility, cardiovascular and fracture risk, migraine, thrombosis and breast and endometrial history.
3
Discuss lifestyle, nonhormonal, local vaginal and systemic hormonal options around the person鈥檚 priorities.
4
Review benefit, adverse effects and bleeding after treatment starts and reassess ongoing need periodically.
sources for this section:SOGC 422a

Safety, red flags and urgent escalation

  • Investigate postmenopausal bleeding rather than attributing it to menopause treatment.
  • Avoid systemic estrogen without appropriate endometrial protection in a person with a uterus.
  • Coordinate specialist advice for premature ovarian insufficiency or major hormone-sensitive cancer and thrombosis complexity.
sources for this section:SOGC 422a

Confirm the local pathway before acting

The evidence source is pan-Canadian, but formularies, funded access, referral routes, public-health directions and service availability remain provincial or territorial.
sources for this section:SOGC 422a

Source and implementation boundary

Read this educational summary with the linked source, current Canadian product information where medicines are involved, and the applicable provincial or territorial pathway. Local formularies, reporting duties, referral routes and service availability can differ.
sources for this section:SOGC 422a

Source documents

Use the linked source documents for complete recommendations, evidence grading, exclusions and implementation detail.

  1. Society of Obstetricians and Gynaecologists of CanadaGuideline No. 422a: Menopause: Vasomotor Symptoms, Prescription Therapeutic Agents, Complementary and Alternative Medicine, Nutrition, and LifestyleDOI 10.1016/j.jogc.2021.08.003 路 J Obstet Gynaecol Can 2021;43:1188-1204.e1 路 accessed 2026-08-20
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