SOGC Position on Hormone Therapy

In 2006, the Society of Obstetricians and Gynaecologists of Canada (SOGC) Consensus Panel on Menopause delivered updated guidelines and perspectives about menopause to Canadians. The report was produced by a panel of experts from different health professions who reviewed all of the research and science about menopause.  

In its report, the Panel focused on issues associated with lifestyle and wellness, the treatment of symptoms, physical changes and sexual health, and women’s concerns about heart disease, cancer and osteoporosis.  Most importantly, the Panel provided advice for Canadian women and their health care providers about the use of supplementary hormones in response to some of the more problematic symptoms or menopause such as hot flashes and night sweats.

In its report the SOGC Consensus Panel advises:

• HT is a safe and effective option for short-term use (up to five years) for the treatment of moderate to severe menopausal symptoms such as hot flashes, night sweats, mood swings, insomnia, difficulty concentrating and vaginal dryness.  In addition, HT has the secondary benefit of providing protection against osteoporosis and colon cancer.
• If you are currently taking HT, especially if used for more than five years, it is important that you evaluate your situation.  Consult with your healthcare provider on a yearly basis to review your dosage, your reasons for taking HT and your risks and benefits.  If you decide to stop HT, your healthcare provider will advise you how to safely stop treatment.
• HT may also be prescribed for long-term use depending on your preference and situation, but once again, it is important to consult with your healthcare provider on a yearly basis to evaluate your risks and benefits.

As an overall recommendation, the Consensus panel suggests that physicians prescribe the lowest effective dose and duration, depending on the treatment goals.  If symptoms recur after short-term therapy, the Panel also advises patients and their physicians to consider how to balance any evident risks against the need to treat symptoms.  In some cases, for example, HT offers extra protection against advanced osteoporosis for women with high risk factors for fractures.  The Panel does say that women who understand their risk factors and wish to pursue long-term HT use should do so only with proper counseling and regular re-evaluation.

The SOGC Panel was clear that hormone therapy (HT) is one of the safest and most effective tools, when responding to the most uncomfortable of menopause symptoms.  Quality of life is clearly a factor that needs to be discussed between patient and health care provider.  Women need to understand the risk factors associated with HT, but they also need to know that they have good options to offset any problematic symptoms.