• Dr. Emma Galloway MD CCFP

Memory Tip: The Menopause 5

SNAP SAMP (BONUS -- Four-in-one SAMP question):

Wherever it says "[MENOPAUSE SYMPTOM]" you can insert ANY one of the following four symptoms: Hot flashes / urge incontinence / stress incontinence / sleep disturbance Jo, 53, comes to your office with concerns about [MENOPAUSE SYMPTOM]. She says they are not bothersome enough to consider starting a medication, but she would like to know if you have any other suggestions that could be helpful.

Can you remember the lifestyle interventions for the above menopause symptoms?

If you remember the MENOPAUSE 5, you can.

It turns out that the MENOPAUSE 5 are effective behavioural interventions for any [MENOPAUSE SYMPTOM], even if you don't remember how to manage any particular symptom.

What are the MENOPAUSE 5? The MENOPAUSE 5 is made of 3 STOPs and2 STARTs:


  1. Smoking

  2. Alcohol

  3. Caffeine


4. Regular exercise

5. Weight loss if required

You can then probably think of another 1 or 2 items for each symptom as needed, depending on the number of answers the question is looking for. Hot flashes? THE MENOPAUSE 5 plus a fan. Urge incontinence? THE MENOPAUSE 5 plus avoiding bladder irritants and dehydration. Stress incontinence? THE MENOPAUSE 5 plus pelvic floor physiotherapy. Sleep disturbance? THE MENOPAUSE 5 plus cognitive behavioural therapy (CBT) or mindfulness training.

The SOGC's Menopause Management Algorithm is my fantastic source for this and other useful advice and it's written at a patient level so I often use it as a handout. http://menopauseandu.ca/resources/MenoAlgorithmE.pdf Name FIVE non-medication interventions for [MENOPAUSE SYMPTOM] in menopause.

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