Menopause is still having a moment – and all signs point to this moment sticking around. Like, for good. Let’s put it this way: Younger Gen X and older millennials aren’t taking anymore you-know-what when it comes to what’s happening in their bodies at this age – it’s a hot topic at brunch with the girls, in the office with fellow coworkers experiencing hot flashes, in celebrity circles (you know it’s in the zeitgeist when Oprah can’t stop talking about it) and even in political spheres. Plus, the scientific research along with over-the-counter and natural products and consumer wellness programs have created a global industry worth up to $19 billion – and growing. Menopause is big business and it’s getting even bigger hype.
For Janet Ko, this craze comes at a good time. On October 1, the president and co-founder of the Menopause Foundation of Canada (MFC) – a national non-profit advocacy organization based in Toronto that’s dedicated to raising awareness of the impact of menopause on women. With a plan to turn this conversation into action, the group, along with its newly named ambassador, Sophie Grégoire Trudeau, released the first-ever Menopause Policy Agenda for Canada in early October. This 34-page document outlines seven priority areas that Ko and the foundation believe will genuinely transform care. “Menopause is just so misunderstood. You know, I really believe most of us still think it’s no big deal – that it’s the end of your period and you’re done. But the reality is, it’s a very important health transition. Women spend up to 40 percent of their life in a stage of menopause, and the symptoms are not short-lived – they can last a decade or longer,” says Ko. When I tell her the timing is interesting to me, since all my friends are comparing our perimenopause symptoms, she’s delighted. “I love that you just said that. Because when I was 46, nobody was talking about it. That’s a big change and it’s a great change. We don’t want our mother’s menopause.”
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It’s one reason this policy agenda is being released now – one-quarter of our population is women over 40, and most of us aren’t keen to grin and bear it like our mothers did when it comes to menopause. “We’re a very significant cohort who are demanding better menopause care and support. And I think for the very first time, thanks to the data and the fact that one-quarter of the paid workforce are dealing with menopause, we’re getting the attention that’s required at the government level,” says Ko. “The seven priorities highlight the systemic barriers that exist to women getting the care we need.”
One of the biggest issues, according to the policy agenda and experts, is around training providers. Canada currently doesn’t mandate menopause education for all physicians and nurse practitioners, and most of our healthcare providers receive little to no menopause education. “Our research shows only 25 percent of women say their family physician proactively raised menopause with them. That’s one of the reasons why we’re calling for a mid-life health check to ensure there is a proactive menopause discussion,” Ko says.
The other big barrier, and one of the policy agenda’s priorities, is to get these healthcare providers paid fairly for comprehensive menopause care. Symptoms can’t be dealt with in a quick conversation that’s tacked onto the end of an appointment to check for strep. Ko and her colleagues are calling for the government to amend the way family doctors can bill for menopause-related appointments. Currently, Manitoba is the only Canadian province with a specific billing code that GPs can use for menopause care. “You could have more than 30 symptoms and it’s a whole-body experience that intersects with cardiovascular, bone health, genitourinary, sexual health and more. Having dedicated primary-care menopause billing codes so we have appropriate compensation for in-office and virtual consultations would make menopause care more equitable for all.” (The care gaps are biggest for rural and remote, Indigenous, Black, racialized women, newcomers and gender-diverse people.)
The remaining priorities touch on expanding treatment access, supporting workers to strengthen the economy through menopause-inclusive workplaces, breaking the stigma and raising public awareness and funding and investing in menopause research. There’s health funding and support all the other stages of our lives, but very little exists once you reach perimenopause and menopause, Ko says, adding menopause receives less than three percent of female-specific research grants from the Canadian Institutes of Health Research (CIHR). Pregnancy – for women who choose it – is one percent of a woman’s life and it receives more than 30 percent of research grants from CIHR. “Despite us having more and more conversations about menopause, it’s these systemic barriers that are keeping women from getting the care they deserve.”
Ko and physicians who are fighting for health equity in menopause are doing their part, but Canadian women can also move the dial. Ko says we can better educate ourselves about perimenopause and menopause and really understand the changes that come with the transition. (She recommends using a menopause symptom tracker – the MFC has one that’s been endorsed by the Canadian Menopause Society.) Perhaps most importantly, she says we need to advocate for ourselves. “Don’t accept not feeling your best. And don’t buy into the old, longstanding cultural norms of putting up with it and pushing through symptoms. You don’t have to,” she says. “I believe Gen X will be the last generation to be in the dark about menopause. Millennials are a more transparent generation, and they’re going to talk about it and demand a different experience. And that’s wonderful.”
MENOPAUSE BY THE NUMBERS
40+ The age of women who make up 25% of the Canadian population
10 million Canadian women currently in a stage of menopause
$3.5 billion The amount unmanaged menopause symptoms cost the Canadian economy every year
1 in 10 Women who will take a lesser role at work, reduce their hours or leave the workforce altogether due to untreated menopause symptoms
1 in 2 Women who feel unprepared for perimenopause and menopause
95% Women who experience an average of seven menopause symptoms
25% Women who say their healthcare provider proactively discussed menopause with them; 75%: Women who say the conversation wasn’t very helpful
40% Women who say their symptoms were undertreated by their physician
Want to make your voice heard and advocate for better menopause care? Go to https://menopausefoundationcanada.ca/change/, complete the form and your message will be sent to your federal and provincial/territorial representatives and Ministers of Health.
