powered by:
aquaomega
elevating the standard of menopause care: breaking through menopause taboo to talk about symptoms and treatments
“i think it's so important to normalize conversations about menopause to dismantle this stigma that's still lingering"
9 minute read
vital talks panelists (left to right: nneka ezurike, dr. rachel ollivier, dr. nese yuksel, shirley weir, dr. iliana lega) agree that midlife is an opportunity for women to make their health a top priority.
katherine holland
discussions about menopause, the biological process where women no longer menstruate and haven’t had a period in 12 consecutive months, shouldn’t be hushed or taboo, experts say.
they belong front and centre as a key part of primary care.
“we need to have a system where every woman, no matter where she lives, can access compassionate, evidence-based support that recognizes menopause as a natural yet significant stage of life, not something that should be dismissed or endured in silence,” says nneka ezurike, pharmacist and pharmacy owner, co-founder of black pharmacy professionals of canada and board member of shoppers foundation for women’s health.
“i want to stress the importance of what we can do to try and raise the bar for menopause care in canada
after all, women make up half the population in canada, and all of them will go through menopause. if that’s not a strong enough case for better care and open discussion, there’s also the fact that women are a growing force in the labour market, impacting the economy and bringing diversity to leadership. supporting this important demographic just makes sense. there’s also a lot at stake for women’s health as they go through these hormonal changes, including the development of risk factors for heart disease like high blood pressure, high cholesterol and obesity.
advertisement
menopause is not just hot flashes and night sweats.
these are some of the thoughts raised during the elevating the standard of menopause care panel on oct. 29, part of women’s health collective canada’s vital talks national seminar series. held in toronto with virtual attendance from across the country, the event was a rally cry for change to improve access to menopause care, increase widespread knowledge of symptoms and treatments, support self-advocacy and secure research funding to drive the need for data to sway policy and care standards.
panelists are leaders in the women’s health community:
nneka ezurike, pharmacist and pharmacy owner, co-founder of black pharmacy professionals of canada and board member, shoppers foundation for women’s health
dr. iliana lega, endocrinologist and researcher, women’s college hospital and associate professor of medicine, university of toronto
rachel ollivier, women’s health researcher
shirley weir, speaker, author and menopause advocate, founder of menopause chicks
dr. nese yuksel, professor emeritus and women’s health researcher, faculty of pharmacy and pharmaceutical sciences, university of alberta and past president, canadian menopause society
advertisement
healthing.ca talked to some of the panel speakers, including ezurike, to learn more about their important takeaways from the seminar.
the need for menopause policy change and research
she emphasizes that addressing the systemic barriers starts with policy and public health strategies that prioritize menopause care. part of this is ensuring coverage for treatments like hormone therapy, counselling or other proven therapies, along with workplace accommodations that recognize the challenges women face going through menopause.
“women are experiencing symptoms that can affect their quality of life,” she says. “but where do we go from there? we really need the data, we need the research,” to advocate for policy change and educate healthcare providers on the realities of menopause and available treatments.
the percentage of canada’s research funding for women’s health is less than seven per cent, remaining unchanged across 15 years, according to research published in the biology of sex differences in october. as the authors note, “females have been underrepresented in preclinical and clinical research. research on females is important for conditions that directly affect women, disproportionately impact women and manifest differently in women.”
advertisement
menopause treatment is an unmet need, where eurike references the 2025 report by the mckinsey health institute in collaboration with the world economic forum that outlines the case for improving women’s healthcare for medical conditions that include menopause:
“women spend 25 per cent more time in poor health than men on average—a gap which, if closed, could add over seven additional days of healthy life for every woman and more than $1 trillion to the global economy annually by 2040.” the report suggests that closing the care gap could unlock $400 billion in global annual gdp by 2040.
“canada has an opportunity to build a stronger economy just based on healthier women,” ezurike notes. “it’s really exciting to see the new data that’s coming and will cause ripple effects into implementing policies and hopefully changes in practice and overall culture when it comes to menopause.”
dr. nese yuksel, professor emeritus and women’s health researcher in pharmacy and pharmaceutical sciences at the university of alberta in edmonton and past president of the canadian menopause society, has long been active in the research community.
“it was very hard sometimes to get funding as soon as you had menopause on the grant (application), so if there’s more support for funding for women’s health in general, but also specifically in areas that are even more underserved, like menopause,” it will lead to momentum in the right direction, she says.
advertisement
a shift in menopause care
she flags the recent announcement by the u.s. food and drug administration (fda) to remove the “black box” warnings from hormone replacement therapy products as an example of the shift in menopause care. the warnings were based on the women’s health initiative study that found a statistically nonsignificant increase in the risk of breast cancer diagnosis, sparking two decades of fear and misinformation surrounding hormone replacement therapy. the average age of women in the study was 63 years, more than a decade past the average age of a woman in menopause, and study participants were given a hormone formulation no longer in common use. the removal of the boxed warnings follows a review of the scientific literature, an expert panel in july and a public comment period.
“there’s a lot of talk that’s happening, which is good,” yuksel says. she also wants individual women to take the reins in their healthcare, speak up and consider midlife a wakeup call to make their health a priority.
“the main message is that there is help and you shouldn’t feel isolated. and it’s ok to reach out, it’s ok to talk to your family physician or primary care provider. it shouldn’t be suffering alone,” she notes. “it’s also understanding what’s happening in your body so you can take those right steps for yourself and then really be your own advocate for what you need to do for yourself.”
advertisement
menopause care is interdisciplinary, whether someone is choosing hormone replacement therapy, pelvic floor therapy, naturopathy, talk therapy or a combined approach. yuksel recognizes a team of healthcare providers that may include family physicians, nurse practitioners, pharmacists and others, with the individual at the centre. you’re the captain of your team, reaching out for resources and expertise.
she stresses that menopause care should be considered primary care for midlife women, serving as a health reset.
“midlife is a really good time to start looking at your overall health, so making sure you get your screenings, making sure you get your blood pressure checked, making sure you know your lab work (blood test results). so it’s about getting all that done.”
how w0men can take control of their health
the shifts that can happen during perimenopause, the transitional period of hormone fluctuation and irregular periods leading up to menopause, mark the start of other changes in your body. yuksel points out that bone loss actually starts in the perimenopause stage, and women experience the most significant decline a couple of years before menopause.
“we used to say, for up to 10 years, you’d have that decline, which you can. but it starts in the perimenopause, and we don’t often think about that. so it’s thinking about your bone health, your heart health, your breast health, your brain.”
advertisement
there’s also the need to identify symptoms that may not be related to menopause but other causes that need attention, so there can be complexity to unravel and treat, she notes. “so if you’re not sleeping, yes, it could be from menopause, but it could be from other things like sleep apnea. and fatigue is one of the most common symptoms that women talk about in menopause. being tired and exhausted and not sleeping and all that. it could be related to not sleeping. but it could also be loss of iron from heavy menstrual bleeding. so it’s bringing in all those pieces and then reading resources that you trust, like the canadian menopause society and menopause foundation of canada.”
yuksel has co-launched a virtual service platform, effica health, for midlife women that will act as a learning hub and a health equity fund to help those who can’t afford the services.
the call to action for women boils down to this: midlife and menopause are an opportunity to improve your self-care with the recommended health checks and improve your lifestyle habits with movement, diet, mindfulness and muscle.
that may be a tall order, but it’s worth doing. shirley weir, founder of menopause chicks and women’s health advocate and educator, helps people navigate perimenopause to post menopause with more confidence and ease.
advertisement
“perimenopause, reaching menopause, being newly in post menopause, they are all invitations and opportunities to invest in our future and current health. first, we want to make sure that we don’t just suck it up or adopt an outdated narrative that means you’re meant to suffer because that’s not true. and we need to make sure that we’re checking in on those folks who are saying, ‘oh, i’m okay, it’s not that bad. i can get through it. i’ve got through childbirth.’ that’s not what this is about. this is about every 22 minutes, a woman dies of heart disease in this country.”
she’d like to see women get to a doctor at age 51 instead of 61 to have their blood pressure and cholesterol checked, for example. weir reiterates that the midlife health reset championed by vital talks would change the future of women’s health and have a positive impact on the stretched healthcare system.
as well, that shift toward self-responsibility is the answer to empowering women’s health.
“if we stay in the place of someone out there who has all the answers and i don’t know anything, we don’t have agency. we lose agency over our health.”
the new reality she describes is based on our current lifespan.
“we’re the first generation of women to turn 50 and have 50 more years to plan for because women’s bodies, unlike men, were designed to reproduce at age 18 or 19 or 20 and die at 50. and it’s not that long ago, less than a couple 100 years ago, where women died in their 50s. now we expect to live to be 85 or 100.”
advertisement
quality of life is at stake for women
weir says that quality of life is what’s at stake: heart disease is the number one premature killer of women. osteoporosis rates are disproportionately higher for women than men because of estrogen loss at 50 and then trying to live for four more decades without that same bone density. dementia impacts more women than men. more women populate seniors care homes, but many of them are living with genital and urinary conditions like incontinence, dryness and recurring urinary tract infections that can have other debilitating health impacts.
“the number two reason after dementia for why a woman gets admitted into long-term care is incontinence,” she says, adding a personal note: “i don’t do squats to fit into my jeans. i do squats so that i will be able to use the toilet unattended when i’m older, and secondly, my number one health goal is to make sure that my adult children never have to take time off work to look after me.”
ezurike, too, wants to see a culture change around menopause so women can feel confident about asking questions and learning for themselves about symptoms to expect and treatments to seek out. her reframing is about positivity and growth.
advertisement
“i think it’s so important to normalize conversations about menopause to dismantle this stigma that’s still lingering. this is a really important, relevant transition in a woman’s life. and i think it should be celebrated rather than looked at as a point of decline.”
she talks about women going through perimenopause and menopause who are in their prime with regard to their careers and life experiences, where people look up to them. open conversations about menopause, like vital talks, validate where women are in their lives.
“it’s a transformative and empowering life transition. and it can be a new phase of wisdom, freedom and self-discovery.”
share story
