Menopause care is more widely available, but financially out of reach for many

TORONTO — Karine Beauchamp couldn’t think straight, felt so exhausted she could barely get out of bed and had unpredictable mood swings ranging from sadness to anger.

“It’s like my resilience just disappeared,” the 48-year-old federal government worker said in an interview from Ottawa.

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“It felt like I wasn’t myself.”

Beauchamp talked to her family doctor, who suggested antidepressants, and a naturopathic doctor, who did blood tests and told her to take more vitamin D and iron.

Finally, a cousin told her about her positive experience with treatment at a private virtual menopause clinic. Beauchamp realized perimenopause — when mid-life women are still menstruating but approaching menopause — might be behind how she was feeling. Beauchamp decided to pay $300 for a consultation, where a nurse practitioner listened and went through all her symptoms and treatment options.

“We spent a whole hour talking about menopause and (that) what I was experiencing was legitimate,” Beauchamp said.

The clinic prescribed hormone therapy and a couple of months later, her mood has stabilized, her period is regulated and she’s feeling “a lot better.”

Although she thinks the care she’s getting is well worth the money, Beauchamp is acutely aware that many women can’t afford to pay for private health care — and doesn’t think they should have to.

“I have nothing disparaging to say about my experience with a private clinic,” she said.

“My beef is the fact that … this is where I ended up and I have to pay out-of-pocket for something I think should be covered universally by the province.”

Beauchamp decided to start a petition for menopause care to be publicly funded. So far she has more than 160 signatures and is sending it to Ontario Health Minister Sylvia Jones this week.

The demand for menopause care has grown exponentially across the country as conversations about mid-life women’s health, which had largely been ignored, have become more normalized — and menopause is now a hot topic.

“We’re at a point in time where this menopause moment has turned into a movement that’s really here to stay,” said Janet Ko, co-founder and president of the Menopause Foundation of Canada.

Much of the void in menopause care is filling up with virtual clinics, Ko said.

“That is good news because women today definitely have more choice and more access. However, that often comes with a price tag,” she said

“Every woman in Canada deserves access to publicly funded menopause care,” said Ko, noting that the health-care system covers care when women are pregnant or preventing pregnancy through birth control prescriptions.

“So through our reproductive lives, there is that care available. And then once you reach your perimenopause and your menopausal years, this is where we’re in really dire straits as women because it’s very hard to find (a) qualified health-care provider.”

There are more than 30 symptoms of menopause and perimenopause, including hot flashes, night sweats, brain fog, insomnia, fatigue, headaches, joint pain, weight gain, heart palpitations, changes in menstrual periods, vaginal dryness, pain or increased urgency to urinate.

Symptoms are linked to the decline in estrogen during perimenopause and are so wide-ranging because there are estrogen receptors in many parts of women’s brains and bodies, said Dr. Wendy Wolfman, director of the Weston and O’Born Centre for Mature Women’s Health at Sinai Health in Toronto.

At least 70 per cent of women have some form of hot flashes, said Wolfman, who is also a past-president of the Canadian Menopause Society.

For 20 to 30 per cent of women, they’re severe.

“That means they can’t function. They have to stop what they’re doing,” Wolfman said, noting that menopause symptoms can be so debilitating that some women quit their jobs.

There are effective treatment options to relieve those symptoms, including hormone therapy, but many primary-care providers — and even some obstetrician-gynecologists — don’t have enough training to be comfortable prescribing them, she said.

Wolfman noted new medications that work “almost as well” as hormone therapy for hot flashes have been recently approved by Health Canada. Because a lack of estrogen disrupts the heat regulation functions of the brain, these medications block a neurotransmitter, neurokinin B, that is involved in that process. One of those medications, called fezolinetant, is now available and can be an option for women who can’t or don’t want to get hormone therapy.

Changing lifestyle factors, including diet, exercise and reducing smoking and alcohol consumption can also be part of menopause treatment, she said.

Wolfman said more access to comprehensive menopause care is badly needed, noting the waiting list for her clinic at Sinai Health is about a year and a half to two years long.

But the rising number of virtual clinics is the “Wild West,” she said, because they aren’t specifically regulated by the provinces.

A recently published guide to virtual care from the Menopause Foundation of Canada aims to help with that.

Women should look for clinics where the providers are licensed, such as doctors, nurse practitioners or nurses, and have received training in menopause care, the guide advises. In addition, treatments should be Health Canada approved.

If it’s a private clinic and there’s a cost, women should ask whether that’s solely for the initial consultation or if followup visits are included in the price. It’s also important to ask if you can get prescribed treatments from your own pharmacy.

“If a virtual care provider requires you to use a specific pharmacy, they may have a financial relationship, such as being owned by them or receiving a referral fee,” the guide cautions.

Hormone therapy should be discussed “as one of several options” and providers of complementary care, including dietitians, pelvic floor physiotherapists and psychologists, should be registered in their fields.

The guide also advises women to make sure a clinic has measures in place to protect their personal health information — something Nese Yuksel said she has prioritized in setting up Effica Health, a private virtual menopause clinic expected to launch later in November for women in Alberta and Ontario.

Yuksel, a professor emeritus in pharmacy at the University of Alberta and also a past-president of the Canadian Menopause Society, applauded the guide, saying Effica Health follows its recommendations. That includes requiring health-care providers to either have or complete specialized menopause training. The clinic also doesn’t dispense medications itself and does not recommend one pharmacy over another, she said.

A 60-minute assessment and a followup visit will be $399, Yuksel said, noting that some women may have coverage through health spending accounts as part of their employee benefits plan.

The clinic isn’t part of a hospital where its registered nurses, nurse practitioners and pharmacists would be paid by provincial public health-care systems, so “unfortunately we do end up requiring out-of-pocket (payment),” she said.

Another virtual menopause clinic is set to launch this January, funded by the Alberta government for three years, said Colleen Norris, who holds the Cavarzan Chair in Mature Women’s Health Research and is spearheading the project.

The free-of-charge clinic, led by nurse practitioners, is badly needed but will only put a dent in the demand, Norris said.

“I honestly believe like within three months, we’re gonna say, ‘look, we’ve already got a six-month waiting list’,” she said.

“Women are not getting the care that they deserve. The only ones that get it are the ones that can pay for it. And that’s ridiculous.”

This report by The Canadian Press was first published Nov. 5, 2025.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

Nicole Ireland, The Canadian Press