B.C. clinicians underscore gaps in menopause care and celebrate recent progress

Millions of Canadian women experience menopause symptoms every year, but relatively little information or treatment is available for many of them.

As millions of Canadians experience menopause, clinicians in B.C. are flagging opportunities to improve the care patients receive.

“I don’t think there are enough resources for not only this, but nothing at all,” said Dr. Ana Teresa Armas Enriquez, a physician in Nanaimo.

Armas Enriquez owns Women’s Vita Medical Clinic, where she prioritizes menopause care. It can take up to six months for someone experiencing symptoms to get in to see her.

“If you wait for a year, you’re actually postmenopausal by the time you come see me,” she said.

Menopause is when a patient goes 12 months without their period, typically around the age of 50. Some people start experiencing the hallmark symptoms in their mid-30s, during a transitional phase called perimenopause.

While mood changes, sleep disturbances, hot flashes, joint paint, vaginal dryness, and dozens of other symptoms present a challenge, Armas Enriquez said medical intervention isn’t always required.

In the case of one of her patients who spoke with CTV News, it was.

“It really felt like in one day there was a very rapid, massive change,” said Pam Shaw, who started experiencing symptoms a decade ago.

Shaw is one of roughly 10 million Canadians – a quarter of the population – over the age of 40 affected by perimenopause, menopause, or post-menopause, according to the Menopause Foundation of Canada.

She had hot flashes and insomnia, often waking up 15 times a night. At her job as an instructor at Vancouver Island University, she experienced brain fog and had a hard time keeping up with her “bright-eyed, bushy-tailed” students.

“In the past, the symptoms of menopause have been treated kind of like a joke – that it’s something trivial, not that important, something that women have to endure,” Shaw said.

“I was very fortunate to find a doctor with advanced knowledge on menopausal (and) postmenopausal symptoms and (who) was able to very quickly get me onto a treatment program that worked.”

‘Old, outdated information’

For the past 10 years, Shaw said her symptoms have been at bay thanks to a low dose of hormone replacement therapy (HRT), which replenishes hormones that decline with age.

Kassidy Delcaro, a nurse at Women’s Vita Medical Clinic, said some clinicians are reluctant to prescribe HRT.

“There is a lot of very old, outdated information about hormone replacement therapy,” said Delcaro, pointing to old studies that link HRT to a serious cancer risk.

The Canadian Cancer Society says the risk is low, and using HRT is a personal decision to be made with a clinician.

“There’s definitely safe ways of going about it,” said Delcaro, noting there are various risk assessments to consider before prescribing HRT.

“People who are appropriate providers of menopausal care do know those different guidelines.”

Next March, the provincial government said it will start covering the cost of HRT for treating menopause symptoms. For care providers, it’s a positive step as conversations about menopause become more common.

“Menopause is definitely having a moment,” said B.C. Women’s Health Foundation CEO Cally Wesson.

“Not every woman will have a baby, but every woman will go through menopause.”

New clinic a first for Western Canada

Wesson, Delcaro, Shaw, and Armas Enriquez agree education about menopause symptoms and treatment options needs to expand.

“A lot of times, we hear stories of women going to their primary care physician and not getting the care that they need,” Wesson said.

That’s unlikely to happen at the Complex Menopause Clinic in Vancouver, which opened earlier this year. It’s the first of its kind in Western Canada, offering specialized care to people with severe symptoms.

“It… could become a standard of care that then other health authorities would adapt,” said Wesson.

“The more we get the right information out, not only to the general community but also to physicians, the better.”