Since menopause, Cathy Hoyles has bought a beach house, started a business and co-founded a non-profit.
“Our body is transitioning, and it could be transitioning into something much better than what you had before,” said the 57-year-old from Corner Brook, N.L. “It takes a lot of work to get there, but it’s worth it.”
Hoyles is an unlikely spokeswoman for the benefits of menopause. For more than a decade, it completely upended her life.
“I felt like I was dying,” she said.
Numerous specialists said her symptoms — including insomnia, migraines, muscle pain and depression — were normal for women her age. They did not discuss the possibility that her pain was connected to menopause.
Her final symptom, night sweats in her early 50s, brought relief: she knew they were commonly associated with menopause.
Her experience prompted her to research menopause. Everything she experienced was listed as a symptom.
Hoyles’ struggle getting information on menopause led her and four other women to launch an advocacy and educational organization, The Menopause Foundation of Newfoundland and Labrador, in February 2025.
The foundation is one example of how access to treatments and support for menopause is growing across Canada. But sources say more still needs to change, as doctors and women often fail to identify menopause symptoms and struggle to access treatment options.
‘Complex feelings’
During menopause, the amount of estrogen and progesterone that a woman’s body produces decreases, until menstruation eventually stops. The average age of menopause in Canada is 51, according to the Menopause Foundation of Canada.
Perimenopause, the period that leads to menopause, typically begins in the 40s, with some women experiencing symptoms in their late 30s. Perimenopause can last between two and 10 years.
Perimenopause and menopause can be marked by sleep disruptions, weight gain, hot flashes, mood swings, anxiety, depression and, for some, thoughts of suicide.
Menopause is universal among women, yet the physical and emotional impacts of it are often misunderstood.
“[Menopause is] not a niche issue,” said Janet Ko, co-founder and director of the Menopause Foundation of Canada, an advocacy organization.
“You’re talking about something that will impact half of the population. Not every woman will get pregnant, but every woman, if she lives long enough, will experience menopause.”
Many women have “complex feelings” about menopause, said Melody Morin, a psychologist in Alberta and founder of Level Up Wellness Group, a private, online clinic.
“In the Western world, we see perimenopause and menopause as almost shameful,” she said. “It’s the end of your vitality, your attraction depletes to others, you’re not able to necessarily have kids anymore. It is, unfortunately, a step in this perpetual reinforcement of women not being able to live a certain lifestyle.”
Most family doctors are not trained to recognize how menopause impacts every part of a woman’s body, says Lori Brotto, a clinical psychologist and professor at the University of British Columbia who has researched women’s experiences of menopause.
According to Brotto’s research, most women cannot afford menopausal hormone therapies, which increase a woman’s estrogen and progesterone levels and cost around $100 a month. Therapies can be taken orally or through a patch on the skin.
In early March, B.C. joined Manitoba as the second province to cover some menopausal hormone therapy medications as part of their pharmacare deals with the federal government.
The federal pharmacare program covers diabetes medication and contraception. But because Manitoba and B.C. already cover contraception through provincial health-care plans, they were able to use some federal pharmacare funding for menopausal hormone therapies.
It is “fantastic” that some of these medications are now publicly covered, says Brotto.
However, this does not mean all women who need these therapies will get them.
“Just because [menopausal hormone therapy] is covered, doesn’t mean doctors are going to prescribe it,” Brotto said.
Many doctors hesitate to prescribe menopausal hormone therapies due to concerns they may increase cancer risk.
The Canadian Cancer Society says that estrogen-only menopausal hormone therapy may increase the risk of uterine cancer for women who have not had a hysterectomy. The society also says menopausal hormone therapy may slightly increase a woman’s risk for ovarian or breast cancers.
In Brotto’s view, more education is needed to boost awareness about treating menopause symptoms.
“There absolutely has to be a national, all-hands-on-deck effort to make sure that menopause education is part of every health-care provider’s [education].”
Private health-care
Doctors also need to be compensated for the time it takes to determine if a woman’s symptoms are related to menopause.
“Menopause care is not a simple five-minute conversation,” said Ko. “It really should be a mid-life health check where you’re looking at a number of different things. And right now, our health-care providers are not adequately compensated to have that kind of a conversation with women.”
To Ko’s knowledge, Manitoba is the only province that allows doctors to specifically bill for menopause treatment.
The lack of public coverage for menopausal care leads many women to seek treatment at private clinics.
Hoyles, who found menopause impacted her ability to handle stress, ultimately needed to take a four-month leave from her job managing a hospital.
“I’m not somebody who’s prone to catastrophizing or cashing out early,” she said. “But I had no choice. I couldn’t carry that load.”
She sought treatment through a virtual clinic in Ontario.
Her symptoms improved after she began menopausal hormone therapy, enabling her to return to work.
Nurse practitioner Allie Kusnierczyk has spent much of the past two years working with women across Canada as part of Level Up Wellness Group, with a particular focus on women’s hormonal health.
The clinic has an interdisciplinary team, allowing her patients to also receive psychotherapy support to address the mental and emotional strain of menopause.
Kusnierczyk is glad she can do this work, and glad a second province is funding some menopausal hormone treatments. But she says too many women rely on private care.
“Not everybody is able to do this private care, or able to pay for prescriptions out-of-pocket,” she said.
Lifestyle changes
Hoyles is encouraged by what she sees as growing interest in menopause care. Nova Scotia announced plans to open a specialty menopause clinic this coming winter. A complex menopause clinic opened in Vancouver in 2024.
But women need to take action to improve their own health in mid-life and not just focus on the failures of the medical system, she says.
Her own education about menopause has caused her to “overhaul” her diet. She eliminated sugar and increased her intake of protein and complex carbohydrates, like sweet potatoes and wild rice.
She traded in long runs and bike rides for shorter strength training sessions to maintain her muscle mass. And she prioritizes sleeping eight hours a night.
She encourages other women to do the same. Menopausal hormone therapies will have little impact if a woman drinks alcohol, smokes or does not eat or exercise properly, she says.
After years of frustration, she has hope more women — like her 25-year-old daughter — will learn how to thrive during and after menopause.
The transition can lead to greater clarity and wisdom, she says.
“We have to rewrite the [menopause] story from one of suffering and misery, because women should not suffer,” she said.
“They don’t need to suffer. They don’t need to be miserable. But we have to understand what’s happening.”
