Is Canada ready for a menopause revolution?

Davina McCall thought she had a brain tumour or Alzheimer’s. She couldn’t sleep. She had mental fog. She was depressed. She was an accomplished television anchor in the United Kingdom, but she thought she was losing it.

“I felt like I knew how to do my job,” she told reporters later, “and then all of a sudden these things started happening.

“I was really scared, and I had nowhere to go.”

But McCall wasn’t sick. She was normal. At age 44, she was experiencing a natural phenomenon that most Canadians do not talk about — the hormonal changes that women experience between the ages of 40 and 55: menopause.

When McCall learned that menopause was the cause of her suffering, she engineered what might be called a menopause revolution in the U.K.

“I was so angry and upset and absolutely floored by the misinformation and the demonization, the shaming for something that every single woman … will go through,” she said. “It’s not like it’s a rare illness.”

Through documentaries, interviews and a bestselling book, “Menopausing,” McCaul has helped open the curtains and crush taboos that prevent both talk about menopause and the use of treatments that can ease symptoms.

Now a few Canadian women are urging Canada to join the movement.

In Canada, going through menopause “is like being sent on a canoe trip with no guidebook and only a vague idea where you are headed … Have fun figuring it out!” writes Canadian author Dr. Jen Gunter in “The Menopause Manifesto.”

“Oh, and don’t write. No one wants to hear about your journey.”

“The U.K. is very far ahead of Canada with respect to our attitude toward menopause,” Dr. Wendy Wolfman, president of the Canadian Menopause Society and board member of the International Menopause Society, told the Star. “Every woman will become menopausal if she lives long enough, while not every woman becomes pregnant.”

Yet in Canada pregnancy is widely discussed and managed, but menopause is not. Research released this month by the Menopause Foundation, a Canadian advocacy group, showed more than half of Canadian women aged 40 to 60 feel unprepared for menopause and more than two-thirds are not aware of common menopause symptoms. Of women who sought out medical advice, more than 70 per cent found the advice inadequate and 40 per cent felt they were undertreated.

Dr. Ariel Dalfen, who leads group sessions on navigating menopause for BRIA, a Toronto-based virtual reproductive mental-health service, sees these struggles in her practice. “Many women experience medical gaslighting (denial of their condition) for a normal transition that happens to half of humanity,” said Dalfen.

Canada needs to better train physicians, educate the public and provide more physical and mental health-care support for menopausal women, Dalfen said.

“This is the new frontier … and services are few and far between.”

In Britain, Parliament is addressing these challenges. Members of the cross-party Women and Equalities Committee are proposing giving menopausal women greater rights and protection in the workplace. They want menopause to become a protected condition like pregnancy and for the government to pilot “menopause leave.”

“Menopause is inevitable. The steady hemorrhage of talented women from our workforce, however, is not.” said committee chair Caroline Nokes, a Conservative MP. “Stigma, shame and dismissive cultures can, and must, be dismantled.”

English MPs have also been urging the government to reduce prescription charges for hormone replacement therapy (HRT), which can ease menopause symptoms. HRT is already free in Scotland and Wales, and all British women have been able to access low-dose HRT from their local pharmacies without prescription since September.

One of the myths that remains potent in Canada is that HRT is unsafe. Many physicians have been afraid to prescribe HRT since a 2002 study announced that its risks outweighed its benefits said Dr. Maria Velez, an associate professor of obstetrics and gynecology at Queen’s University in Kingston.

More recent studies, Velez said, report that HRT, rather than harming health, reduces mortality on average by almost 10 per cent by protecting against cardiovascular and other diseases.

“It’s ridiculous to have women not be able to function for something that is treatable with a medication that’s very safe,” said Wolfman.

Untreated menopause may be the missing link to why more women aren’t breaking through the glass ceiling in Canada, said Janet Ko, co-founder of the Menopause Foundation. She points to a 2020 Catalyst study showing that while Canadian women represent nearly half of the labour force, only about four per cent of Canadian companies have a woman CEO.

“Women’s health was set back by 20 years” by the research falsely declaring HRT unsafe, Ko said.

A majority of Canadian women feel they need support through menopause and believe that workplaces would benefit by doing so, according to the foundation’s study.

In the U.K., almost 90 per cent of women say menopause symptoms affect their ability to work. And women with symptoms are more than 40 per cent more likely to leave their jobs than those without.

U.K. businesses are taking note. An industry-sponsored panel has been granting menopause accreditation and awards since early 2021. Dozens of companies like law firm Burness Paull LLP have invested in training, practical support and appointed “Menopause Champions” in the office.

“This is an amazing initiative to get the conversation rolling,” said Dalfen. “Many women have trouble coming to work or feel they need to step back just when they are reaching their peak level of seniority.”

Not all Canadian experts agree. “Not all women going through menopause have bothersome vasomotor symptoms (hot flashes, night sweats) that impair quality of life,” said Velez.

“Menopause should not be seen as a condition that needs a medical leave.”

Velez also disagrees with low-dose HRT treatments being available over the counter, saying it is not a ‘one-size-fits-all’ therapeutic option.”

But in the U.K., broadcaster Davina McCall’s efforts are taking flight. The “Davina effect” has instigated discussions on daily news and corporate plans for action. Prescriptions for menopause therapies have doubled in the past two years.

Canada’s Menopause Foundation is inspired by the U.K. revolution and hopes to empower Canadian women with evidence-based information, improve health equity and make sure that our workplaces are age and gender inclusive.

“Menopause is a work equity issue, and we are really lagging behind in Canada,” Ko said.

“It is time to bring menopause out of the shadows.”

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