Canadian women are struggling to access menopause care in the public system, with many turning to costly private clinics. A knowledge gap around hormone therapy, poor physician compensation for gynecology, and a lack of mandatory training have created a perfect storm. The Society of Obstetricians and Gynaecologists of Canada is pushing for systemic reforms — from mandatory training to new care delivery models.
Canadian women are facing a serious shortage of menopause care in the public healthcare system, forcing many to pay steep out-of-pocket fees at private clinics. The roots of the problem trace back to the 2002 Women's Health Initiative trial, which raised alarms about menopause hormone therapy (MHT) and triggered a dramatic — and now considered excessive — pullback in its use and teaching. A whole generation of physicians was left either fearful of MHT or untrained in prescribing it, even as updated evidence shows its benefits outweigh risks for many women.
The crisis is compounded by structural failures: poor reimbursement for gynecological counseling under the fee-for-service model, no mandatory gynecology training for primary care providers, and a shortage of family doctors overall. Experts are calling for mandatory menopause training across disciplines, new care delivery models (like group counseling sessions), and a shift toward capitation-based compensation. On the legislative front, Bill S-243 is working through Canada's Senate to establish a national framework for women's health.
Key Takeaways:
Why it matters: Menopause affects half the population, yet systemic neglect — from underfunding to inadequate training — has left Canadian women without adequate care. Fixing this requires not just clinical education, but a fundamental rethinking of how women's health is valued and compensated in the healthcare system.
