Quality Standard Details
Menopause: Care for Women and Gender-Diverse People
- Publication Date
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2025-October-01
- Status
- Published
- Topic Area
- Reproductive System and Hormones
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Menopause refers to the health transition from reproductive to nonreproductive status, or the absence of a menstrual period for 12 consecutive months. On average, perimenopause begins four years before a person’s last menstrual period, but it can start as early as 10 years before.
People may experience a variety of symptoms; vasomotor symptoms (i.e., hot flashes or night sweats) are the most common, affecting 80% of people who experience menopause and lasting for a median of seven years after the last menstrual period. Other symptoms can include changes in mood, musculoskeletal symptoms, sexual difficulties, sleep disturbances, changes in weight and/or body fat distribution, and difficulties with concentration or memory.
People experiencing perimenopause and menopause should receive high-quality care based on the best available evidence. However, lack of awareness about menopause-associated symptoms is widespread, and people have limited access to clinicians with the knowledge to provide evidence-based menopause care. Menopause-associated symptoms are often mistakenly attributed to other conditions, leading to incorrect treatment and delayed care.
Inadequate care for perimenopause and menopause has substantial social and economic effects. Symptoms can lead to strain on relationships with partners, families, and friends. An estimated 10% of people permanently leave their careers as a result of debilitating menopause symptoms. Moreover, Canada loses an estimated $3.5 billion each year due to lost productivity, lost income, and missed days of work linked to menopause-associated symptoms.
This quality standard addresses care for women and gender-diverse people who are experiencing perimenopause or menopause (and postmenopause), including early or surgically induced menopause. The quality standard focuses on the identification, assessment, and management of symptoms at any stage and in all health care settings.
Quality Standard in Brief
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Quality Statement 1: Clinician Knowledge and Skills
Women and gender-diverse people experiencing perimenopause and menopause receive care from a clinician who has the knowledge and skills needed to provide evidence-based menopause care. Clinicians stay current with the knowledge and skills needed to provide evidence-based menopause care.
Quality Statement 2: Identification and Assessment of Perimenopause and Menopause
Starting at age 40, women and gender-diverse people are asked about menopause-associated symptoms to enable the early identification and assessment of perimenopause and menopause.
Quality Statement 3: Evidence-Based Information for People Experiencing Perimenopause or Menopause
Starting at age 40 or earlier, women and gender-diverse people receive evidence-based information about perimenopause and menopause from their clinician.
Quality Statement 4: Management of Vasomotor Symptoms
Women and gender-diverse people experiencing vasomotor symptoms during perimenopause and menopause are offered menopausal hormone therapy as first-line treatment, following an assessment of risks, benefits, contraindications, and individual needs and preferences. People who have contraindications to menopausal hormone therapy or who do not desire it are offered other evidence-based treatment options, including non-hormonal medications and nonpharmacological treatments.
Quality Statement 5: Management of Non-vasomotor Symptoms
Women and gender-diverse people experiencing non-vasomotor symptoms during perimenopause and menopause (including those related to genitourinary syndrome of menopause, sexual health, mental health, sleep, and cognition) are offered evidence-based treatment options.
Quality Statement 6: Appropriate Referral to a Clinician With Expertise in Menopause
Women and gender-diverse people experiencing perimenopause or menopause receive assessment and treatment from their primary care clinician and, if clinically indicated, are referred to a clinician with expertise in menopause.
Supporting Documents
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Patient guide for this quality standard
Know what to ask for in your care
Placemat for this quality standard
A quick-reference resource for clinicians that summarizes the quality standard and includes links to helpful resources and tools
Quality standard implementation toolkit
Quality improvement tools and resources for health care professionals, including an action plan template
Supplementary information to support the data collection and measurement process
Additional Resources
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- Case for improvement (slide deck)
Share why this standard was created and the data behind it, to get the support you need to put it into practice - Technical specifications
See the technical specifications for the indicators within the quality standard - Summary of the public feedback we received
- Case for improvement (slide deck)
Last Updated: February 24, 2026
