Ontario Releases Canada’s First Quality Standard for Menopause Care

Ontario Health has released the country’s first-ever quality standard dedicated to menopause care, marking a major milestone in support of women’s health.

Titled Menopause: Care for Women and Gender-Diverse People, this quality standard sets out clear, evidence-based guidance for clinicians, health organizations and patients across Ontario.

Hiyam Jibry, a lived experience advisor on the Ontario Health Menopause Quality Standard Advisory Committee, says when she began experiencing sudden and random hot flashes and significantly disrupted sleep patterns at age 40, she thought she was ill. She did not know that she was experiencing symptoms of early menopause.

“Because my menopause symptoms began earlier than expected, it was an isolating experience. Even with strong medical support, I found it difficult to navigate what seemed like limited information and options available,” she says.

Now, at 52, Hiyam is grateful for the recognition and awareness of how adversely menopause can affect people and believes this quality standard will lead to better health outcomes and improved quality of life for patients.

“Half of the population will experience menopause. This quality standard raises awareness and education about menopause and empowers patients to get the care and support they need. Standardizing this care helps eliminate barriers, improves quality of life and ensures that the needs of people experiencing menopause are properly met,” she says.

Developed in collaboration with clinicians and patients, the standard focuses on improving the identification, assessment and management of menopause-related symptoms. It applies to all stages – perimenopause, menopause and post-menopause – and for those experiencing early or surgically-induced menopause.

Surveys show that nearly half of Canadians feel unprepared for menopause and many report feeling dismissed or undertreated by their clinicians. Symptoms can significantly impact quality of life, relationships and work, contributing to an estimated $3.5 billion in lost productivity annually.

Dr. Iliana Lega, co-chair of the Menopause Quality Standard Advisory Committee and an endocrinologist at Women’s College Hospital, says the standard is important because the evidence-based, high-quality information and guidance enable clinicians to provide this care more universally. It also provides information for people on what to expect as they go through menopause and from their care team.

The standard details six quality statements, including clinician education, proactive symptom assessment starting at age 40, access to evidence-based information and treatment options for menopausal symptoms. The standard also provides guidance on appropriate referrals to menopause specialists when needed and is accompanied by a patient guide.

“Conversations about menopause are shifting, driven largely by women unwilling to remain silent anymore. Menopause is a physiological, normal and natural transition in a woman’s life. It’s not a medical condition and it is not a pathological change where something is wrong with you. But for many generations, clinicians went through their medical training not learning about menopause and so we now need to catch up,” Dr. Lega explains.

“Our intent is to target the quality standard to primary care providers, who are often the first point of contact for individuals experiencing menopause; their role is essential in recognizing, assessing and managing symptoms. Menopause is generally not a specialty condition that needs to be referred out. That’s why it’s so important to provide concise, summarized information, based on evidence, that is easily digestible and usable by a clinician.”