Perimenopause & Menopause FAQs
Women will spend 30-50% of their lifetime in menopause
What is Menopause Hormone Therapy (MHT) / HRT?
Menopause hormone therapy involves replacing one or more of the hormones that are known to fluctuate and decrease during the perimenopausal and menopausal phase of a women's life. Some women will start to notice symptoms related to hormonal changes as early as age 40. By "replenishing" hormone levels to what they were previously, these symptoms can be alleviated. This may include use of estrogen, progesterone and/or testosterone. Hormone therapy has also been shown to prevent bone loss, improve heart health, and so much more.
Prescribing of Menopause Hormone Therapy is informed by the best available evidence.
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2022 North American Menopause Society’s hormone replacement position statement
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Canadian Medical Association Journal on menopause management
Can hormones be helpful for women who are still getting a period?
Yes! The transition to menopause, which is characterized by eradicate and unpredictable fluctuations in hormones, can last for many years before the final menstrual period. Bleeding during this time could be regular or irregular - regardless, if you are having symptoms, you can likely benefit from treatment.
What are the different types of hormones used?
There are many options here, and there is no "one size fits all". We will review all the options and decide together what is best for you, informed by the current evidence and guidelines. This includes use of Health Canada approved bio/body identical prescription options.
Hormones may be delivered in the form of a pill, patch, gel, vaginal creams/suppositories, and the hormonal IUD. Estrogen, progesterone and/or testosterone are commonly used MHT options.
For a complete picture of available treatments in Canada, The Canadian Menopause Society has a pocket guide that describes all available options which we are happy to discuss in your appointment. You can also use the Interactive Treatment Algorithm available at www.MQ6.com to see what options may be appropriate for you. This website has lots of great resources, so take a browse!
Do I need blood work prior to my appointment?
Women aged 45+ who are experiencing menopausal symptoms generally do not require laboratory testing prior to initiating hormone therapy, or for monitoring of therapy. We treat based on symptoms, not lab values. How you FEEL is what will guide treatment.
Laboratory testing may be indicated for women who are aged <45, when needing to rule-out other potential causes of symptoms, or for those who are not up-to-date on routine screening. Most testing covered under OHIP, for those with a health card.
This approach to testing is aligned with the leading recommendations and guidelines.
When will I notice results?
This will vary greatly depending on the individual, the severity of symptoms, the type and dosage of hormones used, and other factors. For some women, improvements may be noted within weeks. For others, getting to the best dose of the best combination of therapies can be a process. We will work together to get you feeling like yourself again.
Will insurance cover the cost of my appointment and prescriptions?
What if hormones aren't right for me?
Many employee drug plans will cover the cost of prescription hormone therapies, similarly to other commonly used medications. Appointment fees may be eligible for reimbursement for those with private insurance or a Health Care Spending Account. Please check with your insurance provider for details.
While MHT is considered the gold standard treatment for menopausal hot flashes and can help to alleviate many other symptoms, there are a variety of alternatives if hormone therapy is not right you!
Does this require an in-person appointment?
No! Patients are always welcome to come for an in-person appointment, but we can assess your concerns 100% virtually if you prefer, or if that is more accessible for you.
Tip: it's always a good idea to come with a recent blood pressure reading (which can be done at the pharmacy).