Status of Women Committee on June 11th, 2026

[Andréanne Larouche, Bloc, Shefford, QC]

Thank you very much, Madam Chair.

[The Vice-Chair, Liberal, Marilyn Gladu]

I'm sorry, but the bells are ringing.

Do I have unanimous consent of the committee to continue until we get to the end of Madam Larouche's questions?

[Some hon. members]

Agreed.

[Laila Goodridge, Conservative, Fort McMurray—Cold Lake, AB]

Just to confirm, we will still end the meeting at 5:30.

[The Vice-Chair, Liberal, Marilyn Gladu]

That is correct.

You may continue, Madam Larouche.

[Andréanne Larouche, Bloc, Shefford, QC]

Thank you very much, Madam Chair.

I want to thank Ms. Flood, Ms. Alon-Shenker and Ms. Heale for joining us today on this important study.

I think this study has even broader implications. To me, it's a study on the place reserved for women in our society—for aging women. It's more than just a matter of menopause. That's how I see it. Perhaps it's because, before I was elected, I was a project manager working to raise awareness of elder abuse and elder bullying. People will ask me what the connection is. It's that we were talking about ageism. To me, the inability to recognize and adapt to what aging women are going through, and making those “out of the way, you old bag” comments, is a form of ageism. The fact that we're trying to make them invisible in our society—whether on our screens, in businesses or anywhere else—worries me a great deal.

Fortunately, in Quebec, we have a great ambassador, Véronique Cloutier, who made an exceptional series called Loto-Méno. The episode titles really remind me of what you said in your opening remarks. Véronique compares perimenopause and menopause to the lottery, since you don't know whether you're going to experience three, 10 or 30 symptoms. The title of the first episode is “The void”. The second episode is entitled “Personal problem or societal problem?” Should we simply see this as our own problem, or should we look at it from a broader perspective and push companies to adapt? The third episode is entitled “What do we do now?”

It has to do with medication and our health care system. Obviously, we are members of Parliament at the federal level, and everything related to direct patient care and medical school education falls under the jurisdiction of Quebec and the provinces. However, when it comes to research, medications and treatments, there is a connection with the federal government.

We can certainly discuss workplace adaptation again, because I'm interested in that as well, but I want to follow up on the question raised by my colleague Ms. Vien, even though I know you'll be sending us some documents.

Where are we at in terms of research and drug approvals? My colleague mentioned bioidentical hormones, for example.

[Roberta Heale]

I'm sorry. Was that directed to me?

[Andréanne Larouche, Bloc, Shefford, QC]

I addressed all three witnesses, but you can start, Ms. Heale, if you'd like.

If they wish, the other witnesses may add to your response.

[Roberta Heale]

The landscape for treatment for perimenopause and menopause is growing. We have a variety of very effective treatments that are, thankfully, non-hormonal as well as hormonal.

Some of the issues are accessibility. We have to consider that some women will not want or will not be able to take these medications. As well, there are other treatment options that are very effective—cognitive behavioural therapy for vasomotor symptoms, for example—yet all of those treatments, unless the patient has coverage, will be paid for out of pocket, and they're all very expensive.

Sleep is a huge issue, and hormones are not necessarily the treatment for that. Again, the treatments—cognitive behavioural therapy for insomnia—can be extremely expensive.

You've hit the nail on the head. It's so complex. There are so many facets to it. It's not just vasomotor symptoms; it's a whole host of things that are sometimes addressed with what we have and, sometimes, need other treatments.

[Amy Flood]

Yes. If I may add to that, I also feel that, oftentimes—and I believe, Pnina, you spoke to this—women are misdiagnosed. They are showing up with symptoms that are a result of perimenopause and menopause but they're not being recognized as such, so they are being prescribed SSNRIs and anti-anxiety and depression medication, when, in fact, hormone therapy, started earlier, would have been the right first line of defence. Because there's not enough research in the actual symptoms and the linkage to perimenopause and menopause during that hormonal transition, the actual prescribing of treatment is inaccurate to begin with.

Also, I would say that insurance companies are reluctant to carry treatments for menopause and perimenopause because of the costs associated. However, the costs associated with short-term and long-term disability are actually much greater and are a much larger risk. There are very much limited research studies on the long-term safety and effectiveness of hormone therapy. There's also a lot of research emerging showing that it's highly beneficial for other areas in the long-term life of women, such as Alzheimer's and dementia.

We just do not know enough about the effectiveness of the treatments due to the efficacy gap. Things have not been treated on women or tested on women to begin with, and therefore are misdiagnosed, misunderstood and misinformed. This is a root problem beginning with research and data that's disaggregated by sex.

[Andréanne Larouche, Bloc, Shefford, QC]

Thank you.

I have 20 seconds left.

Ms. Alon-Shenker, do you have anything to add?

[Pnina Alon-Shenker]

I'm fine. I'm not doing research on the health care system, so I don't want to comment on that. I think I've commented enough for now.

[The Vice-Chair, Liberal, Marilyn Gladu]

Okay. If you have any other comments, you can send them to the clerk.

I understand there is unanimous consent to continue, so we'll go to Ms. Goodridge for five minutes.

[Laila Goodridge, Conservative, Fort McMurray—Cold Lake, AB]

Thank you, Madam Chair.

Thank you to all of the witnesses for being here today.

Ms. Flood, I really appreciate how you put down the details surrounding the women's research piece. It's something that I have been very passionate about and have brought forward in a lot of different spaces, because it is one of the big challenges. We're hearing about the workforce impacts, but, perhaps, if people had a better understanding of what they were going through, there wouldn't be the workforce impacts if it were actually being acknowledged and treated properly.

The only thing I can compare it to is being pregnant. In the moments before you realize you're pregnant, you think you're going crazy because you're terribly emotional. Once you realize that you're pregnant, you stop thinking you're crazy because you realize that it's just your emotions going a bit wild because of the hormones. You're not actually crazy; you're just pregnant. This is that circular space here.

How much research is being done, funded by the Government of Canada, in the space of perimenopause and menopause?

[Amy Flood]

I can't speak specifically to that. All I can say is that only 7% of research funding is being attributed to women specifically. When you take oncology out of that, it is only 3%.

I don't know the actual dedicated research for perimenopause and menopause. There is also, obviously, the transition from menstruation to pre-perimenopause, to perimenopause, to menopause and beyond. They're starting to see and identify this as a longer-term journey than just perimenopause and middle age in its own right.

[Laila Goodridge, Conservative, Fort McMurray—Cold Lake, AB]

Are there any schools leading the research when it comes to perimenopause and menopause, from a health perspective in Canada?

[Amy Flood]

I can speak specifically to the research institutes within my collective. They are associated with the universities in their areas.

The Women's Health Research Institute in B.C., the Women and Children's Health Research Institute in Alberta, the Women's College Hospital Foundation, the MUHC in Montreal and, now, the IWK in the Maritimes all have projects on menopause and how it's linked specifically, through hormonal transition, to other major areas of burden, such as cardiovascular disease, brain and mental health disorders and other chronic disorders that arise as a result of that hormonal transition.

The affiliated universities are University of Alberta, University of Toronto, University of B.C., McGill University and two universities on the east coast.

[Laila Goodridge, Conservative, Fort McMurray—Cold Lake, AB]

Thank you.

Ms. Heale, are there any tools available to diagnose whether someone is in perimenopause, and what do they look like?

[Roberta Heale]

Yes, there definitely are.

The Canadian Menopause Society and their members have worked to put together algorithms and treatment options for health care providers. There's one in particular I can think of. MQ6 has a link for women for information.

These are great resources but sort of fledgling and not across the board in terms of accessibility or usability for health care providers.

[Laila Goodridge, Conservative, Fort McMurray—Cold Lake, AB]

I'm not sure if this would be better directed to Ms. Flood or to you, Ms. Heale. If a woman is thinking they may be in perimenopause, what should their next step be? What should they do?

[Roberta Heale]

I would suggest that they see their health care provider, but I think, unfortunately, many health care providers don't have the knowledge base, and women are turned away. They don't understand the symptoms and most often will go to social media.

That's been my experience. The amount of misinformation women have is phenomenal. They seek help in other places.

[Laila Goodridge, Conservative, Fort McMurray—Cold Lake, AB]

Ms. Flood, do you have anything to add?

[Amy Flood]

I would concur. I think the lack of research is contributing to the lack of knowledge.

Also, there is no constant state for hormones, so you can't benchmark where a hormone level is to understand whether you're entering or exiting perimenopause or menopause. All you can do is correlate the level of symptomology to...and deduce where you are at and where you are predicted to go based on age and your cycle.

There is very much a lack of training, knowledge and education. Research is the number one port of call.

[The Vice-Chair, Liberal, Marilyn Gladu]

Thank you.

Now we'll go to Madam Ménard for five minutes.

[Marie-Gabrielle Ménard, Liberal, Hochelaga—Rosemont-Est, QC]

Thank you, Madam Chair.

Ladies, your testimony is so enlightening. We're taking notes at lightning speed. Please know that you're speaking to a captivated and passionate audience.

We're focusing here on perimenopause and menopause. We know these are two chapters in the lives of girls and women. Girls, starting as young as eight or nine years old now, go through experiences and physical symptoms that will eventually change. We've discussed pregnancy, motherhood, perimenopause and menopause.

We fully understood that physiological changes in women are often misunderstood. However, we're here at the federal level, and we're trying to adopt the best possible practices while respecting jurisdictional boundaries.

Do you think awareness campaigns to demystify these issues would be a worthwhile approach?

As you have all said, people don't talk about menopause. If we expect employers to lend a hand, we may need to take some preliminary steps first.

Would an awareness campaign by the federal government—through the Department of Health, for example, but perhaps also through other channels—be a worthwhile approach?

We're going to try to explore all possibilities as part of this study.

What are we doing about recognition, understanding and awareness? Not only is there still a stigma, but, as you said, there are also brain fog and mood changes. Here, we are women, and I think we all immediately associated these physical symptoms, which we still must contend with today, with some very crude jokes.

So I'd like you to tell us about the role of raising awareness. I'll start with you, Ms. Heale.