Status of Women Committee on June 16th, 2026

[Shawna O'Hearn]

There is work happening at the provincial government level, across many of the jurisdictions, trying to understand what this even means, bringing it up, trying to remove the silence and the stigma attached to menopause in the workplace. They are starting with the conversation, opening the door, making sure there is a discussion taking place.

Many of the jurisdictions are recognizing that there's not one answer. This is going to take a multipronged approach, which takes time. It's going to take a co-creation model with our employees. Opening that door, putting resources in place, is really important.

One last piece to that is on the leadership that takes place in the workplace. Many of the people who are taking on that role are doing it as volunteers. Who are those volunteers? They typically are women. It becomes invisible labour within the workforce. Not only do we need to bring the conversation forward, but we need to acknowledge it and make sure that it's recognized and valued and that they are supported in that place so it doesn't become an additional workload for employees, particularly female employees.

[Kristina Tesser Derksen, Liberal, Milton East—Halton Hills South, ON]

Thank you.

You've also mentioned several times, and so has Dr. Demers, the lack of information to inform policies and best practice. It's really a question about data collection and how we're interpreting that data. Because data is really where we start and where we identify those problems, that's how we determine how it's going to affect people. Is that right?

Could you comment on the state of data collection from a national perspective? Either one of you can speak to that.

Would you like to answer that, Dr. Demers?

[Sylvie Demers]

Actually, what I'm about to say might sound a little strange, but I think there's actually quite a bit of data out there. You just have to look for it.

[The Chair, Conservative, Dominique Vien]

Excuse me, Dr. Demers, it always seems to fall on you. The time is up. Don't take it personally.

Ms. Larouche, you have the floor for six minutes.

[Andréanne Larouche, Bloc, Shefford, QC]

Thank you, Madam Chair.

I wanted to ask you some more questions.

First of all, thank you very much to Dr. Demers and Dr. O'Hearn for being with us today.

I'll start with you, Dr. Demers.

Dr. Demers, it's interesting to hear you say that, because we get the impression that there's a lack of data. In fact, that's what we sometimes hear.

You're saying that's not the problem. In your opinion, the data exists, but we have to look for it.

I'll let you finish your answer.

Where can we find the data?

[Sylvie Demers]

In fact, when I wrote about female hormones, I thought there wasn't much data. I was surprised to find that a lot of researchers are working behind the scenes. I'm speaking from a medical perspective, not in terms of financial data, among other things. I'm speaking from a medical perspective.

Of course, that's my point of view. I find there's a lot of data. That's why I've written four books. There are hundreds of scientific references. Before reinventing the wheel, we need to look at what researchers have observed over the past several decades. There's actually quite a lot of information. So we start from there and go further. I'm surprised to see that there's actually quite a lot of it.

Obviously, I think one of the most important points is to shift our perspective a bit on premenopause, perimenopause and menopause. We have to look at this from another angle, because it affects every system in the body.

So this requires a commitment. I believe we need to invest heavily in primary care, in other words, family physicians and nurse practitioners, whether through research funding or based on current developments. Often, this has been done in a somewhat piecemeal fashion, but when we put it all together, I think we get a very different perspective.

[Andréanne Larouche, Bloc, Shefford, QC]

Okay.

As I understand it, you're saying that it's not the lack of data that's the problem, but rather trying to compile it all to get a better—

[Sylvie Demers]

We all agree that it's always nice to have more data. I think there's already a lot on the medical side, maybe not on the—

[Andréanne Larouche, Bloc, Shefford, QC]

Could you tell me where the problem lies? Is it due to a lack of information?

[Sylvie Demers]

I'll give you my point of view based on what I have seen.

I would say there are three main reasons. The first has to do with how the medical field works. When people make recommendations, they're working in a very isolated way.

Many women's health issues have been grouped together in gynecology and obstetrics, which was entirely justified because it was thought that female hormones were linked solely to reproduction. That means that recommendations will be made mostly, but not exclusively, by obstetricians and gynecologists. They're excellent. That isn't the problem. They're essential, and they need to be part of the discussion, if you will.

However, there isn't the view that knowledge needs to be integrated. The problem is the integration of knowledge. It needs to be integrated, because a lot of researchers have looked at female hormones: cardiologists, neurologists, psychiatrists, family doctors and urologists.

Of course, there's room for research to improve hormone therapy care. However, I also think that the work should take into account what's being done on the front lines. When someone has an issue, such as shoulder tendinitis, that's related to premenopause, perimenopause or menopause, they go to see their family doctor. However, the doctor won't know whether it's related to a hormonal issue. If they have osteoporosis or depression, who are they going to see? Their family doctor.

There needs to be expertise in front line medicine, because doctors are the ones who see women, by and large. They also need to join forces with all the professionals. Having done so, I can tell you that we have much less need for specialist medical consultations. The specialists love that, because they have clear-cut issues in front of them, not issues due to hormones. When the issue is due to hormones, they don't really know.

I'll give you one example, but I could give you several.

Premenopausal patients often have heart palpitations. Doctors don't know if that's due to a lack of progesterone. They don't know. They don't learn that. The patient isn't sent to gynecology; they're sent to cardiology. The cardiologist does a thorough examination but concludes that those are benign palpitations. They aren't really sure what to make of that.

That's how it is for a lot of women with health problems who reach premenopause, when their cycles are still regular. I think that's the crux of the issue. In any case, that's what I saw. It jumped out at me. It's easy and straightforward.

[Andréanne Larouche, Bloc, Shefford, QC]

Okay.

I take it that, if we had to keep in mind one recommendation, it would be about integrating knowledge.

[Sylvie Demers]

It would be a matter of integrating current knowledge, not reinventing the wheel. There are loads of scientific articles out there. Of course, research is always appropriate.

[Andréanne Larouche, Bloc, Shefford, QC]

That's great.

I'm hearing a lot about it being necessary to look at the front lines.

[Sylvie Demers]

It's necessary. It's required, otherwise we won't get anywhere. Again, we won't get anywhere.

[Andréanne Larouche, Bloc, Shefford, QC]

I have less than a minute left, so I'll go quickly.

We're talking about integrating knowledge, but also about raising awareness and debunking certain myths. You said you worked on the documentary Loto-Méno. My family doctor is a woman, but it used to be a man. He was very open to women's health issues. We're trailblazers in Quebec, thanks in particular to the documentary Loto-Méno.

What has changed?

[Sylvie Demers]

We now know that women's hormones play a role in every system. Women are always taught to see the dark side of femininity, but there's such a bright side. These hormones play a role in every system, and that's why things go so wrong when something starts to get disrupted. We women are complex.

[The Chair, Conservative, Dominique Vien]

Thank you, Dr. Demers.

Mrs. Roberts, you have the floor for five minutes.

[Anna Roberts, Conservative, King—Vaughan, ON]

Thank you, Madam Chair.

Thank you to the witnesses.

Dr. Demers, you spoke about the complete medical history. Has there been any research done on, for example, if a female is on certain medication, how that medication interacts with the hormone medication and if it acts in a positive or negative way? For example, if you're on blood thinners, they say you shouldn't eat pineapple or you shouldn't have other fruits that would counteract the medication.

Is there any proof of that or any research that has been done on that?

[Sylvie Demers]

In fact, I personally use observation notebooks. For a number of years, I noted down the medications women were taking, their dosages and the effects. That's how I came to draw up a list of medications and interactions, as well as effects on effectiveness and dosage. I'm someone who will measure things.

When it comes to teaching doctors, nurse practitioners, clinical nurses or pharmacists, they're taught how to prescribe hormone therapy using art and science. It's obviously important to take into account what medications patients are taking.

My obsession, if I can put it that way, is to provide women with the safest and most effective hormone therapy possible. Everything interacts with medication, whether it's our lifestyle habits or the way we take hormones, among other things.

It's complex, but that has to remain the doctor's objective. Doctors have to be trained. It isn't that complicated, but there are still precautions to take. For example, for someone who has been prescribed thyroid hormones or someone with type 1 diabetes, it's important to take everything into account. It's the role of family doctors and nurse practitioners to have a holistic view and incorporate knowledge. The human body is complex.

[Anna Roberts, Conservative, King—Vaughan, ON]

Do you think that male doctors or female doctors are better equipped to deal with this issue?

[Sylvie Demers]

Right now, our training is definitely very tainted by the patriarchal approach. Students are taught that female hormones cause problems and cancer. That's still more or less the way things are seen. People always talk negatively about hormones.

I'm trying to change things, because there are always two sides to every story. Female hormones are not hormones that cause or fuel cancer; they're good hormones.

Everything has been mixed up, and there's some confusion. The stereotypes are still very sexist. Things are still very patriarchal. I prescribe testosterone to men, transgender women, transgender men and biological women. That means I'm in a good position to see people's prejudices. It's so obvious that it jumps out at you.

We have to change the perception that women are poorly designed—poor women. That's not true. There are a lot of benefits to being a woman. When women are in menopause and not doing well, it's because they're losing their good hormones. That can be treated easily by giving the right dosage of hormones. Women generally do well after that.

[Anna Roberts, Conservative, King—Vaughan, ON]

I know that the studies have changed. I remember going to my doctor when I was in menopause. We were told that once we were on those drugs, we had to stay on them for life. I understand that's changed now. Now the period of staying on the hormone medication is five years. Is that correct?

[Sylvie Demers]

Those are myths, dogma. When the 5- or 10‑year period was set, it wasn't based on science at all. Things have changed a lot now.

In Quebec, the Institut national d'excellence en santé et en services sociaux has also looked at this. They released a report in October 2024. There's no longer an age for taking hormones. It's truly up to women. The institute didn't have a mandate to comment on the preventive side of hormone therapy, but it may do so in the future. It focused on how to relieve symptoms, and it limited itself to certain aspects. That said, there's no longer an age for taking hormones.

I will be brief, but what's interesting is that there are two extremely positive points. The institute recognizes that the hormone therapy I have favoured for 25 years—namely, transdermal 17β‑estradiol with micronized progesterone—is the first-choice treatment. It has been recognized for a long time in Toronto, in the protocols for transgender women. It was recognized in 2019. It's coming along for women. It also recognizes that—

[The Chair, Conservative, Dominique Vien]

Dr. Demers, there's a lot to say on the subject; there's no doubt about that. I would ask you to send us the second point you wanted to discuss in writing. Maybe one of my other colleagues will ask you about it.

Ms. Nathan, you have the floor for five minutes.

[Juanita Nathan, Liberal, Pickering—Brooklin, ON]

Thank you, Madam Chair.

My first question is for Dr. Demers.

We've heard testimony that menopause is not simply a health issue. We've talked throughout about that. It's also a workplace issue, an economic security issue and a gender equality issue. Many women described spending years trying to understand symptoms that were affecting every aspect of their lives, including their ability to work. Some spoke about reducing hours, turning down opportunities or leaving jobs altogether before receiving appropriate support, because they were not able to identify what was going on with them.

From your clinical perspective, how are gaps in menopause diagnosis, treatment and physicians' education affecting women's ability to remain in the workforce? What health care reforms would have the greatest impact on improving both health outcomes and economic security for women?