Thank you, Madam Chair.
Good afternoon everyone. It's a pleasure to be here.
My name is Anne‑Patricia Prévost, and I'm a family physician. I serve on the board of directors of the Fédération des médecins omnipraticiens du Québec. I work in an academic setting affiliated with the Université de Sherbrooke. I am here today to offer you a perspective rooted in the clinical reality of the women we care for as family physicians.
As Ms. Brunot mentioned, perimenopause and menopause are not diseases. They are normal phases of a woman's life, just like other life transitions such as pregnancy and aging. Some women will experience symptoms severe enough to interfere with their daily functioning, including at work.
As family physicians, we must avoid two pitfalls: trivializing symptoms when they become debilitating or, conversely, systematically medicalizing a normal life transition. These, then, are our two challenges. In practice, experiences vary widely. Some women will go through this phase with few repercussions, while others will have symptoms that disrupt their sleep, cognition, mood and functional capacity. It's a very heterogeneous experience.
Women who see a doctor do so primarily because they have symptoms such as sleep disturbances, brain fog, mood swings, joint pain, night sweats and hot flashes. It is our duty to thoroughly assess the impact of these symptoms and investigate their possible causes, as there are many. Given these symptoms, there are differential diagnoses to consider.
It is also our duty, first and foremost, to promote healthy lifestyle habits among these women and to provide adequate and appropriate care. I'm thinking of a patient who thought she was experiencing burnout because she had significant sleep disturbances. Ultimately, it was related to her perimenopause. On the other hand, I had another patient who thought her symptoms of night sweats and brain fog were related to menopause when in fact she had sleep apnea. So, it's very important to take a holistic approach to properly differentiate between the various conditions associated with these symptoms.
We also observe that there's a great deal of variability in clinical knowledge. There is a lot of underdiagnosis, overdiagnosis, and a lack of understanding of symptoms. There is confusion in the media, there are myths, and there are common misconceptions. We must be wary of misinformation, the excessive commercialization of certain approaches and the proliferation of tests or treatments that have no proven benefit. Conversely, we must also ensure that women with significant symptoms do not lack access to effective treatments when indicated.
I'm now going to discuss the impact of this on work. Symptoms related to menopause or perimenopause can interfere with daily functioning. This is very real. However, these effects are often invisible, trivialized or unrecognized. Small or large adjustments can be made. Better access to care can also have a positive effect on job retention. As physicians, it is our role to support these women's functional abilities—including their participation in the workforce—when the transition becomes difficult.
I would, however, be cautious about messages that suggest women in perimenopause or menopause are less capable of working or less productive. Most continue their professional lives successfully. Rather, we must ensure that those experiencing significant symptoms do not find themselves lacking support, treatment or understanding.
To achieve this, I have a concrete plan to propose. It consists of three actions: better information, better support and better care.
First, we should improve awareness among the public, employers and managers to normalize the conversation without stigmatizing it.
Second, we should promote simple, flexible and inexpensive accommodations in the workplace.
Finally, we should improve training for professionals and ensure rapid access to relevant, high-quality, evidence-based care.
If you had to remember just one sentence today, it would be to normalize without trivializing and to support without overmedicalizing. There are women who are successfully navigating this transition. As for those experiencing significant symptoms, they should never be invisible, misunderstood or left without support.
Thank you very much for your attention.