Thank you, Madam Chair.
I would like to begin by thanking the Standing Committee on the Status of Women for inviting me to participate in this study.
I've been a family physician since 1998. I'm also a biologist with a Ph.D. in experimental medicine. In January 2005, I founded a clinic specializing in hormone therapy for women, men and transgender individuals. I'm likely one of the Canadian physicians who has treated the largest number of women for issues related to premenopause, perimenopause and menopause. For the past 25 years, I have been advocating for women's access to safe and effective hormone therapy—specifically, a regimen consisting of 17β‑estradiol in the form of a transdermal gel and progesterone, commonly known as “bioidentical hormone therapy for women”.
I have authored four books and hundreds of scientific articles published by Les Éditions de l'Homme, including the bestseller Hormones au féminin: Repensez votre santé. I have also analyzed in detail the links between female hormones and vitamin D, cholesterol, cardiovascular disease and breast cancer. I was a medical expert in the acclaimed documentary Loto-Méno. Since May, Loto-Méno has helped provide Quebec women with unrestricted coverage of transdermal 17β‑estradiol, or Estrogel, and micronate oral progesterone.
What struck me the most about women in perimenopause and menopause is the trivialization of their suffering. Yet the signs and symptoms of perimenopause and menopause, due in large part to the shortage of estradiol and progesterone, affect every system in the body. They are not limited to hot flashes, which affect about 80% of women. Unlike hot flashes, which may decrease or even stop over time, many consequences of a female hormone deficiency will all too often worsen: joint or muscle problems, osteoporosis, atherosclerosis, heart attack, heart palpitations, metabolic changes, genitourinary syndrome, sleep disorders, fatigue, anxiety and depression, as well as digestive disorders, to name just a few.
For many women, the lack of treatment results in time off work due to exhaustion or chronic pain. Financial insecurity then becomes the reality for many women. Female hormone therapy is recognized as the most effective treatment. It can be bioidentical or non-bioidentical.
Unfortunately, due to some confusion between these two types of hormone therapy by the Society of Obstetricians and Gynaecologists of Canada, or SOGC, access to hormone therapy remains very limited. First, the scientifically proven risks of hormone therapy are associated with oral or non-bioidentical estrogens and, above all, with progestins, not with transdermal 17β‑estradiol combined with progesterone, which is known as bioidentical hormone therapy. In addition, with few exceptions, the SOGC advises against prescribing hormone therapy for preventive purposes alone, which deprives many women of preventive medicine.
In addition, the premenopausal period, when menstrual cycles are still regular, is not recognized. Yet this is a crucial period that can last more than a decade, during which women begin to be overdiagnosed, overmedicated, over-referred to mental health services and placed on disability. Contrary to popular belief, menopause doesn't last just one day. The premenopausal, perimenopausal and menopausal periods together account for about half of women's life expectancy.
It should be noted that estradiol and transdermal 17β‑estradiol hormone therapy combined with progesterone is the only type of hormone therapy that can be calibrated, which makes it possible to maximize its many benefits and reduce its risks. How I treat women is increasingly recognized by many colleagues I have trained, and it is in high demand, even sought after, by women. My experience shows that, when properly prescribed, hormone therapy helps women stay in the workplace longer.