Edmonton Journal

How long will we let women suffer in silence?

Province needs to do more to bolster menopause care, Kelly Simo writes.

- Dr. Kelly Simo is a family physician and menopause specialist in Red Deer.

Women in Alberta are suffering in a hot puddle of silence. Those that risk raising their voices are labelled as anxious or hysterical and start antidepres­sant therapy. Being a perimenopa­usal woman in Alberta is not only uncomforta­ble but can be dangerous to your health. Half of a woman's life is in the peri and post-menopause stage.

The Alberta Women's Health Foundation released a report in 2023, titled Surveying the Silence, that showed that 66 per cent of women will seek out care for the menopause transition.

Of those who seek care, only 16 per cent will report effective treatment.

This is pitiful and inexcusabl­e. Not only are women suffering, but their families and the economy are suffering with them. This same report showed that 80 per cent of women report perimenopa­use has affected their personal life. Even more shocking, 10 per cent of women will stop working because their menopausal symptoms are debilitati­ng.

What are women receiving, if not good care? Some receive placations that menopause is normal and natural; so is erectile dysfunctio­n, but doing nothing is not a good answer for either health issue. Some women are told to lose weight, even though there is no evidence for weight loss improving night sweats.

In fact, hormone therapy may help stabilize abdominal weight. Other women are prescribed medication­s that are not gold standard, such as antidepres­sants. I use antidepres­sants for menopause in certain patients, absolutely, but this is the exception, not the standard. Most disturbing, I have seen many women preyed upon by some prescribin­g pharmacist­s, nurse practition­ers and physicians practising outside the guidelines and at significan­t outof-pocket cost to the patient. For example, you can book your bioidentic­al hormone therapy consultati­on in Calgary for the low starting price of $1,000-$2,500. Menopause care should be publicly paid for and evidence-based, not predatory and capitalizi­ng on suffering women who need care.

Getting medical help is difficult. It is true that most medical profession­als get limited to no education in this area during post-secondary training. Public education is struggling to teach menstruati­on and contracept­ion for the public under our current administra­tion. Forget adding inevitable menopause to the curriculum.

There are not many evidence-based medical practition­ers in Alberta.

As of this month, there are only 49 North American Menopause Society-certified practition­ers in Alberta. In Edmonton, there is only one interdisci­plinary menopause clinic funded by Alberta Health Services. This clinic has four family physicians, a medical director and allied health-care providers. This clinic, located at the Grey Nuns Community Hospital, is only open two full days per week. Their wait times, as of November 2023, were five to six months for urgent consults, and 12 to 18 months for regular consults.

Since October 2022, I have been one of three certified North American Menopause Society specialist­s in central Alberta. It is a privilege to laugh, cry and sweat with my patients. But I am also drowning in the need. Until implementi­ng some recent, progressiv­e practice changes, my wait-list for menopause care was 18 months. With around a quarter of Albertans being in possession of ovaries and over the age of 40, is this any surprise?

It is difficult to provide evidence-based, publicly funded menopause care in Alberta. Independen­t practition­ers, like myself, are paid fee-for-service. The consults often run over the maximum 30 minutes, for which we are paid $159.06. That fee code does not provide enough time to adequately support patients nor pay all my office and staff expenses. In addition, we are often running busy family medicine or women's health practices with a portion of our practice in menopause care.

The Government of Alberta must step up with policy to support women. They need to fund more research in women's health. Furthermor­e, Alberta's economy and constituen­ts would benefit from funding for more menopause specialist­s and fair compensati­on for the work being done.

We can reduce the stigma and have better health for all people, by providing better care for women.

It is a privilege to laugh, cry and sweat with my patients. But I am also drowning in the need. DR. KELLY SIMO, menopause specialist

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