Only 13 per cent of women say employers offer adequate menopause support. GreenShield hopes to change that
A recent survey by GreenShield on hormonal health in the Canadian workplace has found only 13 per cent of respondents felt their employer offered adequate menopause or hormonal health support. Meanwhile more than 50 per cent said their employer offered nothing at all.
"As a nurse, it’s not surprising. I was very sad to hear and see these numbers. It's very disappointing when there are already solutions and supports available," said Karma Stanley, clinical nurse manager and lead of GreenShield's hormonal health program. "We just need to help organizations make this available to their employees so that we really recognize the driver of economic participation and workforce well-being that’s playing into women’s care."
Stanley describes the problem as linear, with each barrier feeding into the next. It starts with recognition – more than a quarter of women surveyed did not initially connect their symptoms to menopause, which is understandable given the more than 30 symptoms associated with perimenopause. Once women do identify what is happening, they hit an access wall, noting that 40 per cent of women surveyed admitted they didn’t know where to go for help.
"Fewer than 40 per cent actually discuss their symptoms with their healthcare providers once they get that appointment," she said, also noting that fear of dismissal is a top concern among women surveyed as 21 per cent of respondents cited they were worried their symptoms would be brushed aside.
"We want to shift the story for women to understand that these are life transitions that are hormonal, not personal failures," said Stanley.
Across the country, one in five Canadians lack regular access to a family physician or nurse practitioner with provincial numbers faring even worse. Moreover, more than a quarter of women surveyed did not initially recognize their symptoms as related to menopause or perimenopause.
"People then are forced to spend months, years researching their symptoms on their own, booking those multiple appointments, and cycling through providers until they actually are able to find care," Stanley noted.
Even when women do get an appointment, another barrier emerges, Stanley said, highlighting epistemic injustice, a term that describes the harm caused when a person's knowledge of their own body is discounted. That includes testimonial injustice – not being believed – and hermeneutical injustice, where people lack the language to describe what they are experiencing.
Menopause is a predictable life stage, not something that should catch the healthcare system off guard, and the response should match that predictability – specialized programs and clinics built around women's transitional care.
To that end, GreenShield’s nurse-led hormonal health program is built around that logic. Nurses with specialized training in hormone health conduct comprehensive intake assessments, helping women connect symptoms they may not have linked to menopause – joint pain, for instance – and then build individualized care plans.
"We wanted to create a solution that was a whole-body approach," she said, noting that care plans may include work with a registered dietician, a fitness coach to support bone health, sleep hygiene strategies, and stress management.
"When we talk about what causes people to reach out for support, I think a lot of people think it’s the hot flashes," she says. "But actually, the most common driver for a person actually reaching out for support is the impact on the cognitive and mood disruptions, where they will say to us, ‘I don't even recognize myself anymore’."
Stanley believes a nurse-led model works well because nurses can do the detailed assessment work that helps patients make sense of a broad mix of symptoms, then translate that into a practical care plan. In her view, nurses are well placed to connect the dots, offer whole-person support, and guide patients toward the right practitioners when medication or other specialized treatment is needed.
She also suggests that trust is a major part of why the model is effective. Nurses can create a more open conversation, which makes it easier for patients to talk through symptoms and concerns they may have struggled to raise elsewhere. Just as important, she sees nurses as strong navigators of the healthcare system – people who understand what supports exist, how to assess needs properly, and how to build care plans that reflect the full picture rather than a single symptom.
Stanley acknowledged the program’s success will be judged first by whether symptoms ease and become more manageable over time. She points to early indicators such as patient feedback, notably when participants describe finally feeling cared for, as an important signal that the model is working. The team also tracks clinical measures through baseline blood work and follow-up monitoring to assess hormonal health outcomes more closely.
At the centre of the evaluation, though, is the patient’s experience from start to finish - how they feel when they enter the program, how they respond during treatment, and how their condition changes over time. Stanley suggests that this can look different for different people, with some benefiting from shorter lifestyle-based interventions and others needing support over a much longer period.
Still, the broader goal is sustained symptom management and better overall health outcomes, areas where employers need to increasingly address, suggests Stanley.
She underscored they need to treat hormonal health programs as built-in solutions for a predictable life stage, not accommodations granted on request.
"We know that this is going to impact a large majority of our workforce. Let's create solutions for them where people aren't asking for accommodations or considering it as an intervention, but that it's a solution," she said, also highlighting the new national framework for women's health - a bill currently being read - as a signal that the policy conversation is catching up.
"We want to create programs or include programs in our benefits package that have that proactive design, early intervention, clear navigation, life stage specific supports and access," she said. “That's the solution that we've created to help reduce those poor outcomes.”
