Menopause Hormone Therapy: 2023 Update


  • Denise Black, MD Department of Obstetrics and Gynecology, University of Manitoba



The publication of the Women’s Health Initiative (WHI) study in 2002 caused a precipitous decline in use of menopause hormone therapy (MHT). Prior to publication, approximately 43% of women aged 45–74 used MHT; following publication, this number dropped to 11%. Fear of breast cancer was the largest motivator behind this decline. Since the WHI study, menopause medical education has been inadequate; it is estimated that 41% of medical schools do not include menopause education in their undergraduate curriculum. The same study highlighted significant knowledge gaps regarding menopause management among practicing physicians.

Menopausal women are asking questions and expecting answers. Advocacy groups such as the Menopause Foundation of Canada are empowering women to acknowledge the impact of menopausal symptoms on the workplace, personal relationships and personal health. As MHT is considered first-line therapy (in the absence of contraindications), it behooves healthcare providers to have a working knowledge of MHT.

Author Biography

Denise Black, MD, Department of Obstetrics and Gynecology, University of Manitoba

Dr. Denise Black is a graduate of the University of Manitoba School of medicine and she completed residency training in OB/GYN in Manitoba as well. In a career that spans 4 decades, she has been involved in both the academic and private practice. While in academia, Dr. Black served as the Director of the post graduate medical education program in Obstetrics and Gynecology and served as an examiner for the Royal College. She also was the OB/GYN consultant for the Manitoba HIV team during the early years when intrapartum AZT was first introduced as a way to reduce vertical transmission. Access to appropriate and timely contraceptive care is a professional passion, and advocacy, education, and removing barriers to access is a personal mission. Dr. Black has published in both the fields of contraception and menopause and worked as an author of the SOGC menopause guidelines.


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How to Cite

Black D. Menopause Hormone Therapy: 2023 Update. Can Prim Care Today [Internet]. 2023 Oct. 25 [cited 2024 Apr. 19];1(3):17-21. Available from: