Menopause Hormone Therapy in 2025

Abstract

Menopause is, in fact, a single day officially marked one year after the cessation of menses. It is followed by post menopause which can last for half of a women’s adult life! Menopause typically occurs between the ages of 46 and 52 years with an average age of 51. It signifies the end of reproductive function, and is marked by fluctuating and declining hormone levels, which can lead to a range of often distressing symptoms. The perimenopause is the transition phase that precedes menopause, lasting up to 10 years. For many women, menopausal symptoms may first appear later in the perimenopause. While we use the term “women”, guidance applies to all patients who experience menopause, even if they do not identify as a woman.

When people use the term “menopause” they are usually referring to the “climacteric”, a period which includes the perimenopause, menopause, and early post menopause stages.

In Canada, over 2.5 million women are between the ages of 45 and 55, and up to 80% of them will experience menopause-related symptoms. There are now over 30 validated symptoms of menopause, some of which can have a significant impact on function and quality of life. A recent study by the Menopause Foundation of Canada reported that up to 10% of women will leave the workforce due to unmanaged menopausal symptoms.

The most impactful symptoms of menopause include vasomotor symptoms (VMS) which include hot flashes and night sweats, sleep and mood disturbances, memory issues, muscle and joint pains, and symptoms of the Genitourinary Syndrome of Menopause (GSM) such as vaginal dryness, bladder issues, and sexual dysfunction.  Recent evidence has shown that frequent or severe menopausal vasomotor symptoms are linked to a higher risk for illnesses including cardiovascular disease and diabetes.