Understanding Menopause

Menopause marks the end of menstrual cycles, confirmed after 12 consecutive months without a period. The average age of menopause in Canada is 51 years.

It’s caused by the natural decline of ovarian hormone production — primarily estrogen, progesterone, and testosterone.
These hormonal changes can affect the body in many ways, impacting sleep, mood, energy, cognition, sexual function, and bone health.

Common Symptoms

  • Hot flashes and night sweats (vasomotor symptoms)
  • Sleep disturbance or insomnia
  • Mood changes, irritability, or low mood
  • Fatigue and difficulty concentrating
  • Vaginal dryness, itching, or pain during intercourse
  • Urinary urgency or recurrent infections
  • Decreased libido
  • Weight gain or bloating
  • Muscle and joint discomfort

Our Menopause Care Program at our Winnipeg Walk-In Clinic

We provide individualized care designed around your stage, symptoms, and health profile.
Our program includes:

  • Comprehensive medical assessment
  • Hormone testing (if indicated)
  • Review of cardiovascular and bone health risks
  • Personalized treatment options
  • Ongoing follow-up and dose adjustments

Menopausal Hormone Therapy (MHT)

MHT — also known as Hormone Replacement Therapy (HRT) — remains the gold standard for managing moderate to severe menopausal symptoms.

When started within 10 years of menopause or before age 60, MHT can:

  • Reduce hot flashes and night sweats by up to 95%
  • Improve mood, sleep, and cognition
  • Prevent osteoporosis and fractures
  • Improve vaginal and sexual health
  • Reduce cardiovascular risk in healthy women

Types of Hormone Therapy

Estrogen Therapy (ET):

  • Available as transdermal patches, gels, or creams
  • Safest route for heart and clotting risk reduction

Progesterone Therapy:

  • Protects the uterine lining from overgrowth
  • Bioidentical micronized progesterone supports sleep and calmness

Combination Therapy:

  • Tailored for patients with an intact uterus
  • May include estradiol with progesterone or a selective estrogen receptor modulator (TSEC)

Non-Hormonal Options

For women who cannot or prefer not to use hormones:

  • Fezolinetant– new Health Canada–approved non-hormonal treatment
  • SNRIs/SSRIs– venlafaxine, desvenlafaxine, escitalopram
  • Gabapentin or oxybutynin– for night sweats and sleep disturbance
  • Lifestyle and Behavioral Therapies:
  • Cognitive Behavioral Therapy (CBT)
  • Mindfulness and stress reduction
  • Weight management and exercise

Monitoring and Safety

We prioritize safety through:

  • Regular follow-ups
  • Mammogram and pelvic screening
  • Hormone level monitoring (if appropriate)
  • Annual risk assessment for cardiovascular and breast health
  • Dose adjustments based on ongoing evaluation

Frequently Asked Questions

Q: Is hormone therapy safe?
Yes — when started within 10 years of menopause or before age 60, the benefits generally outweigh the risks for most women. We use government-regulated, bioidentical formulations for safety and consistency.

Q: What are “bioidentical” hormones?
They are hormones identical in molecular structure to those your body naturally produces (e.g., estradiol and micronized progesterone).

Q: Do I need hormone testing?
Diagnosis of menopause is usually clinical, but testing may help guide treatment or assess balance once therapy begins.

Q: How long should I stay on MHT?
There is no mandatory time limit. Treatment duration is individualized, based on symptoms, quality of life, and ongoing evaluation.

Q: What if I can’t take hormones?
We can discuss several non-hormonal prescription and lifestyle options to help manage symptoms safely and effectively.

PATIENT RESOURCES

Helpful Links

Lifestyle Tips for Symptom Relief

  • Maintain a balanced diet rich in calcium and vitamin D
  • Engage in regular physical activity
  • Avoid smoking and limit alcohol
  • Manage stress with mindfulness or yoga
  • Prioritize sleep hygiene