‘Desperation’ drives women to private menopause care

Some women are paying private clinics up to four times the amount the public health system pays doctors for menopause primary-care visits patients can get free.

One Winnipeg woman said “desperation” drove her to make an appointment with a private clinic that charges $385 for an initial assessment by a nurse practitioner.

Erika, who did not want her last name published, said for the past year she’s suffered worsening menopause-like symptoms, including night sweats, brain fog and heavy menstrual periods. The single mother who works two jobs and turns 40 this summer said her family doctor and another primary-care physician she went to both told her she’s too young for menopause.

Neither, evidently, assessed her for perimenopause, the transition leading to menopause. During that time — which can begin when a woman is in her 30s and last for several years — hormone levels fluctuate and produce, in many cases, the symptoms Erika described.

“To be dismissed repeatedly that I’m too young is very frustrating,” said the woman, who made an appointment next month with Menopause Practice Inc. on the advice of others who’ve had similar experiences.

“I’m so desperate to have help, I’m willing to pay for service,” she said Friday. “I know there’s many, many women who can’t.”

Doctors Manitoba president Dr. Nichelle Desilets said women need to know they can get a menopause assessment free of charge.

“It is important for all Manitoba women to know that menopause assessments by physicians are fully covered under medicare as essential medical care,” Desilets, a family physician in Neepawa, said in an email.

The province pays $96.33 for the physician’s time and all other costs, such as the clinic space, staffing and supplies, according to the physician advocacy organization.

Manitoba’s Health Services Insurance Act prohibits any physician charging more to a patient paying privately than the province would pay for the same medically necessary service under the public system. Nurse practitioners working outside the public health-care system don’t face those restrictions.

Demand for their services surged after the previous Progressive Conservative government closed the Mature Women’s Centre — a one-stop shop for menopause treatment at the Victoria Hospital — in 2017.

That closure — and an estimated 150,000 Manitobans without a primary-care doctor — opened the door slightly to two-tiered health care, with some desperate women opting to pay out of pocket to be seen by a private nurse practitioner.

On Monday, the NDP government announced the opening of the Manitoba Menopause Clinic in fall 2027 to close the gap and expand care.

“Some private clinics offer health and wellness services beyond the scope of medically necessary care, which are not insured under the public system,” Health Minister Uzoma Asagwara said in a statement Friday.

“Patients have the option to pay for those services.”

Since April 1, the Canada Health Act requires provinces to ensure that patients aren’t charged for medically necessary care when a service would otherwise be covered if provided by a physician.

Federal health-funding transfers could be clawed back if a province doesn’t comply with the act.

Last year, Manitoba doctors billed for 13,012 menopause assessments, with many more women receiving menopause advice and care during other check-ups, Doctors Manitoba said.

Dr. Omolayo Famuyide, a certified Menopause Society of Canada practitioner and board member, runs a Winnipeg women’s health clinic in the public system that devotes two days a week to menopause care.

“It’s exploded in the last 2 1/2 years,” she said.

“A big driver has to do with media coverage, and women advocating for themselves and demanding more from clinicians and employers.”

Menopause can be a challenge to treat because there’s no single diagnostic test and symptoms vary, she said.

Famuyide described women in their 40s and 50s who may be caring for children and/or parents while at the peak of their careers when they’re hit with heavy bleeding, erratic periods, hot flashes and brain fog.

“They want some level of support for their symptoms,” she said, noting she has patients who travel from as far away as Thompson, something that could be avoided if the province funded virtual visits for menopause care, reducing wait times.

Manitoba’s new menopause clinic, which will be located on Kenaston Boulevard in south Winnipeg, will include virtual care for women across the province, with nurse practitioners as part of a multi-disciplinary team, Asagwara said earlier.

For now, Manitoba is committed to remaining in compliance with the Canada Health Act, the minister said Friday.

“We… will continue working with nurse practitioners and other partners to take further steps to enhance care, clarify services, improve access and ensure care is delivered within a clear, consistent framework that protects patients, upholds national standards and strengthens public health care in Manitoba,” Asagwara said.

carol.sanders@freepress.mb.ca