Quebec associations concerned about menopausal hormone therapy practices

A woman speaks with a doctor. (CDC/pexels.com)

Menopause has received significant media attention in Quebec in recent years, with many women seeking relief from its side effects.

However, “concerning practices” have been raised by three professional associations, which issued two joint statements, one to members and the other to the public, on Wednesday morning.

In the messages, the Collège des médecins du Québec (CMQ), the Ordre des infirmières et des infirmiers du Québec (OIIQ) and the Ordre des pharmaciens du Québec (OPQ) reiterated the importance of following ethical best practices.

In particular, the associations expressed concerns about certain practices among health care professionals.

Media reports have already highlighted cases of patients being prescribed excessive hormone doses too quickly, with others undergoing unnecessary blood tests.

“In recent months, the CMQ and the OIIQ have been contacted on several occasions regarding concerning practices related to the care of women presenting with symptoms associated with perimenopause and postmenopause,” reads the advisory sent to professionals. “Additionally, the OPQ has had to answer numerous questions regarding hormone therapy.”

The three associations say they wish to remind “physicians, nurses — particularly specialized nurse practitioners — and pharmacists who provide care and services related to hormone therapy of their professional and ethical obligations,” to ensure the public’s safety, particularly when it comes to prescriptions, advice and the dispensing of products.

“Physicians, nurses — particularly specialized nurse practitioners — and pharmacists are required to exercise rigour when prescribing or recommending paraclinical tests," the notice states. “These must be ordered based on clinical assessment and supported by evidence and recognized guidelines. Prescribing unnecessary, extensive or clinically unproven tests violates professional and ethical obligations.”

Relying on evidence

The notice to patients mentions that several approaches exist for menopausal symptoms, but not all are supported by scientific evidence.

It adds that patients are encouraged to consider hormone therapy treatments approved by Health Canada, which ensures that efficacy and safety standards are met.

“Given the multitude of treatments for menopausal symptoms available on the market, it is important to remember that not all of them are based on established scientific evidence,” said CMQ President Dr. Mauril Gaudreault. “Physicians must act in accordance with their ethical obligations when guiding a patient through hormone therapy.”

If a patient wishes to alleviate the effects of menopause, pharmacists and physicians are asked to assess the symptoms and discuss possible options to find the right treatment.

Pharmacists, for their part, can monitor therapies and make adjustments as needed, in collaboration with physicians and nurses, noted OPQ President Jean-François Desgagné.

“Like all health care professionals, pharmacists have an obligation to rely on evidence-based data and only recommend products approved by Health Canada, a fundamental guarantee of safety for patients,” he said. ”It is in this spirit that the OPQ has joined the CMQ and the OIIQ to remind all relevant professionals of their ethical obligations, so every woman can receive rigorous, safe and personalized care.”

OIIQ President Luc Mathieu adds that nurses and specialized nurse practitioners play a “key role in informing and supporting women so they can make decisions that respect their needs and well-being.”

“Perimenopause and menopause can have significant impacts on women’s daily lives, as well as their physical and mental health. It is essential that they be able to count on high-quality support and safe care,” said Mathieu.

The statements also address the issue of specialization, stating that professional titles are strictly regulated by law and there is no recognized medical specialty in hormone therapy or menopause for physicians or nurses.

They add that physicians, nurses and pharmacists must not promote one brand or type of hormone therapy over another.

Furthermore, hormone therapy may only be initiated with a patient’s free and informed consent given “without undue pressure or influence,” and can be withdrawn at any time.

The Canadian Press’s health coverage is supported by a partnership with the Canadian Medical Association. The Canadian Press is solely responsible for this journalistic content.

This report by The Canadian Press was first published in French on April 15, 2026.