Menopause is a natural life stage, but for many women, the symptoms can be unexpected, frustrating, and have a real impact on daily life and overall well-being. Understanding your treatment options—and what is covered under your ASEBP benefit plan—can help you make informed decisions alongside your healthcare providers. 

Understanding menopause and perimenopause 

Perimenopause is the transition period leading up to menopause, when hormone levels begin to fluctuate. This phase can start several years before the final menstrual period and often brings physical and emotional symptoms such as hot flashes, night sweats, irregular periods, sleep disturbances, and mood changes. For some women, these symptoms can affect work, relationships, and quality of sleep. 

Menopause is defined as the permanent cessation of menstruation and typically occurs between the ages of 45 and 55. Symptoms may last anywhere from two to eight years. Research suggests that about 25 to 30 per cent of women seek medical treatment to manage menopause-related symptoms. 

Early recognition of perimenopause and timely medical advice can help reduce the severity and long-term impact of symptoms. 

Treatment options for menopause symptoms 

There is no one‑size‑fits‑all approach to menopause treatment, and needing support or treatment is common and valid. Every woman’s experience is unique, and treatment decisions depend on symptom type, severity, medical history, and personal preferences. Broadly, treatment options fall into four categories. 

Hormone therapy 

Hormone therapy remains the most commonly prescribed and effective treatment for many menopausal symptoms. It typically involves estrogen alone or a combination of estrogen and progesterone. 

Hormone therapy is widely used to manage hot flashes, night sweats, vaginal dryness, and irregular periods. It is available in many forms, including tablets, patches, gels, and vaginal products. Brand‑name and generic options are available. ASEBP covers prescription hormone therapies for menopause that are licensed by Health Canada and have an approved indication. Coverage for newly approved products may be added following appropriate national and provincial review processes. 

While hormone therapy is effective for many women, it may not be appropriate for those with certain health conditions or risk factors. Decisions about hormone therapy should always be made in consultation with a healthcare provider. 

Non-hormonal prescription treatments 

Some women prefer non-hormonal treatments or are unable to use hormone therapy due to medical reasons, personal values, or comfort level. 

In recent years, manufacturers have developed new non-hormonal medications to address menopausal symptoms. A newer class of drugs, known as neurokinin 3 (NK3) receptor antagonists, target the brain pathways involved in temperature regulation. 

The first medication in this class, Veozah® (fezolinetant), was approved in Canada in December 2024 for the treatment of moderate to severe hot flashes. Additional medications in this class are under review and are expected to be approved in the coming years. 

These treatments may provide an important option for women who are not candidates for hormone therapy or who prefer a non-hormonal approach. NK3 medications are expected to cost approximately $200 to $250 per month and require approval through ASEBP’s Special Authorization program, which includes robust clinical criteria that must be met before coverage is considered. 

Alternative and non-drug approaches 

Some women choose complementary or lifestyle-based approaches to symptom management. These may include herbal remedies or natural health products such as vitamins, minerals, or homeopathic preparations. Under ASEBP benefits, certain non‑prescription products may be eligible for reimbursement through Wellness Spending Accounts (WSA 1 and WSA 2). Eligible items include over‑the‑counter remedies that have a Drug Identification Number (DIN) printed on the label, such as pain relievers or cold medications, as well as vitamins and supplements (e.g. vitamin D, ginkgo biloba, etc.).  

Non-drug strategies—such as dressing in layers, using fans, avoiding triggers like hot beverages, and maintaining a cool sleeping environment—may also help manage symptoms for some individuals. 

It is important to discuss any natural health products with a healthcare provider or pharmacist, as these products may not be effective for everyone and are not always supported by strong scientific evidence. 

Bioidentical hormone therapy 

Bioidentical hormone therapy often refers to compounded hormone products. These are customized hormone mixtures prepared by pharmacists to meet individual patient needs and are often marketed as “natural” alternatives to Health Canada–approved hormone therapies.  

Major North American medical organizations caution against their use due to safety concerns, including lack of regulation, inconsistent dosing and limited scientific evidence regarding their effectiveness and safety. 

Trusted menopause resources 

If you need additional information on available support and symptom management, you may also find these resources helpful: 

• Menopause Hub – Evidence-based information supported by Canadian expert groups 

• Menopause Tool – An interactive tool to explore symptoms and management options 

• Menopause and U – A comprehensive resource addressing menopause treatment questions 

Bottom line 

Menopause symptoms can have a meaningful impact on daily life, and for many women, that impact is significant. Effective treatment options are available, and support is available when symptoms become challenging. Seeking advice early and understanding both hormonal and non‑hormonal options can help you manage symptoms and maintain your quality of life. 

The information provided in this article is for personal use, reference, and education only. ASEBP does not provide medical advice. Before starting any medication or product, you should always consult with your pharmacist, health care provider, or call Alberta Health Link at 811.