We are writing to you as a collective of physicians and menopause practitioners across Alberta to advocate for the creation of a dedicated billing code for menopause care within the Alberta Health Care Insurance Plan (AHCIP)

This initiative is essential to ensure that physicians are appropriately compensated for the time, expertise, and complexity required to deliver high-quality, evidence-based menopause care — care that supports over half of Alberta’s population through one of the most significant biological transitions of their lives.

The Current Landscape:
Menopause is a universal biological event - every woman, if fortunate to live long enough, will experience it. The average age of menopause in Canada is approximately 51 years, and women will spend one-third to one-half of their lives post-menopause.

Up to 80% experience menopause-related symptoms such as hot flushes, night sweats while many also face mood fluctuations, sleep disturbances, cognitive decline, sexual dysfunction, abnormal menstrual bleeding and fatigue - factors that can profoundly affect quality of life, work performance, and mental well-being.

Beyond symptoms, menopause is a time of physiologic vulnerability. The decline in ovarian hormones increases the risk for:

• Heart disease
• Osteoporosis and fracture
• Weight gain and metabolic dysfunction, and
• Genitourinary Syndrome of Menopause (GSM)—affecting up to 80% of women.

Despite these well-documented risks, menopause care remains one of the most under-recognized and underfunded areas of women’s health.

 
The Problem: Structural Gaps in Care:
The absence of a dedicated billing code is a major barrier preventing equitable access to care.

Current provincial billing codes - such as 03.03B (pregnancy), 03.03C (postpartum), and 08.19G (mental health) - appropriately acknowledge time and complexity for other important life stages. Yet, no such recognition exists for menopause, a transition equally deserving of comprehensive, evidence-based attention.

Menopause management requires:

• Extended, time-intensive consultations (often 30–60 minutes)
• Comprehensive risk assessment (cardiovascular, bone, metabolic, and cancer risk)
• Individualized hormone and non-hormone therapy counselling, and
• Shared decision-making with complex psychosocial considerations.

Under the current compensation model, most physicians cannot sustainably dedicate this level of care. This results in long wait times, fragmented services, and inequitable access - particularly for women in rural or underserved regions who are least able to access private, for-profit alternatives.

 
Proposed Solution: A Dedicated Menopause Billing Code:
We propose the introduction of a Menopause Care Billing Code modeled on the 03.08M structure (extended consultation) with the ability to add incremental time units as needed.

This would recognize the complexity and multidisciplinary nature of menopause care, acknowledging that a single visit may address multiple overlapping issues - cardiovascular risk, mood, sexual function, sleep, bone health, and vasomotor symptoms.

This code should mirror the philosophy of:

• 03.03B – Pregnancy care
• 03.03C – Postpartum care, and
• 08.19G – Mental health care,
  while reflecting the broader, systemic approach needed for midlife health and prevention.
   

Why This Matters:

1. Economic and Workforce Impact: Unmanaged menopause symptoms cost the Canadian economy an estimated $3.5 billion annually in lost productivity, absenteeism, and early retirement (Menopause Foundation of Canada, 2023).
   • 1 in 10 women leave their jobs due to untreated symptoms.
   • Supporting menopause care means keeping skilled women in the workforce, reducing health system burden, and promoting economic stability.
2.  Alignment with Alberta’s Health Priorities: The Government of Alberta’s refocused health care strategy emphasizes patient-centered, efficient, and accessible care. Menopause care fits squarely within this mandate. A dedicated billing code would enable more family physicians to provide this essential service within the publicly funded system, reducing reliance on private or non–evidence-based clinics.
3. Learning from Manitoba: A National Opportunity for Leadership:  In 2024, Manitoba became the first province in Canada to introduce a dedicated billing code for midlife and menopause care—a bold and forward-thinking move that has already improved access and recognition for this critical stage of women’s health. By adopting a similar model, Alberta has the opportunity to lead the country as the next province to prioritize comprehensive, evidence-based menopause care. Doing so would position Alberta as a national leader in health innovation, equity, and preventive medicine—setting a powerful example for others to follow.
4. Preventive Health and Cost Savings: Comprehensive menopause management can mitigate long-term risks of cardiovascular disease, osteoporosis, diabetes, and depression—conditions that represent a substantial proportion of Alberta’s chronic disease costs.

Conclusion:
Menopause care is an essential pillar of women’s health, as significant as pregnancy and postpartum care. By introducing a dedicated menopause billing code with incremental time flexibility, Alberta has the opportunity to:

• Improve patient outcomes and preventive health
• Retain women in the workforce
• Empower physicians to provide evidence-based, comprehensive care, and
• Establish itself as a national leader in advancing equitable midlife health care.

We would greatly appreciate the opportunity to meet with you or your team to discuss this initiative further and to share insights from frontline clinicians delivering menopause care across the province.

Together, we can ensure that Alberta leads the country in recognizing and supporting the health needs of women in midlife and beyond.

Thank you for your continued commitment to improving the health and wellbeing of all Albertans.

Warm regards,
⸻

Signed on behalf of Alberta physicians delivering and championing menopause care across the province.

(Effective December 13th 2025, this petition has been extended to the public and to women across Alberta)