Closing The Gap: A Provincial Framework For Menopause Health in Ontario

British Columbia and Manitoba have both moved to cover menopause hormone therapy through their public drug plans. Ontario has not. Transdermal estrogen and micronized progesterone are frequently recommended for women with an elevated risk of venous thromboembolism, since current evidence indicates a lower VTE risk with the transdermal route than with oral estrogen in appropriate patients. Oral estrogen remains a reasonable choice for many other women. Ontario women who already qualify for the Ontario Drug Benefit program may seek case-by-case coverage of the transdermal route through the Exceptional Access Program; women who are not ODB-eligible have no such option and pay for it themselves. This paper lays out a five-part framework, built by Menopause Matter, for closing that gap: drug coverage, physician training, better data, workplace support, and a clearer path to care. It identifies the administrative mechanism, already in place under the Ontario Drug Benefit Act, through which this change can be evaluated without new primary legislation, and provides a transparent, scenario-based estimate of the likely fiscal scale.