https://www.infirmiere-canadienne.com/blogs/ic-contenu/2025/08/11/menopause-probleme-de-main-doeuvre-infirmiere
Problems facing health care today poised to become worse in the future
By Ashley Holloway
August 11, 2025
istockphoto.com/FrazaoStudio
Within the context of a profession that is physically, emotionally and mentally demanding, the symptoms of menopause, combined with the stigma associated with discussing its challenges, presents a significant workforce issue within the nursing profession in Canada.
There are three groups of regulated nursing professionals in Canada, the distribution of which varies across the provinces and territories. These regulated members include registered nurses (RNs), nurse practitioners (NPs), licensed practical nurses (LPNs) (known as registered practical nurses in Ontario) and registered psychiatric nurses (RPNs), the total combined supply of which exceeded 431,000 professionals in 2018.
Despite a 17.1% increase in male nurses joining the profession between the years 2013 and 2018, nursing remains a predominantly female profession, and in 2021, the Canadian Institute for Health Information (CIHI) reported that 91% of regulated nurses were female.
In this article, I examine why the safe and effective management of the symptoms of menopause should be viewed as a nursing workforce issue. Coupled with the current trajectory of the health-care system and the demographics of this population, if left unaddressed, it will only worsen in the coming years.
The need for a multigenerational workforce
One of the realities of having a female-dominated profession includes workforce disruptions due to maternity leaves. Due to the frequency with which this occurs, pregnancy and maternity leaves within the profession are normalized, highlighting the importance of having a multigenerational workforce. In Canada, the average age of an LPN is 41, whereas the average age of RNs, NPs and RPNs was between 43 and 44 in 2021. This average has decreased over the past several years, indicating a trend toward a younger workforce within the regulated nursing professions.
With that in mind, the median age of retirement for RNs in Canada, which make up the majority of the regulated nursing professionals, is 63. Likewise, Canadians are living longer than before, and for many reasons, such as financial need and obligation, they continue to work longer than their counterparts from previous generations. This is evidenced by only 44.9% of individuals aged 60 to 64 reporting being fully retired in 2023 compared to a strong trend toward early retirement in the 1980s.
Staffing tug-of-war
Although it is difficult to calculate the rate of attrition of regulated nursing professionals, Statistics Canada reported a 24% increase in job vacancies for RNs and RPNs between the first quarters of 2022 to 2023, the highest increase across all jobs in the labour market. LPNs were not far behind, with a 20.2% increase in job vacancies for the same period. Combined, these statistics reveal a proverbial staffing tug-of-war of the regulated nursing professional workforce today. As such, retention strategies of these health-care workers are a common theme across all provinces and territories.
With more than 50% of Canada’s nurses aged 40 and over, a majority of this workforce is in the age range in which perimenopause traditionally begins. Additionally, it is anticipated that there will be a 27% increase in working women aged 45 to 55 by 2040 in Canada. Although pregnancy and maternity leaves are normalized within the nursing profession, there is little recognition or support for navigating perimenopause, menopause or post-menopause, the symptoms of which can be debilitating.
Cost of menopause
On average, Canadian women spend up to half of their life in a menopausal state, be it in perimenopause, menopause or post-menopause. Although most women reach menopause between the ages of 45 and 55, in some cases, this can begin as early as age 40. Furthermore, nearly one-quarter of women will suffer with severe symptoms. Menopause is more than simply hot flashes and night sweats. The significant decline in estrogen leaves menopausal women at risk for several serious health conditions, including osteoporosis, heart disease and genitourinary issues, the unmanaged symptoms of which cost the Canadian economy an estimated $3.5 billion annually.
Along with hot flashes, night sweats, muscle and joint pain, and genitourinary issues, the symptoms of menopause also include mood changes, depression, memory loss, insomnia and sexual problems. Furthermore, 44 to -62% of women also report experiencing an increase in cognitive decline as a result of these symptoms. Within the context of a profession that is physically, emotionally and mentally demanding, the symptoms of menopause, combined with the stigma associated with discussing its challenges, presents a significant workforce issue within the nursing profession in Canada. Supporting research includes the following:
- In a recent exploratory study that examined the effect of menopause on the caregiving abilities of regulated nursing professionals, authors Vanderzalm et al. (2023) found that participants reported experiencing a significant amount of anxiety related to their ability to provide patients with safe, effective care due to the symptoms of menopause.
- In addition, the Menopause Foundation of Canada recently released a report titled Menopause and Nursing in Canada,which highlights some of the barriers that nurses face in relation to managing the symptoms of menopause at work. These barriers include the inability to consistently practice symptom alleviation habits due to shift work.
- Moreover, Vanderzalm et al. (2023), also supported by the Menopause Foundation of Canada report, found that nurses were often reluctant to speak with their co-workers and managers out of a fear of negative consequences, a lack of trust in leadership and the entrenched workplace culture of “pushing through,” no matter the cost. The mental and emotional impact of the symptoms of menopause can also be equally as debilitating, leaving some nurses feeling a lack of self-confidence, shame and low self-esteem. Furthermore, absences from work often result in an increased workload for staff, thus perpetuating the cycle of absenteeism and promote turnover, which may compromise patient care.
The federal government recently developed the Nursing Retention Toolkit, which focuses on overarching strategies to create a positive and supportive workplace environment, safe staffing practices, professional development and mentorship opportunities, and other key areas of improvement. Although these macro-level strategies are a move in the right direction, more focused attention to this unique issue within the regulated nursing professions is required.
Recommendations
The Menopause Foundation of Canada calls for more specific measures to be taken, such as starting with normalizing the discussion around this topic and its effects in this particular context. These measures are aimed at the general population, but apply well to the nursing profession.
In their Menopause and Nursing in Canada report, recommendations are separated into four broad buckets: “work to change nursing culture,” “education,” “better working conditions,” and “better benefits.” These recommendations include the following:
- Emphasize the need for educating managers and colleagues about the detrimental effects of these unmanaged symptoms and promoting dedicated actions to reduce the stigma around menopause and its symptoms.
- Create supportive working conditions, including more balanced and flexible shift schedules.
- Leverage the experience of older nurses through the development of mentorship roles.
- Tailor the design of the physical spaces and break rooms to create more comfortable workspaces and the provision of specific resources and mental health supports for menopause, such as counsellors who are familiar with this population, and the introduction of dedicated sick time.
To some, the implementation of these recommendations could be interpreted as misspent tax dollars. However, the COVID-19 pandemic exposed existing challenges in an already-stressed health-care system in Canada and introduced several negative unintended consequences, such as increased rates of substance abuse and self-harm, as well as a higher prevalence of mental illnesses.
The shortage of family physicians across the country, the changing health needs of Canadians, the large number of health-care workers nearing the age of retirement, and severe workplace stress all demand the full attention of Canada’s regulated nursing professionals. Supporting the regulated nursing professionals is paramount to creating a sustainable health-care system for today and for the future. Without them, there is no system.
Ashley Holloway, MPH, LPN, G.Dip. GBLD, CD, is a nurse, writer and editor who teaches writing and health-care leadership in Calgary and serves as editorial director at Unleash Creatives.
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