Amid a wave of frank and open discussions about women’s health, more plan sponsors are beginning to review their benefits and human resources policies with an eye to providing better support.
It’s something that a group of health-care experts, speaking during a panel discussion at Benefits Canada’s 2024 Chronic Disease at Work conference in February, said could make a big difference to addressing historical barriers to health-care that those assigned female at birth have faced.
“I think it’s really important to recognize that 33 per cent of women report that their benefits plan does not provide enough coverage to meet their health needs, whereas only 17 per cent of men say the same thing,” said Carmen Bellows, registered psychologist and director of mental-health solutions at Sun Life Financial Inc., referencing the insurer’s 2022 survey of more than 2,300 working Canadians.
Read: Canadian women share what evolving benefits and workplace policies mean to them
Also speaking during the panel, Patricia Lee, founder of Canadian Women with Fibroids, highlighted the impact of uterine fibroids on women in the workforce. Uterine fibroids are tumours that grow in a woman’s uterus. While they’re typically not cancerous and many women who have them don’t experience symptoms, they can cause painful and heavy periods, pelvic pressure, constipation and more. One in four women are diagnosed with fibroids by age 30 and one in three by age 40.
Lee herself was diagnosed with fibroids at age 34 after a blood transfusion, setting off a “decade of turmoil” while she learned to manage a chronic health condition. Leading up to her diagnosis, she experienced heavy bleeding during her periods for a couple of years, but “we’ve learned over time that periods are supposed to be painful or supposed to be heavy and, for that reason, we tend to ignore when that’s happening to us.”
Uterine fibroids can significantly impact women’s quality of life and their productivity at work, Lee said. Without adequate treatment, women often withdraw from activities they enjoy due to pain or discomfort. But because women are often required to start at the bottom of the treatment ladder after a diagnosis and treatment options vary province-by-province, she said they need help navigating the health-care system and what’s covered under their insurance.
Read: Just 14% of U.S. women say employer recognizes need for menopause benefits: survey
Bellows said it’s important for employers looking to better support women plan members to implement policies and benefits to become menopause-inclusive workplaces.
Menopause typically begins between ages 45 and 55 — coinciding with the time women are reaching their peak earning years and taking on more senior roles in their career. There are five million working Canadian women aged 40 and older, meaning roughly a quarter of the Canadian workforce could be experiencing menopause symptoms.
While Bellows noted menopause is a phase of life for anyone who menstruates, half of women feel uncomfortable discussing it. The silence around menopause has left one in two women feeling unprepared for the transition and the associated health impacts, according to a Menopause Foundation of Canada study.
“We do need to educate ourselves [and] recognize that menopause affects women very differently throughout their lifetime,” she said, noting the Menopause Foundation’s study found, on average, a woman will experience seven of the more than 30 identified symptoms of menopause.
Read: A look at the U.K.’s menopause-supportive workplaces
Those symptoms, which include hot flashes, poor sleep, depression, joint pain and brain fog, can be debilitating. One in 10 women exits the workforce every year due to their menopause symptoms. “When we think about the potential losses — economically, intellectually — within the workforce, we need to act.”
Bellows stressed the value of menopause education, to ensure women know more about that phase of life and empower them to seek out various treatment options. She also suggested employers ensure their benefits plans have adequate coverage for psychologists, clinical counsellors and other mental-health practitioners and that their drug formularies cover hormone replacement therapy, the most effective treatment for menopause symptoms. She also noted new clinical research indicates that hypnosis can help reduce hot flash frequency.
Also speaking during the panel, Dr. Mita Manna, medical oncologist at the Saskatchewan Cancer Agency and assistant professor at the University of Saskatchewan, underlined the impact of breast cancer on working women. Breast cancer patients tend to have unique challenges, as many are in the midst of their careers and often have caregiving responsibilities for children and/or elderly parents. She also noted patients may have to deal with the financial implications of taking time away from work and possibly travelling to access treatment. Young women are also often induced into early menopause by their cancer treatments.
Manna’s practice is made up predominantly of breast cancer patients ranging from as young as age 20 to those aged 80 and older. While her team is able to help women manage the short-term side effects of cancer treatment, including hair loss and nausea, they often struggle with the long-term side effects. This is partly because breast cancer patients often have to take hormone-suppressing medications, which slow or stop hormone-sensitive tumours. Those longer-term side effects are also often occurring as women re-enter the workplace, she said, adding people returning to work from a cancer-related leave of absence can benefit from flexibility in their schedule to attend appointments and manage symptoms.
Read: Back to basics on menopause support
Manna also works with a small group of metastatic stage four cancer patients. While it’s a terminal diagnosis, many are living longer — upwards of five years or more — and are able to continue participating in the workforce with accommodations.
Both Lee and Manna stressed the importance of quick coverage of innovative drugs and treatments by private payers. Women are often left waiting for new uterine fibroid treatment options to be recognized and covered by their insurance, after established treatments haven’t worked. “Insurance companies tend to say, ‘well, we’ve already got this treatment medication and it works, so why should we cover that [new] medication?’” said Lee.
The time between a Health Canada approval for a new cancer therapeutic and its coverage by private plans is often months or years, though pharmaceutical companies sometimes provide compassionate access. It can delay patients’ access to critical new drugs or force them to pay out of pocket, Manna said.
“That is one of the biggest gaps and detriments [in benefits], where patients are not only dealing with the stress of cancer but also having to deal with figuring out the paperwork, communicating with their insurers . . . and get everything all sorted out.”
Read more coverage of the 2024 Chronic Disease at Work conference.