Menopause. It's hot, it's flashy and it's having a moment. Just ask Erin Keaney — or better yet, catch one of her shows.
"O-M-G, I started sweating at four this morning," Keaney tells the audience after bounding on stage sporting a cape and feather boa while a friend points a leaf blower in her direction, as much to cool her down as to create a glamorous windblown effect.
Hot flashes, belly fat and mood swings — nothing is off limits when Keaney takes the stage. A Toronto-based Realtor by day, occasional comic by night, her campy act is part of a growing movement dragging menopause out of the shadows and into the spotlight.
At her latest gig in Toronto, more than 200 people turned up, most of them mid-life women laughingly commiserating as Keaney joked about constantly perspiring and gaining weight.
"Your hormones are slowing down and your body is making pillows for when you fall down," Keaney quipped as the audience erupted in laughter.
Keaney, who is 52, says poking fun at her menopause journey is one way of normalizing a topic that is often spoken about in hushed tones — or not at all.
"I'm just kind of telling my story," Keaney said. "Why should we be ashamed, right? Why is it such a secret, such a mystery?"
Demand for more support, answers
More women are asking that question as the push to rebrand menopause gains momentum, driven in part by a demographic that is both growing and becoming more vocal.
The average age of menopause is 51, which means 12 months have passed since a woman's last period. But the symptoms before that — known as perimenopause — and after, post-menopause, can last for years.
According to a December 2022 Statistics Canada population estimate, there are more than 10 million women over the age of 40 in Canada, a cohort that often feels their menopausal symptoms are dismissed or trivialized.
Samantha Montpetit-Huynh, 52, is a personal trainer based in Toronto. When she started to feel the "change" herself, she started tailoring the workouts she offered to the needs of menopausal women — and the conversation that came with it was immediate.
"Everybody was like, 'Thank God, where have you been?'" Montpetit-Huynh said.
She says the hormonal fluctuations affect women in their 40s and 50s, a time when they're often in the prime of their careers and juggling family responsibilities.
"They're leading a very stressful lifestyle, they're managing their career and kids and home," she said. "My business went through the roof because I was talking to these women and listening to them and giving them some support."
The demand for better support during menopause has fuelled Montpetit-Huynh's fitness business, as a broader market for this demographic is exploding, especially online. There are mid-life influencers on TikTok, celebrity menopause wellness products on Instagram and doctors on other platforms, too, advocating for mature women's health.
There are some questionable claims out there promising quick fixes, experts say, but the flood of "solutions" for menopause — good and bad — stems from a lack of research and knowledge in the medical community.
Shame, stigma from menopause: study
It's a blind spot rooted in the misguided notion that menopause is something women just have to endure, says Trish Barbato, co-founder of the recently created Menopause Foundation of Canada, a national non-profit advocacy group.
"I think what I find the hardest is that women feel that they should just suck it up, that every woman needs to bear this like a burden," Barbato said. "And to me, that's just complete bunk."
Barbato and Janet Ko launched the foundation last year and released a landmark study that found the shame and stigma associated with menopause have often left women feeling blindsided.
WATCH | The National brings together experts to answer questions about menopause:
Ko says that while more people are talking about menopause, awareness among women themselves is lagging.
The study found that while women are usually aware of hot flashes and period changes, she says, many didn't know of dozens of other menopausal symptoms — including heart palpitations, urinary tract infections, anxiety and depression.
"So there's a whole host of symptoms that if you don't understand that that's part of perimenopause and menopause," Ko said, "you're not able to connect the dots — and you're actually not able to manage your own health."
The study's findings support that idea: Among women who turned to their family doctors for help, the study found that many female patients felt undertreated and that their symptoms were trivialized.
So to help women navigate their care, Barbato says, the foundation's website includes contact information for health-care practitioners certified by the North American Menopause Society.
"Women need to optimize every aspect of their life," Barbato said. "We need them as caregivers. We need them to lead their families. We need them to be leaders at work. We need them to be functioning in society.
"They can't do that if they don't sleep every single night."
'This is an important part of health'
Dr. Wendy Wolfman, who is part of the foundation's medical advisory group, says access to care is critical, especially because the likelihood of such conditions as osteoporosis, heart disease and other gynecological complications increase as women enter menopause.
"I've spent the last 22 years of my life trying to fight that attitude [of sucking it up], and it's been such an uphill battle," she said.
Wolfman was one of the first in the country to create a menopause clinic, which opened at Mount Sinai Hospital in Toronto more than two decades ago and is one of only a handful in Canada.
There's a two-year waiting list to see Wolfman, and while Sinai Health Foundation launched a $50-million fundraising campaign in October to expand programs in mature women's health, Wolfman says medical schools need to pay more attention to menopause.
"I can't possibly see everybody, but I'm trying to educate as many people as I can — and we're training as many fellows as we can," Wolfman said. "We need to change our curriculum, we need to modernize it. We need to recognize that this is an important part of health.
"Not every woman gets pregnant," she said, "but every woman who lives long enough will become menopausal."
Wolfman says the lack of knowledge around menopause in both the medical field and the patient population affects access to treatment that could dramatically improve a woman's quality of life.
The most effective treatment for symptoms is hormone therapy, but family doctors can be hesitant to prescribe it and women are even warned against it, despite updated guidelines that Wolfman says showcase it as being a safe and effective option for many women.
"I see these women whose lives are tremendously disrupted and they say, 'You know, I'm not going on hormone therapy, I'm going to tough it out," she said. "And they can't sleep, they can't function at work, and sometimes symptoms last seven to 10 years — years, not months."
Wolfman says she hopes women will advocate for themselves, particularly if they feel they're not getting the health care they need and are having their symptoms trivialized.
"If we're not getting the health care we need, we need to be politically active and speak up," she said.
Women's advocate fielded 100,000 questions in year
More women are doing just that, and they're finding strength and support in doing so. Last fall, Montpetit-Huynh launched her first Hot Flashes and High Heels gathering in Toronto, connecting dozens of women, including Shirley Weir, founder of Menopausechicks.com.
"What I really want women to know is that they are not meant to suffer. We're the first generation of women to turn 50 [who] have 50 more years to plan for," Weir said. "So this is not something to fear, but it's actually this huge window of opportunity where we can step forward, put our health on the front burner."
Based in Vancouver, Weir says she launched her website in 2012 to offer support and a knowledge base for women. She also teaches master classes on navigating menopause. In the last year alone, Weir says, she has fielded more than 100,000 questions.
"Those are new conversations for women. I don't think they're necessarily happening at the annual health appointment with doctors. So it's great that we can step out of the medical community and have those conversations together."
The Hot Flashes and High Heels event took place in a lingerie factory where cocktails were served while local vendors sold undergarments alongside vaginal moisturizers. The venue and the products were intentional, Montpetit-Huynh says, designed to challenge the negative cultural perceptions of aging that contribute to the shame and stigma around menopause.
"I really feel that this, this second stage of life, menopause, it really is an opportunity for women to reconnect and understand that this second stage of life can be their most powerful. They can feel independent and strong and sexy."
Back at the comedy show, Keaney's act is done. As she stands before a giant fan backstage trying to cool off, she says the menopause movement is just heating up.
"I'm just open and I talk about my experience and they say, 'Oh my God, I'm going through the exact same thing.' So something resonates, and if you're open and have the dialogue, we can all support each other."