How do I get HRT in Ontario?

"You'll have to wait for a specialist."

Who can prescribe it

Menopause hormone therapy is a prescription treatment, so the first step is a clinician who can assess you and prescribe. In Ontario that includes a nurse practitioner. The College of Nurses of Ontario says NPs are authorised to diagnose, order and interpret diagnostic tests, and prescribe medications.

At Hormone Therapy Ontario that's a Nurse Practitioner, who assesses you, orders your bloodwork, writes your plan and sees you at follow-up.

Is it even worth asking?

Yes. Canada's obstetrician-gynaecologist society, the SOGC, calls hormone therapy the most effective treatment for hot flashes and night sweats. Ontario Health's menopause quality standard says that from age 40, clinicians should ask about menopause-associated symptoms, and notes that guidelines recommend menopause hormone therapy as the first-line treatment for hot flashes and night sweats.

Source: SOGC Guideline No. 422a (2021); Ontario Health, Menopause Quality Standard.

So if you've been putting it off because you assumed you'd be waved away, you're allowed to ask.

How it goes, step by step

1. Assessment, online. Your symptoms, history and medications, in your words, from home. Bring your list.
2. Bloodwork, if it helps, at a lab near you. Ordered when it will change a decision, at a local collection centre with our requisition.
3. A plan you understand. Hormone therapy if it's appropriate, non-hormonal options if it isn't, and the reasons either way.
4. Follow-ups. Check in, adjust, repeat bloodwork when it's due.

Bring a list, not a score out of ten

The 3am symptoms are gone by the 3pm appointment. A list doesn't forget. "I lose words mid-sentence" tells the NP more than a score out of ten, and your assessment starts from it.

What if I don't have a family doctor?

"Come back when you have a GP."

You're far from the only one: about 2.3 million Ontarians don't have a family doctor.

Source: Ontario's family doctors' college (OCFP), 2024 figure.

You can book with us directly. You don't need to wait for a referral. The assessment, the requisition, the prescription if appropriate, and the follow-ups all happen here, with a Nurse Practitioner.

If you do have a family doctor, or get one later, nothing changes in how we see you. We can send them a summary, with your permission. That's your call, not ours.

What will it cost?

Three parts: our visits, your bloodwork, the medication. Bloodwork usually goes on your Ontario health card. The medication is covered by a public plan only if you're 65+ (Ontario Drug Benefit) or 24 and under without a private plan (OHIP+); otherwise it's your drug plan or the pharmacy.

Source: ontario.ca, What OHIP covers: medically necessary lab tests, including at community labs, when a nurse practitioner orders them (https://www.ontario.ca/page/what-ohip-covers).

Source: ontario.ca, Ontario Drug Benefit and OHIP+.

Will I definitely get it?

Not definitely. Hormone therapy isn't right for everyone, and we'll tell you if it's not for you. If it isn't, there's a plan B: non-hormonal prescription options exist for hot flashes and night sweats.

Source: SOGC Guideline No. 422a (2021).