What you were told
"You're too young for menopause."
Perimenopause and menopause. HRT, BHRT and MHT online, when they're right for you.
Perimenopause symptoms often arrive while your periods are still coming, just changing. Night sweats, broken sleep, brain fog and mood changes are worth an assessment, whatever your age. Hormone Therapy Ontario is an online menopause clinic for adults anywhere in Ontario, where a Nurse Practitioner goes through menopause hormone therapy, and the options besides it, with you, plainly.
What it sounds like before anyone says "perimenopause".
"I wake up soaked."
Night sweats are hot flashes at night, sometimes enough to change the sheets.
"I'm wide awake at 3am."
Falling asleep is hard, or you wake in the small hours and stay awake. Broken sleep often comes with night sweats, and it makes everything else louder.
"I lose words mid-sentence."
Brain fog. Losing words, losing your train of thought. It doesn't sound like hormones at all, which is why it gets missed.
"I snap, or cry, and don't know why."
Irritability, low mood, tearfulness or a new kind of anxiety that feels out of character.
"My periods have gone unpredictable."
Closer together, further apart, heavier, lighter or skipped. Often the first clear sign of perimenopause.
Ontario's menopause quality standard asks clinicians to ask about menopause symptoms from age 40. If nobody asked you, we will.
Source: Ontario Health, Menopause quality standard (September 2026).
Menopause hormone therapy, plainly.
What it is
"HRT is too risky for anyone."
Menopause hormone therapy is prescription hormone treatment for menopause symptoms. MHT, menopausal hormone therapy, is simply the newer name for HRT. Hormone therapy is the most effective treatment for hot flashes and night sweats.
Source: SOGC Guideline No. 422a (2021).
Ontario's quality standard says people with hot flashes or night sweats should be offered menopausal hormone therapy as first-line treatment, after their risks, benefits and preferences are assessed.
Source: Ontario Health, Menopause quality standard, Quality Statement 4.
Who it usually suits
The Menopause Society says that for women under 60, or within 10 years of menopause, with no reason to avoid it, the benefits for bothersome hot flashes, night sweats and bone loss outweigh the risks. Starting after 60, or more than 10 years out, the balance is less favourable. The type, the dose, how long, how it's taken and when you start all change the picture. Your clinician goes through your own risks.
Source: The Menopause Society, 2022 hormone therapy position statement.
Who goes carefully
If you've had breast cancer, a blood clot, stroke or heart attack, liver disease or unexplained vaginal bleeding, we go carefully. That's why your history comes first, and nothing is prescribed on a form.
Bioidentical hormones (BHRT)
Bioidentical describes the molecule. It doesn't mean natural, and it doesn't mean safer.
Plan B
There's a plan B. Non-hormonal prescription options exist for hot flashes and night sweats, for people who can't or would rather not use hormones. If hormone therapy isn't right for you, we'll tell you, and tell you why.
Source: SOGC Guideline No. 422a (2021).
What menopause care here involves.
- Assessment with the NP, online, from home. Your symptoms, history and medications, in your words. Bring your list.
- Bloodwork if it's useful, at a lab collection centre near you, with our requisition. Ordered when it will change a decision. It's the only in-person step.
- Hormone therapy where appropriate, or non-hormonal options, with the reasons either way.
- Follow-ups online, from home. Check in, adjust, repeat bloodwork when it's due.
Your care is led by a Nurse Practitioner at every step. You can book with us directly. If you do have a family doctor, we can send them a summary, with your permission.
No clinic to get to. Your visits happen online, from home, anywhere in Ontario.
Three parts to the bill.
- Our visits: the assessment and follow-ups.
- Bloodwork: usually your Ontario health card.
- Medication: a public plan if you're 65+ (Ontario Drug Benefit) or 24 and under without a private plan (OHIP+). Otherwise your workplace drug plan, or you at 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+ eligibility.
Asked plainly
Answered plainly.
01Am I too young for perimenopause?
Symptoms often arrive while your periods are still coming. If they're getting in the way, that's reason enough for an assessment, whatever your age.
02How do I get HRT in Ontario?
Book an assessment with a clinician who can prescribe it. A nurse practitioner can.
03Can I get HRT without a family doctor?
Yes. You can book with us directly.
04Do I need a hormone test first?
Usually not. For most people, symptoms are enough to identify perimenopause or menopause.
05Is hormone therapy safe?
For most healthy women under 60, the benefits generally outweigh the risks. Your own risks still get checked.
Some things don't wait for a list. Bleeding after menopause, or a new breast lump: contact a clinician promptly or call Health811 (811). Chest pain, sudden weakness or stroke signs: call 911.
Ask us. We'll give you a straight answer.
Tell us it's the Hers door and how to reach you. We'll call to book your online assessment.
In an emergency, call 911.