New data from Manulife Canada's Group Benefits business shows HRT claims among women aged 45 to 54 rose 228% over the past five years, with the sharpest growth occurring in just the past two years.
Claims among women aged 35 to 44 rose 46% over the same period, and those aged 55 to 64 rose 66%, meaning growth was steepest but not confined to the age group most associated with menopause onset.
"For many years, HRT was used more cautiously due to concerns about potential health risks," said Dr. Farzana Haq, physician lead of women's health at Cleveland Clinic Canada, which serves as medical director for Manulife's Group Benefits business. "Today, we have a much stronger body of evidence showing that HRT can be a safe and effective treatment option for many women experiencing menopause symptoms."
Manulife cited Canadian Menopause Foundation-sourced figures that unmanaged menopause symptoms cost the Canadian economy $3.5 billion annually and contribute to one in ten women leaving the workforce, with 95% of women experiencing menopause symptoms during what are typically prime working years.
Manulife has tracked HRT utilisation before. A prior report from Manulife, produced with Cleveland Clinic Canada and CAMH's womenmind initiative and covering 2021 to 2023, found HRT use among women aged 45 to 65 rose 20.7% over that three-year window, alongside a finding that only 13% of women in that age band were using HRT at all.
The new figure - a 228% increase over five years from 2021 to 2026 specifically among women aged 45 to 54 - reflects a narrower age band and, notably, the most recent two years driving the bulk of the increase. Growth has clearly accelerated well beyond the earlier report's baseline rather than simply extending the same linear trend.
Manulife's claims data arrives at the same time the company is actively expanding its own menopause-related service offering. In 2025, Manulife Group Benefits became the first Canadian insurer to partner with Maven Clinic, and it has now extended complimentary access to Maven's menopause programme to more than 1.4 million Group Benefits members, with the same support also rolled out to eligible Manulife Vitality and Flexcare members.
That is a legitimate and useful benefit, but it also means Manulife has a direct commercial interest in normalising and promoting higher HRT utilisation among its own plan members, since increased engagement with its Maven partnership is a programme success metric for the insurer.
That does not make the underlying claims data inaccurate - aggregate claims figures are a real, measurable data source - but brokers citing this figure to employer clients should frame it as Manulife's own book of business trending upward, not as a fully independent measurement of national HRT trends.
Manulife is not alone in treating menopause and hormonal health as a competitive group benefits differentiator. GreenShield has built out its own Personalized Hormonal Health Programme through the GreenShield+ platform and has helped fund the national Can-RISE study into the menopause transition, positioning itself similarly as a specialist in this space.
Both companies are converging on the same underlying data point - roughly 40% of women reportedly not knowing where to seek hormonal health treatment - and both are building competing virtual care and navigation offerings to capture that unmet demand.
For brokers, this growing competitive investment across multiple major Canadian insurers is itself a signal: menopause and hormonal health support has moved from a niche benefits add-on to an area insurers are actively differentiating on, which is worth factoring into carrier selection conversations for employer clients with a workforce skewing toward women in their forties and fifties.
Jenn Foubert, assistant vice-president, health, well-being and disability products at Manulife, framed the trend as evidence that "these therapies are generally well-established and affordable treatments, making it possible for employers to continue supporting women's health in a meaningful and sustainable way through their benefits plans."
The practical implication is that HRT is typically already covered under standard drug benefit plans with extended health coverage, meaning the real gap for many organisations is not coverage itself but awareness, care navigation, and workplace flexibility that lets employees actually access treatment - exactly the kind of support offerings insurers are now building out as a competitive feature rather than an afterthought.
