OPINION: TIME TO STOP IGNORING THE HEALTH OF MID-LIFE WOMEN
On Feb. 13, from the Maritimes to British Columbia, Canadians will be awash in red for Wear Red Canada Day. Red should shake us awake. It is the colour of blood, of alarm, and of urgency.
After eight years with the Canadian Women’s Heart Health Alliance, I have learned that symbols without systemic change are not enough to protect women’s hearts or their future health.
Heart disease remains the leading cause of death for women in Canada. Women are still more likely to be misdiagnosed, under-treated, and underrepresented in research. But the challenge is broader than cardiology. What continues to hold women’s health back is a failure to recognize the central biological driver of lifelong health: ovarian function and estrogen.
For too long, ovaries have been viewed almost exclusively through the lens of reproduction. Once childbearing ends, their importance is assumed to end as well. This belief is scientifically outdated and clinically harmful. The ovaries are not just reproductive organs. They are architects of women’s health across the lifespan.
Estrogen shapes the heart and blood vessels, brain, bones, kidneys, metabolism, and immune function. Yet most women are never told that ovarian reserve and estrogen levels begin to decline in their late 30s. By the time symptoms are recognized, biological changes have often been underway for years.
Menopause itself is one day in a woman’s life. What truly matters is the long reproductive transition and reproductive aging process that surrounds it. This transition represents a major biological shift that increases vulnerability to chronic disease. Still, our health system largely waits until disease develops before responding.
We wait for the heart attack. We wait for osteoporosis. We wait for cognitive decline.
This reactive model is neither ethical nor sustainable.
Instead of treating reproductive aging as an inconvenience, we must recognize it as a critical window for prevention. Irregular cycles, sleep disruption, anxiety, fatigue, and metabolic changes are often dismissed as stress or normal aging. In reality, they may be early warning signs of increased cardiovascular and neurological risk that deserve attention and care.
Two generations of women have paid the price for misunderstanding estrogen and its role in health. In the early 2000s, the Women’s Health Initiative led to widespread fear-mongering of hormone therapy. Its findings were interpreted in ways that halted appropriate treatment for many women, regardless of age or timing. A generation of women entered their reproductive transition with little guidance and even less support.
The consequences are now evident. Higher rates of fracture, heart disease, and reduced quality of life among older women are not inevitable outcomes of aging. They are the result of decades of policy and research neglect.
What is needed now is a paradigm shift, and that shift must be supported by public policy and funding.
Canada needs a national women’s health strategy that recognizes reproductive aging as a cornerstone of chronic disease prevention. Federal and provincial research funding must prioritize mid-life women, not only pregnancy or late-life disease. Medical education must train clinicians to understand ovarian aging as a key determinant of heart, brain and bone health. Health systems must invest in specialized clinics and integrated-care models focused on prevention during the reproductive transition.
These are not luxuries. They are cost-effective interventions. Preventing heart disease, fractures, and dementia saves health-care dollars while preserving quality of life for millions of women.
Wear Red Canada Day should be more than a symbolic gesture. It should be a catalyst for action.
If we are serious about improving women’s heart health, we must stop treating the ovaries as an afterthought and start recognizing them as central to lifelong health. We must move from crisis care to prevention, from silence to science, and from awareness to accountability.
This Feb. 13, let red stand not only for awareness, but for political and scientific commitment. Women’s health will not change through slogans alone. It will change when we fund it, teach it, and build health systems around it. It is time to rethink women’s health from the ovaries outward and finally align policy, research, and care with the biology of women’s lives.
Wear Red Canada is celebrated annually across Canada on Feb.13, to raise awareness about women’s heart health. Events are held across the country to serve as a reminder for all people in Canada, but especially women, to be mindful, curious, and proactive in the management of our heart health and wellness.
Colleen Norris is a University of Alberta nursing professor, Cavarzan Chair in Women’s Health Research and research lead of the CKHui/LHHW Women’s Heart Health Research Collaborative.
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