Why female executives are reluctant to talk about menopause
“How can I compete with men when I can’t sleep?”
That’s the question Andrea said she asked herself when, at 50 and a senior executive at a Canadian financial services company, she realized she was not performing as well as she had previously.
“I looked around the table at all the men and thought, ‘I can’t sleep. I sweat all the time. How can I ever compete with these guys?’”
Andrea said her doctor told her that menopause symptoms were something she would just have to bear, a natural part of aging.
Andrea’s experience is typical in Canada, where a lack of information and fear cause millions of women to miss out on hormone-replacement therapies (HRT) that ease menopause systems, according to experts.
Caused by plummeting estrogen, menopause symptoms — including hot flashes, night sweats, insomnia, depression and transient memory loss — interfere with most women’s lives, according to a U.S. survey. And these challenges emerge between ages 45 and 55, just as women are likely to move into leadership positions.
Yet less than one in 10 Canadian women are treated.
Janice, an ultrafit, public-sector manager, remembers looking down during a meeting to see her pants soaked with blood. She was suffering from menstrual flooding, which affects a quarter of menopausal women. “It was hard to explain why I would leave and not return to meetings,” she remembers.
The bleeding, night sweats and insomnia took Janice to a doctor. “The doctor told me to ‘wait and see’ and did not offer to treat me with medication,” Janice remembers. “If my problem had been penile disfunction, there would have been a treatment for that.”
Janice agreed to “wait and see.” Then she waited some more. Then she broke down.
Overcome by lack of sleep, body changes and depression, Janice had to take a three-month leave. “I knew there was going to be blowback on my career,” she said, “but I just collapsed.”
When a 1997 American Medical Association report asserted that HRT extended life expectancy by three years, it became accepted treatment. Two-thirds of 30 retired Canadian professional women informally polled by email for this article took HRT in 1990s.
But then things got scary. A rushed 2002 study by the U.S. Women’s Health Initiative (WHI) announced that HRT increased risk of breast cancer, heart attacks and strokes. Women and their doctors were told that HRT’s risks outweighed its benefits, according to Dr. Maria Velez, an associate professor of obstetrics and gynecology at Queen’s University in Kingston.
Since then, physicians have been afraid to prescribe HRT, despite WHI’s methodology coming under serious scrutiny, said Velez. The study was definitively debunked in 2019.
“My doctor refused to prescribe HRT,” said Lois Sweet, who was an associate professor at Carleton University in Ottawa from 2000 to 2012. Sweet couldn’t sleep because night sweats left her sheets soaking, she said. But it was hot flashes while she was teaching that really affected her professional life.
“There I would be, standing in front of a group of young people, and suddenly my body would turn into a furnace … turning me a brilliant red while sweat poured down my face. It was excruciating.”
Sweet said she begged her doctor three times for HRT before he would prescribe it. “It was like a magic potion … It made a huge difference in my life.”