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.
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.”
Many professional women older than Janice and Andrea did not suffer as much. In 1994, more than 20 per cent of Canadian and more than half of American and French menopausal women were taking HRT.
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.”
New research shows HRT is highly beneficial when given to symptomatic women within 10 years of menopause onset or under age 60, said Velez. Rather than harming health, studies show HRT reduces mortality on average by almost 10 per cent, by protecting against cardiovascular and other diseases.
Dr. Wendy Wolfman, a professor at the University of Toronto and director of the Menopause Unit at Mount Sinai Hospital, is trying to defeat the lack of information about menopause and fear about HRT.
“Women have to be aware that the major killer of women after menopause is cardiovascular disease. Eight times as many women die from it than from breast cancer,” said Wolfman. “It’s ridiculous to have women not be able to function for something that is treatable with a medication that’s very safe.”
Ridiculous, perhaps, but apparently difficult to talk about. Fourteen female financial services executives did not respond to a request to participate in this article, even with their identities concealed.
Menopause is not discussed around executive tables, said Nan DasGupta, a senior partner at the Boston Consulting Group and a leader of the company’s women’s initiative. “For men, aging is associated with experience, expertise, gravitas, wisdom,” said DasGupta. But aging women “are perceived as past our prime, grandmotherly.”
Corporations need to find ways for menopausal women to “continue to thrive, work and feel like they can be themselves,” she said.
Wolfman and Velez said much more research into mature women’s health is needed. Only one per cent of medical research is invested in female-specific conditions beyond oncology, according to a recent McKinsey & Company study.
Andrea is now taking HRT and feels much better, she said. “Being able to consistently fall asleep and stay asleep for six to seven hours was a really big change for me.”
But Andrea said she is frustrated and unnerved because she has a new family doctor who is against HRT. “She said she would take me off the hormones if it was up to her.”
Katharine Lake Berz is a consultant and writer on Vancouver Island and in Toronto.
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
