When menopausal hot flashes caused sweat to run down Donna Cook's face during business meetings, she joked to concerned colleagues, "I'm having my personal summer."
But for executives like Cook, menopause symptoms such as profuse sweating, nasty mood swings and memory lapses aren't funny.
Cook, 54, felt self-conscious when she had to blot up sweat while giving presentations at System Planning Corp., an Arlington, Va., firm that does scientific research and government contract work. She said she would awake several times a night in drenching sweats after she stopped taking hormone replacement medication, which she had been on for about 10 years.
"I would oversleep in the morning. I'd miss the alarm. I'd be late for work. I constantly felt like I was playing catch-up," she said. Sometimes, she had trouble remembering how to do routine duties.
Two years later, her symptoms are less frequent and severe, but her problem points to the embarrassment and loss of confidence suffered by many women executives at midlife.
A survey of the National Association of Female Executives, sponsored by the maker of a menopause drug, indicated 95 percent of the 843 respondents had suffered from the physical symptoms of menopause.
Insomnia, night sweats and daytime hot flashes were reported as the most vexing problems, and 56 percent said they deal with symptoms daily. Nearly 8 out of 10 reported mental or emotional symptoms such as forgetfulness and irritability.
Forty-one percent had used hormone pills such as Premarin or Prempro to control symptoms.
About half of the women reported lack of sexual desire and painful intercourse because of vaginal dryness. That could explain why emotional well-being and romantic relationships were ranked as the two areas most affected by menopause symptoms, ahead of professional life, said Dr. James Simon, a gynecologist and menopause specialist at George Washington University in Washington, D.C., who helped design the survey questionnaire.
Plenty of earlier studies have examined how menopause affects women in general, said Simon, but "a generation ago, there weren't enough female executives to bother" doing a survey of that group.
He said menopause symptoms may be more prevalent because of the growing obesity problem. "Fatter women are more likely to have hot flashes than thinner women," he explained.
Simon said he was not compensated for the survey by Barr Laboratories of Woodcliff Lake, N.J. The company makes Cenestin, a synthetic, plant-derived prescription drug for menopause symptoms. The survey was conducted online by pollster Harris Interactive in February.
The results will be reported next week in San Diego at the annual meeting of the North American Menopause Society, a doctors' group. Simon is the group's immediate past president.
Study for working women
Amy Niles, president of the National Women's Health Resource Center in Red Bank, N.J., said past educational campaigns about menopause have not targeted women in the work force. They are more likely than their mothers to have to deal with menopause.
"I think we've made great improvements over the last few years in creating awareness that this is a significant issue" that women should discuss with their doctors, Niles said.
Dr. Lauren Streicher, a gynecologist at Northwestern Memorial Hospital in Chicago and author of "The Essential Guide to Hysterectomy," which addresses menopause, said her lower-income, less-educated patients are more likely to accept the strains of menopause as just another big bump in life. Her well-educated professional patients are more likely to seek help and often complain about lack of sleep, which leaves them less motivated and less focused at work.
"This has an incredible impact on their ability to function in the corporate world," she said.
Streicher said many women were confused and scared of hormone therapy after federal researchers reported in 2002 that estrogen-progestin pills sold as Prempro could increase risks for heart attacks, breast cancer and strokes. Many doctors still recommend short-term hormone treatment.
"In an executive position ... you have to look your best," and project a calm, focused and capable image, said Rosalie Roberts, a 61-year-old survey participant who owns an Omaha, Neb., public relations business. She had moderate symptoms until several years ago but occasionally would sweat enough during meetings that she would head to the restroom during breaks.
"In my business, that's very, very unfortunate," Roberts said.