By Diana Valenzuela
Because “the change” is different for people of color.
While we’ve written endlessly about what menopause is like, from how it affects your mindset and your sleep to your diet and your sex life, the fact is, menopause isn’t a monolith. This change and the symptoms that come with it are not the same for everyone, so there’s a good chance that you don’t relate to your doctor’s or friends’ perceptions of how menopause “should” feel. Research shows that menopause can vary vastly depending on the person, and one significant contributor to those differences is ethnicity and race.
It’s become apparent that people from minority groups often don’t relate to the general consensus of how the menopausal experience looks. And we all know that having an “atypical” transformative experience doesn’t feel great. At best, it’s an unwelcome return of that icky, mid-puberty anxiety of feeling like your first period or first kiss isn’t coming according to the timeline prescribed by the “cool” kids or the John Hughes movies. At worst, you may experience discomfort, pain, and feelings of isolation and neglect from healthcare professionals or loved ones.
Most of us know by now that people of color experience a “healthcare gap”: This is a discrepancy in the healthcare some groups receive that falls short of the best practices. The American Medical Association reports that because of this gap, minority groups face higher rates of morbidity despite advances in medical care. We know that breast cancer is more fatal to Black women, for instance, for a variety of interwoven reasons. In other words, minority patients are facing a complex blend of historical prejudices, daily microaggressions, and institutional racism while simply trying to stay healthy.
With that mess in mind, it’s not surprising that people of color going through menopause have been reporting that their journeys deviate from the “standard” experience. Luckily, various professionals of different backgrounds are hard at work gathering data on how menopause feels to people of different races, while community organizers have started creating spaces to heal.
If you’re currently going through menopause (or will be menopausal in the future) we’re here to help you untangle how your own change of life might deviate from what you might have expected. We’re breaking down the data along with expert advice on how to achieve emotional wellness during this sometimes unpredictable and often tumultuous time.
What menopause is like for non-white people
Many findings on the ins and outs of menopause can be traced back to the Study of Women’s Health Across the Nation (SWAN). Since this massive study began in 1994, participants have provided data to seven research centers across the country.
According to SWAN research, Black and Latina women reach menopause at age 49 — though the median age for reaching menopause in the U.S. is 51 and the median for white women is about 51.4. Aside from reaching this new life phase earlier, Black and Latina women report suffering more severe vasomotor symptoms (hot flashes and night sweats) than white women for longer periods of time: “White women experience hot flashes for around 6.5 years, while for Latinas it’s 8.9 years, and for Black women, it’s 10 years” the study found. Another study reported that Asian women are least likely to experience those disruptive vasomotor symptoms.
To confirm that these disparities could be closely tied to race, a 2022 study stated that the differences they observed (like Black women reaching menopause earlier, feeling more severe hot flashes, getting poor sleep, and feeling more pain) weren’t affected by other factors: “The difference remained after adjustment for body-mass index, education, menstrual cycle characteristics, and gynecologic and medical history.”
While the physical discomfort and mental stress of menopause are exhausting enough, an earlier onset of menopause is concerning for health reasons, too. Research shows, for instance, that women who experience earlier menopause have lower bone density in their post-menopausal years, which often results in more bone fractures. And we don’t need to tell you that experiencing any bone fractures as a senior is a frightening prospect that no one could possibly need more of.
Why do these disparities exist?
Nanette Santoro, MD, who contributed to SWAN, theorizes that chronic stress might account for a person of color’s “atypical” menopause experience (including intense symptoms and earlier onset): “My educated guess is that a lot of the differences have their basis in lifestyle, socioeconomic status, and other stressors such as systemic racism and their long-term consequences.” And the American Psychological Association reports that discrimination causes chronic stress in non-white ethnic groups (which, as any non-white person knows, is fairly obvious).
Unequal access to healthcare or discrimination from providers may play a role in how people experience menopause, too. According to a 2022 study, Black people were 26 percent less likely to be prescribed hormone replacement therapy (HRT), which can alleviate symptoms like hot flashes, bone loss, and other issues that can affect quality of life. Similarly, Latina women were 32 percent less likely to receive HRT. The same study found that Black women were also less likely to be prescribed vaginal estrogen for issues like vaginal dryness or intense hot flashes.
There’s no straightforward answer to why people of color experience a different version of healthcare, since race and ethnicity interact with socioeconomic status, gender, and other factors. But stress, racism, and other forms of discrimination seem to play major roles.
That being said, we should be careful not to frame race as a cause of more extreme or intense menopausal experiences — it’s about how people of non-white backgrounds are treated and the healthcare they have access to. Omisade Burney-Scott, the creator of the Black Girl’s Guide to Surviving Menopause, notes that there are no physiological differences between people of different races and ethnicities who experience menopause; being a person of color is not the problem, and blaming people of color for the way their bodies feel will solve exactly nothing.
What can we do about it?
Burney-Scott points out that all of us — healthcare providers especially — need to actively question health disparities instead of brushing them off or taking them for granted: “Why do you think there are such wildly diverse experiences across gender and across race? What is happening inside a family, a culture, and systems of oppression that would make these experiences wildly different?”
That being said, you can also take steps to manage your individual experience. Burney-Scott says that since “there’s a huge beautiful community of people trying to figure this thing out together,” linking up with other menopausal people can help.
Maybe you already have a circle of pals ready to share individual experiences of this fraught phase of life (and this can be a great way to get back in touch if you’ve drifted a bit, too). But if not, don’t feel discouraged: We swear, there are so many new friends out there waiting to commiserate with you. The Black Girl’s Guide to Surviving Menopause is a powerful project that explores the culture and narrative shifts around menopause that centers the stories of Black women, women-identified, and gender-expansive people. Elektra Health provides evidence-based education, one-on-one support with a menopause guide, and a thriving member community. Plus, you can find small groups in your community or by surfing Facebook. Some groups will celebrate people of color, people of specific ethnicities, or people of different genders, and other groups will be open to everyone. Look around and play with what fits; you’ll be sure to find a space where you can feel messy, joyful, despondent, and inspired (maybe all at once).
While we’ve laid out all the ways menopause can vary, Burney-Scott believes one particular element of menopause is universal, and it might be the best part: “There’s a different kind of knowingness that you have access to as a menopausal person.” This newfound wisdom that you’ve accrued with age will help you navigate through this unpredictable period.
See Original Article at Katie Couric Media