If You’re a Woman of Color, Here’s What to Know About Menopause – Oprah Mag

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As the creator of Black Girl's Guide to Surviving Menopause podcast and social media project, Omisade Burney-Scott, 55, has two missions. The first is to normalize menopause, a natural event that will happen to more than half of the population yet still remains shrouded in silence. The second: to center the voices of Black women and gender-expansive individuals, who experience many of the same symptoms that white women dohot flashes, insomnia, joint painbut often do so in a very different (and usually more intense) way.

Hers is an enormous undertaking, with 50 million+ U.S. women, women-identifying people, and nonbinary people currently in menopausedefined as the end of ones menstrual cyclesand millions more in perimenopause, the four to 10 years leading up to it. More than a third of these are women of color, yet this universal hormonal phenomenon is rarely discussed within their communities, and the experiences and stories of Black and Latinx women are rarely centered in the media or by physicians, according to Denise Pines, Immediate Past President of the Medical Board of California and founder of WisePause Wellness, a pro-aging platform.

When we read about menopause, we think of white womens menopause [experiences] because those are the stories that get told, Pines says. But while our biology may be the same, our experiences are not. Black and Latinx women enter menopause earlier and have longer-lasting, more intense symptoms. Hispanic women are more likely to report feeling bothered by vaginal dryness, urine leakage, and increased heart rate, whereas Black women frequently cite hot flashes and night sweats, according to the Study of Womens Health Across the Nation (SWAN), a decades-long study examining the health of midlife women across ethnicities.

Burney-Scott notes that news reports will often briefly mention the fact that Black and Latinx women have longer and more intense symptoms of menopause but then there is a hard stop. What about the why?

The average age of menopause in the U.S. is 51. SWAN findings reveal that Black women tend to begin menopause about nine months earlier than white women. Other SWAN findings show that Black and Hispanic women endure hot flashes for several years longer than other racial and ethnic groups (10 years and nine years, respectively, versus 6.5 for non-Hispanic white women) and Black women experience irregular bleeding for longer periods of time than white women.

Michelle A. Albert, MD, MPH, professor of medicine at the University of California at San Francisco, president-elect of the American Heart Association, and president of the Association of Black Cardiologists, says this phenomenon, called early-onset menopause, triggers a cascade of events leading to worsened health outcomes for BIPOC women. Cardioprotective estrogen plummets during menopause, meaning all women, regardless of race or ethnicity, experience an increase in heart disease and stroke risk during and after the menopausal transition, but the earlier the age of menopause, the greater the risk. Female hormones also help to protect you from obesity and insomnia, as well as keep cholesterol levels down, and those are all factors associated with elevated heart disease risk, too, Albert says. Additionally, early-onset menopause ups the risk of osteoporosis (estrogen helps keep bones strong) and depression.

Black women are also three times more likely to experience premature menopausemenopause before age 40, sometimes caused by smoking or autoimmune conditions such as lupus or rheumatoid arthritiscompared with white women, leading to a 40 percent higher risk of developing coronary heart disease over their lifetime, per research presented at a 2021 American Heart Association (AHA) meeting.

A 2022 SWAN study published in Womens Midlife Health proposes that some of the disparities that exist between white women and women of color in perimenopause and menopause are likely attributable to structural racism in the U.S. This link has yet to be definitively proven, notes study coauthor and SWAN investigator Ten T. Lewis, PhD, associate professor of epidemiology at Emory Universitys Rollins School of Public Health in Atlanta, but we know that stress matters.

Explains Albert, Its called allostatic load, which refers to the wear-and-tear from lifetime and ongoing stressors that Black women disproportionately face compared with white women. Systemic racism, including poor access to healthcare, toxic work environments, unsafe neighborhoods, socioeconomic challenges, and more, can weather the body, over-taxing various hormonal and biological processes and fueling chronic inflammation. This can lead to long-lasting health ramifications, including an earlier, more challenging menopause.

Despite the fact that Black women enter menopause earlier, and the symptoms last longer, they are the least likely to leave the office with a prescription for hormone treatment, says Sharon Malone, MD, Washington, D.C.based ob-gyn and chief medical officer of Alloy Womens Health. This may have to do with the common but erroneous belief that Black people have a higher pain tolerance, suggest some experts. Women of color often go to the doctor and the doctor says, Oh, no, youre too young [for menopause], Pines says, or they want you to grind it out, and women walk away with nothing. Or they assume patients cant afford hormone replacement therapy or other solutions. This goes beyond a comfort issue: Symptoms like hot flashes and weight gain can be linked to future heart disease, diabetes, and other serious conditions that are already more prevalent among Black and Latinx women.

Several of the experts interviewed for this story said there are concrete steps BIPOC women can take to help flip the script and improve the odds of an easier, healthier menopausal transition.

Malone notes there are plenty of positives accompanying this time of life in general. For a lot of women, its the first time they get to focus on themselves. Youve been concerned about your children, your job, the lens through which people view you, and trying to live up to those expectations. You get to 55, and its freeing.

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If You're a Woman of Color, Here's What to Know About Menopause - Oprah Mag