Black women can experience earlier, more intense menopause symptoms.
Acknowledging cultural and systemic biases and learning about your patients’ experiences with the healthcare system and their bodies can help you tailor treatment to meet needs.
Black women experience menopause symptoms earlier and more intensely than other women. OB/GYNs of color say that addressing disparities means fighting against racism and for culturally sensitive care.
“Black women often begin their menopause journey earlier for a few reasons, whether it be due to the daily stresses of racism or early surgical menopause due to hysterectomies and oophorectomies performed due to higher rates of uterine fibroids,” says Monica J.R. Williams-Riley, MD, a functional medicine and sexual health and wellness specialist, board-certified family physician, and expert practitioner with Cliovana.
Data from the Study of Women’s Health Across the Nation (SWAN) shows that Black women experience heavier bleeding than White, Chinese, and Japanese women during perimenopause. SWAN data has also shown that Black women undergo a longer and earlier menopausal transition period than White, Chinese, and Japanese women. Earlier menopause can make people vulnerable to other health problems, including cardiovascular disease and osteoporosis, but may increase protection against breast cancer.
Black women have the highest surgical menopause rate of any race, which may be due to “higher stress levels and lack of community and medical support,” Dr. Williams-Riley says. Black women are also vulnerable to being “thrust into early menopause” following hysterectomy and oophorectomy procedures, which are more often conducted on Black women than White women, she adds.
For those experiencing symptoms of menopause, stereotypes and racism can serve as barriers to seeking or receiving care.
“Some patients may feel the damage from the Women’s Health Initiative runs deep, and the lack of patients of color in many clinical trials may make them wonder if medications will work for them,” says Sameena Rahman, MD, a board-certified gynecologist and Founder of the Center for Gynecology and Cosmetics.
Dr. Rahman adds that in some cultures, and due to certain stereotypes, women of color are told to “suck it up and deal with” menopause symptoms rather than seek medical treatment.
Dr. Williams-Riley adds that many of the stereotypes about menopause within the Black community are “rooted in the thought process that people of color don’t experience pain and discomfort [in] the same way” as other women.
“These stereotypes often include notions of Black women being overly strong and resilient, implying that they should endure menopausal symptoms without complaint,” Dr. Riley says. “Such stereotypes overlook the unique challenges Black women face during menopause, dismissing their valid health concerns.”
Recognizing and challenging stereotypes is one of the first steps in providing patients with attentive, empathetic, and personal care, she says.
Addressing disparities in menopause
To address disparities in menopause, doctors should work with patients on an individual basis to understand their experience with women’s healthcare and any hesitations that exist. This includes making an effort to learn about their patients’ cultures, traditions, beliefs, and values and to integrate them into treatment plans, says Dr. Williams-Riley.
“Culturally sensitive care is paramount; understanding that cultural factors influence menopausal experiences underscores the importance of seeking providers proficient in such care. Moreover, dispelling prevailing stereotypes and stigmas surrounding menopause within diverse communities is vital,” says Dr. Williams-Riley. “Empowering women of color through self-advocacy and knowledge ensures a smoother menopausal journey, fostering overall health and vitality.”
She suggests talking to women about using lifestyle tactics like exercise and nutrition to their benefit and educating them about resources and treatments like hormonal therapies. Be mindful to address these issues earlier with women of color due to their likelihood of earlier onset menopause, she says.
In addition to empowering patients, it is important to acknowledge personal biases and failures of the healthcare system, Dr. Williams-Riley adds.
“Physicians and the health services community must confront their cultural and systemic biases to ensure equitable treatment for communities of color—and this begins in medical school training,” she says. “Embracing these changes not only enhances patient-doctor relationships but also contributes significantly to reducing health disparities, ensuring that every individual receives the quality care they deserve, regardless of their cultural background.”
Dr. Rahman encourages doctors to address “the elephant in the room” by telling patients something like, “I know the medical protocols that we have in place have historically been rooted in systemic racism, and I am here to take a step toward making it better for you.”
She adds that “doctors should listen to patients, take their complaints seriously, and validate their concerns” in healthcare settings and in their experiences with their bodies.
What this means for you
Black women may experience earlier, more intense menopause symptoms—with less support. Practicing individualized, culturally sensitive care can help address disparities in menopause treatment.