Menopause might be a nonnegotiable for anybody lucky enough to have a uterus — and it isn’t usually a great experience for anyone. But this universal condition is also deeply personal, with many factors impacting the duration and severity of someone’s symptoms, such as their diet, how much they smoke, and how much they exercise. But one of the most significant aspects that scientists are now (and finally) investigating is how a person’s race factors into their menopause experience.
While research about how and why BIPOC experience menopause differently is still emerging, one thing is clear: People of color tend to have it worse when it comes to their symptoms and are more vulnerable to the health risks associated with menopause. To dig into why, here’s what you need to know about how race can influence this significant midlife transition.
What the numbers say
Research on peri/menopause — and medical research in general — tends not to include diverse participants. As such, the results often skew toward the very limited experience of white women. However, one landmark study, the 1994 Study of Women’s Health Across the Nation (SWAN), gives us many insights into the racial disparities that can affect the menopause journey.
Over the course of 25 years, SWAN researchers studied the experiences of women from various racial, ethnic, and socioeconomic backgrounds. Here are some of their most significant findings:
- Black women are more likely to report heavy menstrual bleeding, which may lead to the need to have a hysterectomy, which triggers early menopause.
- Black, Asian, and Latina women usually start menopause earlier than white women. Black and Latina women in particular tend to reach menopause two years earlier than the average age (51 years old).
- Black and Latina women tend to experience more frequent and severe hot flashes than any other group.
- The average length of menopause-related hot flashes and night sweats is 10.1 years for Black women, 8.9 years for Latina women, and 6.5 years for non-Latina white women.
In other words, women of color tend to experience menopause earlier, longer, and with more debilitating symptoms that can seriously impact their quality of life.
Now, a woman starting menopause earlier or having more intense symptoms than their girlfriends doesn’t necessarily mean that their health is in a bad place, according to Kerry-Anne Perkins, D.O., an obstetrician-gynecologist at Alliance OBGYN.
“The [severity and duration] of your symptoms is not a reflection of you having a disease of any kind,” says Perkins. However, entering menopause earlier means being exposed to certain health risks at a younger age than most.
“For instance, estrogen is really important when it comes to maintaining cardiovascular and bone health,” Perkins explains. “But once estrogen declines with menopause, the risk of heart disease, cholesterol problems, and osteoporosis increases.”
This is one of the major concerns physicians have for many BIPOC entering their menopause transition — especially considering women of color already tend to have a higher prevalence of heart disease and diabetes.
The reasons behind the racial disparities in reproductive aging are complex. Biological factors, like genes, can influence how people experience menopause. But there are countless uncontrollable aspects that can impact a person’s biology. For example, stress and anxiety have been shown to worsen hot flashes and other menopause symptoms (which is one reason we’re always preaching about prioritizing mental health during peri/menopause).
Arun Karlamangla, M.D., a member of the SWAN team and professor of geriatrics at the David Geffen School of Medicine at UCLA, shared with Everyday Health that allostatic load — wear and tear on the body accumulated by someone exposed to chronic or repeated stress — may drastically impact menopause. People from disadvantaged communities tend to have greater allostatic load than their more advantaged counterparts.
To illustrate: The Black women who were selected for the SWAN study grew up during the Jim Crow era, a time when American society was heavily shaped by institutional racism and segregation. In 2022, researchers who conducted a systematic review of the SWAN publications over the years discovered that Black women reported experiencing more financial stress, chronic discrimination, violence, and other hardships. Those women had higher rates of metabolic disease, high blood pressure, and osteoarthritis than the white participants, even before they entered perimenopause.
While many of the laws of the Jim Crow era have been dismantled since the 1960s, inequities within our healthcare system still remain. Many BIPOC people still do not have access to affordable insurance, quality health care, or education around menopause, which can affect how they experience and deal with their symptoms.
While hot flashes and night sweats can be wildly uncomfortable and at times unavoidable, there are plenty of treatments that can help make the transition a more tolerable one, says Perkins. And yet, studies show that Black women are less likely to receive hormone replacement therapy, which can help reduce the severity of hot flashes.
Even if a person of color can access great healthcare, medical racism may affect their willingness to open up about their symptoms — or visit a doctor at all. Due to a lack of research, menopause is still commonly misunderstood among M.D.s. It doesn’t help that racial bias still looms large in healthcare settings, where many patients of color report not feeling heard or understood by their providers.
Resources for women of color going through menopause
Just as no single problem is to blame for these racial inequities, there’s no single solution. Until BIPOC folks experience true equity in public health, it’s up to us as individuals to advocate for change: much more diversity in studies and better access to healthcare regardless of socioeconomic status, for starters.
It’s also up to all us to connect with one another around the issue so the topic of menopause is normalized in our culture. Research shows that women with more optimistic outlooks about menopause are better able to tolerate symptoms, and finding community can help shift how we view this pivotal period in our lives. We’re big fans of these support communities specifically for BIPOC women:
- Black Girl’s Guide to Surviving Menopause
- Directory of Black Women Physicians
- Menopause Whilst Black
- Black Women in Menopause Facebook Group
- Latina Women’s Support Group on Facebook
- Black Woman Going Through Menopause Support Group on Facebook
- Indian Menopause Society
The good news: The support for BIPOC moving through menopause is growing, which means women of color don’t have to suffer alone. But we all have to let each other know we’re out here to lend a hand or an ear.
Adele Jackson-Gibson is a movement coach, energy healer, and freelance journalist living in Oakland, CA. She loves showing people where mindfulness and fitness meet, spends much of her time contemplating the wisdom of the human body as well as nerding out about anime. Please ask her about her cat. Read more of Adele's work here.
Looking to connect with a community of women who know what you're going through? Check out The Hot Spot!