Addressing Racial Disparities in Menopause

Understanding Menopause and Its General Impact

Menopause is a natural stage in every woman’s life that marks the end of her reproductive years and monthly menstrual cycles. It typically occurs between the ages of 45 and 55 but may occur earlier or even later in some women. You’ve reached menopause when you have gone 12 consecutive months without periods.

The experience of menopause varies from person to person. Due to the hormonal changes your body goes through during this time, menopause brings with it certain symptoms like:

1. Hot Flashes: This is a common symptom that women face during menopause and the years leading to it, which feels like a wave of heat spreading through your body, causing a rise in your body temperature and sweating.

2. Night Sweats: When hot flashes happen at night, they’re called night sweats. They cause you to wake up drenched in sweat and may be followed by chills.

3. Mood Changes: Hormonal changes during menopause can lead to low mood, anxiety, depression, and low self-esteem.

4. Sleep Disturbances: Some women also find it difficult to fall or stay asleep during menopause.

5. Vaginal Dryness: The drop in blood oestrogen levels during menopause causes the vaginal walls to become thin, dry and less elastic, making sex uncomfortable or painful.

Women worldwide face menopause, but how it is viewed and dealt with can differ based on their culture, society and economic status. In this blog, we’ll explore some racial disparities that exist around menopause.

Read more - Essential Things to Know About Menopause.

Racial Disparities in Menopause Experiences

Curious about how racial differences can influence the way women experience menopause? Research has shown that the experience of menopause varies in terms of severity of symptoms, age of onset, and access to healthcare across different racial groups. 

1. Symptom Severity and Prevalence:

A study conducted on non-Hispanic Caucasian, African American, Chinese, Japanese and Hispanic women in the US on the frequency and severity of common menopausal symptoms showed that most menopausal symptoms varied by ethnicity - 

• Vasomotor symptoms (VMS) of menopause, such as hot flashes and night sweats, were more prevalent in African American and Hispanic women.
• Vaginal dryness was more prevalent in Hispanic women.
• Among Hispanic women, the symptoms of menopause varied by their country of origin.

African American women are 24% more likely to experience hot flashes compared to white American women (study).

African American women were more likely than Caucasian women to report any hot flashes, severe hot flashes, and hot flashes for more than 5 years (a study among peri-menopausal women).

The Caucasian, African American and Hispanic women had the highest rates of frequent irritability, nervousness, and psychological distress, and Chinese and Japanese women had the lowest (findings from the Study of Women’s Health Across the Nation).

2. Age of Onset:

Several researches suggest that women living in developing countries (including Latin America, Indonesia, Singapore, Pakistan, Chile, and Peru) experience natural menopause several years earlier than those in developed countries.

Some studies also indicate that women living in rural areas have an early natural menopause compared to women in urban areas.

Based on a 2011 study,

• African American and Latina women have natural menopause about 2 years earlier than white women.
• Mayan women have been reported to experience menopause early, around the age of 45.
• The average age of menopause in Thai women is 49.5.
• The median age of menopause in white women as well as Asian women ranges from 50-52.

However, factors like body mass index, diet, smoking, and passive smoke exposure may affect the age of onset of menopause.

Black and Hispanic women who enter menopause earlier than white women have higher menopause-related health risks and experience symptoms for a greater duration.

3. Access to Healthcare:

But why is this so? This is due to the systemic barriers faced by women of colour, including lower insurance coverage rates and less access to healthcare professionals committed to addressing health disparities for the wider population.

Social and Economic Factors Contributing to Disparities

Social and economic factors such as income, education, employment status, community safety and social support can contribute to disparities. Here’s a list of such factors and how to overcome them.

1. Income Inequality

Financial challenges or low income can restrict a woman’s access to menopause healthcare, prevent them from getting proper treatment for the management of menopause symptoms, and limit their education and awareness about menopause.

2. Education and Awareness 

Knowledge about what happens to your body during menopause and the symptoms it causes is necessary to understand what is normal and what is not. A lack of education about menopause and its management in certain races can leave women confused and prevent them from being able to identify symptoms that require medical treatment.

3. Cultural Beliefs and Stigma

In many cultures and societies, menopause is considered a taboo that is not openly discussed. Destigmatising menopause and allowing discussions about it can improve working conditions and help women get the support and medical care they require.

Health Outcomes and Risks

We have seen how women from different racial and ethnic groups experience menopause differently, with variations in the severity and duration of symptoms, age of onset of menopause and access to proper healthcare facilities.

If racial disparities are not addressed, women may face poorer menopausal health and an increased risk of certain health conditions.

1. Cardiovascular Health

According to the National Institute of Aging, 

• Black women experience more and earlier stiffness of the arteries than white women. 
• The risk of cardiovascular diseases is higher in Black and Hispanic women compared to white and Chinese women.

Due to the hormonal changes happening in your body at the time of menopause, the risk of cardiovascular diseases may be exacerbated, making women of colour more prone to heart-related health conditions at menopause.

2. Bone Health

During menopause, the decline in oestrogen levels in your body results in more bone resorption (breakdown of bone tissue and transfer of calcium from the bones into the blood) than formation, leading to osteoporosis, which makes your bones brittle and weak. Therefore, special preventive measures such as calcium and vitamin D supplements are required to maintain healthy bones after menopause. 

Limited healthcare access in certain races causes disparities in the screening and diagnosis of osteoporosis. 

A 2011 study has shown that the proportion of African American women who, despite their fracture, are diagnosed with osteoporosis is less than 40%, even at age 80 years or older. 

3. Mental Health

All forms of racial disparities in menopause, like more severe symptoms, early age of onset, limited access to proper healthcare, and socioeconomic stressors, can lead to mental health issues like anxiety and depression among women of colour.

Addressing the Gaps

How can we address racial disparities? Here are some practical measures that could help bridge the gap.

1. Culturally Competent Care

Doctors should be trained to understand the unique needs and experiences of menopause faced by women of different races. A culturally competent doctor who is aware of the impact of culture and diversity of different populations can provide high-quality patient-centred care.

2. Community-Based Programs

Programs can be conducted to make women aware of what changes to expect during menopause, what is normal and what requires medical attention. Providing education, resources, and support can empower women to face the menopause and its challenges. 

3. Policy Changes

Certain changes in policies, like those regarding health insurance and access to healthcare and medications, can help address disparities in menopause. Making insurance and healthcare affordable can benefit women from lower socioeconomic status, improve their health outcomes, and lower the risks associated with menopause.

4. Research and Data Collection

More research has to be carried out to understand how menopause experience varies in different racial and ethnic backgrounds. A proper understanding of the challenges they face and their needs and taking necessary measures can lead to better health outcomes in underrepresented groups.

What Can Women Do?

Women can address racial disparities through these methods:

a) Seek Information:

• Using reliable sources or seeking advice from your doctor, educate yourself on what menopause is and the symptoms to look out for.

b) Advocate for Better Care:

• Work for equal healthcare for all. You can also join organisations or groups that work towards providing menopause-related education and awareness.

c) Connect with Others:

• Joining support groups and sharing your experiences on menopause can help raise awareness about the different challenges faced by women from different racial backgrounds and can also provide emotional support and practical tips to manage them.

Wrapping Up

We are all different and unique. Recognising, accepting and celebrating those differences is what keeps us all together. 

Racial disparities in menopause are not just health-related but also an issue concerning social justice. Acknowledging the challenges faced by women of colour during menopause and taking steps to resolve them can lead society towards equal healthcare facilities and support for all women.