For Black women, menopause is different. Doctors don’t always realize this.
When Danette Fogle, a Black, 65-year-old retired school teacher was 34 years old, she started experiencing a few bothersome changes in her menstrual cycle. They were compromising her quality of life and she believed they could have been signs that she was entering perimenopause. Most women don’t start experiencing symptoms until their early 40s, but since studies have shown that Black women tend to begin the transition earlier than women of other races, Fogle understandably visited her gynecologist in search of answers and reassurance for herself.
However, what actually stuck with her from her visit wasn’t helpful advice or guidance: it was laughter from her gynecologist, an unexpected reaction to something that was affecting her life in a very significant way.
“When I said to him, ‘I think I’m starting menopause,’ he laughed out loud as if it was the most ridiculous thing he had ever heard,” Fogle shared in an interview with The New York Times. “Not only that, he literally called his nurse in and said, ‘Can you believe this woman?’ Like I wasn’t even in the room.”
Fogle was humiliated by the backlash from her doctor. She said the experience made her feel like she was better off just figuring things out on her own. She decided to go “without any medical help,” she said, managing her changes from perimenopause into menopause solely. It lasted for over 15 years. She reached menopause when she turned 50.
According to the Cleveland Clinic, the average length of perimenopause is about four years, but this is not the case for most Black women. “When we read about [perimenopause and] menopause, we think of white women’s [experiences] because those are the stories that get told,” Denise Pines, a former president of the Osteopathic Medical Board of California and founder of WisePause Wellness, a pro-aging platform, tells Oprahdaily.com. Her observation supports how, while all women may share the same biology, their experiences differ among the races. Studies are showing that Black and Latinx women are entering menopause sooner than their white counterparts and are experiencing more intense, longer-lasting symptoms.
Early Onset Menopause Symptoms are Worse for Black Women
Per data from decades-long research by the Study of Women’s Health Across the Nation (SWAN), which looks at the health of women in their middle years across ethnicities, the average age of menopause in the United States is 51, but Black women usually start menopause about nine months earlier. They also suffer longer episodes of irregular bleeding and hot flashes for about 10 years, as compared to white women whose symptoms typically last for around 6.5 years.
Additionally, Black women are three times more likely than white women to experience premature menopause (menopause before age 40), sometimes caused by smoking, or autoimmune diseases like rheumatoid arthritis or lupus.
Stress and Racism Matter
A recent SWAN study (published in Women’s Midlife Health) also suggests there is a link between structural racism and the disparities between white women and women of color during these stages of life in the United States. While the connection bears further research, the differing impacts of stress is widely recognized.
Michelle A. Albert, MD, MPH, professor of medicine at the University of California at San Francisco, and president of the American Heart Association and president of the Association of Black Cardiologists, knows that stress and racism directly affect the ways menopausal symptoms present in Black women. She explains to Oprahdaily.com how, “It’s 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 can have detrimental effects on many aspects of life, such as access to healthcare, work environments, neighborhoods and socioeconomic challenges, and these factors can take a toll on the body, putting strain on hormonal and biological processes. This contributes to chronic inflammation, and as a result, can lead to long-term health consequences, including an earlier and more difficult menopause.
Although Black women tend to enter menopause earlier and experience longer-lasting symptoms, “they are least likely to leave the office with a prescription for hormone treatment,” Dr. Sharon Malone, an ob-gyn and chief medical officer of Alloy Women’s Health based in Washington, D.C. also tells Oprah’s digital platform. She explains how the issue points to what often happens when Black women complain of common symptoms like vaginal pain or dryness: they are either misdiagnosed or simply dismissed. There is also the misconception they have a higher pain tolerance, so they are typically advised to just tough it out without any viable solutions or simply told they’re too young for menopause. The prospects of such directions (or lack thereof) are alarming, as symptoms like hot flashes and weight gain, for example, can actually be linked to future heart disease, diabetes and other serious conditions already more prevalent among Black women.
How to Be Your Own Best Advocate
While every woman’s experience with perimenopause and menopause is unique, doctors say there are ways Black women can have smoother and healthier transitions that truly make a difference.
- Take a few steps to reduce stress. Experts suggest that higher levels of physical activity (about 30 minutes of heart-pumping exercise during most days of the week) can have a positive impact on reducing stress. It also helps to prevent heart disease, improve the mood, and support healthy weight management. This is especially important for Black women, as they tend to have higher rates of obesity, which can intensify symptoms like hot flashes and night sweats.
- If you’re a smoker, try to quit. According to the Black Women’s Health Imperative, (a national nonprofit dedicated to achieving health equity for Black women), Black women who smoke often do so to reduce stress. However, smoking is a major factor in increasing the risk of heart disease, cancer, stroke, and diabetes, as well as triggering early menopause.
- Find a doctor who understands you. According to a study by the Mayo Clinic, only 7% of medical residents expressed confidence in their ability to counsel patients about menopause, so the prospect of finding a well-informed, trusted doctor is already a tall order. But organizations like The North American Menopause Society’s (NAMS) “Find a Menopause Practitioner” feature or Black Doctor 24/7 are great places to start for finding medical professionals that offer proper menopause management. NAMS also provides helpful articles on the many factors surrounding perimenopause and menopause like hot flashes, memory challenges and hormone therapy.
