Are Vasomotor Symptoms More Severe in Black Women?

For many women, the menopausal transition occurs between the ages of 45 and 55. However, emerging research suggests that ethnicity and race may play a part in this timing. According to a recent study, Black women started menopause an average of 8.5 months earlier than white women.

This might be because Black women experience more menopause triggers at an earlier age than white women. This may include:

• Hysterectomy: A hysterectomy is a procedure that removes the uterus. If the ovaries are also removed, menopause begins. Black women are up to three times more likely to undergo a hysterectomy for fibroid tumors than other ethnic groups.
• Family history: Women who have close relatives who had early menopause are more likely to experience premature menopause themselves.
• Chronic fatigue syndrome: Women who have myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) are more likely to have premature menopause.

It’s important to note that a person’s health status and family history aren’t the only causes of early menopause. The age at the onset of menopause can also be influenced by a person’s socioeconomic status and other lifestyle factors such as smoking or alcohol use.

The hormonal changes that occur during menopause can cause a wide range of emotional and physical symptoms. While many people notice similar symptoms, Black women tend to have more severe outcomes and may experience symptoms for a longer duration.

Here’s an overview of the most common symptoms of menopause for Black women.

Physical effects

Menopause is often marked by periods of these and other symptoms:

• insomnia
• decreased libido
• vaginal dryness
• irregular bleeding
• painful sex (dyspareunia)

Arguably, the most well-known symptoms of menopause are vasomotor symptoms (VMS) like hot flashes and night sweats. Research indicates that Black women are at a higher risk of more severe hot flashes than white women.

One study showed that roughly half of Black women encounter VMS during pre-menopause, while just over one-third of white women experience the same.

Emotional/social effects

Menopause can have a direct impact on your mental and emotional health. According to one small study, up to two-thirds of people going through perimenopause experience memory problems and have a harder time focusing.

Another common concern is irritability and intense emotions. A 2016 study found that people who experienced depression after childbirth or mood changes during menstruation were more likely to experience these symptoms during menopause. But more research is needed to know that for sure.

There’s also a lack of research on whether the emotional symptoms of menopause are more significant in Black women than white women. But Black women may experience worse symptoms due to inequalities in the healthcare system.

There’s a record of racial inequality within the medical field. Black women often face more discrimination, racism, and mistreatment than white women. It’s also more common for Black women to be misdiagnosed or left untreated.

In a recent study, researchers reviewed the data of more than 200,000 in the United States Veteran’s Health Administration. They found that Black women were 26% less likely to be prescribed hormonal therapy for menopause symptoms than white women. Black women were also less likely to be treated with vaginal estrogen.

More research is needed to fully understand these disparities.

Why does it matter?

Menopause can be a time of confusion and discomfort. No one should have to go through that alone.

Many Black women aren’t afforded adequate care due to racism or prejudice against their socioeconomic status. This can lead to serious long-term health concerns, as menopause is associated with an increased risk of several conditions, including:

• stroke
• heart disease
• bone fractures
• bone loss (osteoporosis)

Women who experience menopause at an earlier age are thought to have a shorter lifespan than women who go through the menopausal transition later in life.

Receiving appropriate care as soon as menopause symptoms occur can have a powerful positive impact on long-term health outcomes.

Menopause is a natural process, but that doesn’t mean it’s easy. Remember, you don’t have to experience these symptoms alone. There are many effective treatments that can make menopause a lot more manageable.

Here’s a guide to the best menopause treatments for your individual symptoms.

Hormone replacement therapy (HRT)

HRT helps balance sex hormone levels to alleviate VMS like hot flashes and night sweats. It can also help improve brain fog, osteoporosis, joint pain, vaginal dryness, and mood changes.

Your doctor can discuss the best dosage for your unique needs. Oestrogen HRT comes in many forms, including:

• pills
• implants
• skin patches
• topical sprays or gels

Another option is combined HRT, which includes estrogen and progesterone. If you have a low sex drive, your doctor may also suggest testosterone HRT.

Medications

Depending on your specific symptoms, your doctor may prescribe medication. Here’s an overview of some options and what they’re used for:

• prophylactic antibiotics for chronic urinary tract infections (UTIs)
• prescription sleep medication for insomnia
• low dose estrogen-based or nonhormonal lubricants for vaginal dryness
• topical minoxidil, ketoconazole, or zinc pyrithione for thinning hair or hair loss
• calcitonin, denosumab, raloxifene, or teriparatide for postmenstrual osteoporosis
• eflornithine hydrochloride topical cream for unwanted hair growth on the face and chin
• selective serotonin reuptake inhibitors (SSRIs) for anxiety, depression, hot flashes, or mood changes

Menopause-friendly diet

During menopause, your body needs extra nutrients to help your body adapt to the changes it’s going through. Here are some healthful choices to fill your plate with:

• lean proteins such as tuna, turkey, chicken, tofu, beans, and lentils
• nutrient-dense vegetables like Brussels sprouts, kale, broccoli, spinach, collard greens, and asparagus
• calcium-rich foods like milk, fortified plant-based milk, winter squash, edamame, almonds, leafy greens, and yogurt

There are also certain foods you may want to avoid. Spicy foods, alcohol, and caffeine may worsen VMS like hot flashes or night sweats.

Self-care

Self-care is essential for your overall health and well-being. Self-care tips for menopause include:

• talking with your friends about your feelings
• investing time in the activities or hobbies you enjoy
• wearing comfortable, breathable clothing
• going for a walk or doing a gentle exercise several times a week
• placing a portable fan on your desk if you get hot flashes at work
• switching to 100% cotton or linen bedding to keep you cooler at night
• using a lubricant during sex or masturbation to prevent painful penetration

Menopause is different for everyone. However, VMS and menopause symptoms may be more severe in Black women than white women. There is also a trend of Black women going through the menopausal transition at an earlier age than white women.

Research shows that there is a lack of equity in the way Women of Color are treated during menopause and in the healthcare field at large. It’s important to advocate for your own health and well-being.

Discuss your menopause concerns with a doctor, and be sure to detail your symptoms. If you feel like they aren’t taking your concerns seriously — or if they aren’t providing you with an appropriate level of care — it might be time to find another doctor.

And remember, you’re not alone.