Menopause isn’t just common, it’s something every woman will experience when they reach midlife or shortly after. From hot flashes to vaginal dryness, the menopausal transition may not be the most comfortable time in a woman’s life, but it’s a necessary one. Black Americans face an even more difficult time with symptoms and treatment for them.
If you’re here, you probably have some questions.
- What is menopause?
- Why do Black people have worse symptoms?
- Why do they have a greater chance for premature menopause?
- What medical treatments are available?
- Can you manage menopause without hormone therapy?
Keep reading for the answers and more information on symptoms and stages of menopause, possible complications, and statistics.
What is Menopause?
Menopause is something every woman-born female must face at some point, whether they naturally progress through the transition or it is caused by hormone therapy, hysterectomy, or illness such as cancer. What is menopause exactly?
The Symptoms
The signs of menopause change as you transition through the various stages (more on that below) and are different for every person. For example, hot flashes may be a common symptom that most people associate with menopause, but some women rarely get them or they are mild, so early signs of perimenopause could be mistaken for another illness or condition.
Menopausal symptoms can include:
- Menstrual Cycles: They may become irregular, cause heavy bleeding, or you may notice spotting and other changes.
- Urinary Incontinence: A loss of bladder control is quite common. It may feel like a sudden feeling of urinating or cause leaking with physical activity or sneezing.
- Sleep: Trouble sleeping could be caused by hot flashes or urinary incontinence. However, trouble falling or staying asleep may have no other known cause.
- Sexual Health: Vaginal dryness and thinning skin can make sexual intercourse uncomfortable. Hormonal changes may affect libido. It’s common for those in menopause experience changes in their sex drive.
- Mood: It’s not fully understood why women in menopause experience mood changes. However, stress seems to play a role. Self care and speaking with a therapist may help.
- Body Changes: Changes in hormone levels affect the body in various ways, including appearance, cognitive ability, and bone density.
The Stages
There are three stages of menopause: perimenopause, menopause, and post-menopause. Progression through each stage may vary based on age, lifestyle, family history and treatment.
Perimenopause
During this “menopause transition,” women may experience symptoms of menopause while still having menstrual periods. Ovaries atrophy, or slowly lose muscle, so they release less estrogen and progesterone. While a woman can still get pregnant, fertility slowly declines with age and as perimenopause progresses. This stage can last anywhere from three to ten years, leading to menopause. For a vast majority of women, this menopausal transition typically begins around mid- to late 40s.
Menopause
Menopause immediately follows once menstrual periods have stopped for one year. This is when ovaries stop releasing eggs and pregnancy is no longer possible. The average age of menopause is 51, but many other factors such as previous illness, the number of pregnancies, and family history can affect this.
Postmenopause
Postmenopausal women may experience symptoms of menopause for several years after their last menstrual cycle. However, these tend to become more mild over the years, dissipating until they are less bothersome or even disappear completely. Women’s health concerns don’t disappear with their menstrual periods, though, and post-menopause creates a higher risk for complications.
The Potential Complications
Not all women will experience these complications, but there is an increased risk with age. Hormone therapy and other treatments may come with their own potential complications, but could also help mitigate those associated with menopause. It may also be possible to address these complications directly if you are at risk or experiencing symptoms. It’s important to work closely with your medical provider on a treatment plan that works best for you.
Postmenopausal complications may include:
- Cardiovascular Disease
- Osteoporosis
- Loss of Bladder Control
- Urinary Tract Infections
- Changes in Sexual Function
- Weight Gain
- Mental Health Issues
Black Women and Menopause Symptoms
Throughout Black history and into today, differences in how Black people experience various health conditions and how they are treated for them are well documented. All women experience menopause, so it is crucial that healthcare providers have a good understanding of women’s health, especially for Black women.
Medical Statistics
Looking at the statistics, it’s easy to see how Black Americans not only experience menopause differently, but are also treated differently because of it. One study published in Women’s Midlife Health by researcher Sioban Harlow looked at the disparities that the Black population faces. The study shows that, despite reporting their difference in symptoms, they aren’t getting the appropriate difference in care. Let’s take a closer look at the numbers.
Black people are:
- More likely to report experiencing hot flashes than White people
- More likely to report symptoms of depression
- Less likely to report sleep problems but more likely to experience them
- More likely to report increased physical limitations
- More likely to have existing health conditions prior to menopause, such as obesity, diabetes, or cardiovascular disease
- More likely to experience worsening of pre-existing conditions
Healthcare Experiences
According to the same study, discrimination and other structural issues within the healthcare system greatly affect the treatment that Black Americans receive for menopause and other conditions. Because they may receive no or inadequate treatment for pre-existing conditions, it may cause higher risk for more severe symptoms and complications because of menopause.
Medical studies are an important part of learning more about why Black people experience menopause differently, and how it can be treated to reduce symptoms. Many community groups, national organizations, as well as state and federal agencies are working to reduce disparities within the healthcare system to ensure everyone has equal access to care.
Managing Menopause
Regardless of race, managing menopause can help you feel better physically as well as mentally. Treatment can range from hormone therapy to lifestyle changes but often include a blend of both, depending on your symptoms. You’ll need to work closely with your healthcare provider on what will work best for you.
Hot Flashes
Hot flashes cause a sudden feeling of warmth, usually in the chest, neck, and face. You might appear red, have blotchy skin, and sweat. It’s also common to feel anxious or have mild heart palpitations. Fluctuations in body heat could lead to feeling chilled as the hot flash ends. The episodes usually only last a few minutes but can be intense. If they occur often and affect daily activities, it’s time to talk to your doctor about treatments.
A Medical Treatment Plan
The Office on Women’s Health offers information on menopause treatment options, such as hormone therapy. While it’s important to do your research and understand what is available, you should ask questions and learn more from your primary care doctor or specialist before making an informed decision about your care. Remember, though, that medical treatment for menopause is not always necessary.
- Menopause Hormone Therapy: These prescription medications are often prescribed for premature menopause or very severe symptoms that affect daily life. They should replace the estrogen levels that your body now lacks because the ovaries are not producing it themselves, thereby reducing or eliminating any symptoms of menopause.
- Topical Hormone Therapy: Creams, gels, and inserts with low doses of estrogen may be used directly on or in the vagina to help ease symptoms where they are most bothersome without many of the side effects or additional risks caused by hormone therapy medications.
- Natural Remedies: Not all herbal or natural remedies work for everyone and you should discuss the use of non-prescribed supplements with your doctor before use. However, many women report positive experiences with supplements like black cohosh, red clover, and soy.
Lifestyle Changes
Women usually don’t need medical intervention for menopause, but they can still make lifestyle changes to reduce their symptoms. These changes may also help reduce symptoms of or risk factors for other health conditions.
- Keep a menstrual calendar
- Do yoga and other bone strengthening exercise
- Take care of your cardiovascular health
- Meditate for stress relief
- Control weight gain
- Improve sleep
- Do Kegel (pelvic floor) exercises for bladder control
- Manage blood pressure, cholesterol and other common health conditions
The Menopause Guidebook
The North American Menopause Society publishes the Menopause Guidebook. The newest edition includes the most up-to-date information on menopause, from scientific advancements to the latest recommendations for medical treatments and holistic approaches to symptom management. It is ideal for both healthcare professionals and patients. You can purchase a copy yourself or ask your provider if they offer them as handouts. If they don’t currently, you might suggest that they do.
Taking Women’s Health (And Black Americans) Seriously
Hot flashes aren’t the only signs of menopause, and while many women experience only mild symptoms, more severe ones many make it difficult to go about daily activities. The menopausal transition could be more difficult for the Black population and those who self identify as Black. Monthly cycles may stop, but the need for quality women’s health care does not. Organizations like Black Health Matters work to raise awareness of the importance of such care for Black Americans.
