Empower Her: Black Women and the Menopause Journey

Menopause, an inevitable phase in a woman’s life, signifies a ‘pause’ in menses, irrespective of ethnicity, socioeconomic background, or geographical location. Yet, for Black women, this natural transition carries unique challenges which are rooted in historical racial injustice, misogyny and chronic stress. It’s a journey marked by disparities and resilience, with menopause serving as a moment for reflection, self-care, and community support. In this article, we delve deeper into the distinctive aspects of menopause for Black women, including the symptoms they experience, steps for a healthier transition, and a comprehensive look at treatment options tailored to their specific needs.

The Disparities Black Women Face

Extensive research reveals that Black women experience menopause earlier than their White counterparts. The Study of Women’s Health Across the Nation (SWAN) found that the average age of menopause for Black women is 49.3 years, while White women experience it at 51 years. Moreover, Black women endure menopause symptoms, such as hot flashes, for a longer duration – 10 years versus 6.5 years. Disturbingly, Black women are three times more likely to encounter premature menopause, occurring before the age of 40. This disparity can be attributed to the historical burden of stress, including structural racism, toxic work environments, limited healthcare access, and socioeconomic challenges.

Symptoms Experienced by Black Women

Black women often face more severe menopausal symptoms, a burden compounded by existing mental and physical health challenges. These symptoms include:

1. Vaginal Dryness Leading to Painful Sex: This distressing symptom can lead to discomfort and pain during intercourse, impacting the quality of life for Black women.

2. Hot Flushes: Characterised by a sudden feeling of heat in the upper body, hot flushes are known to be more intense and long-lasting for Black women.

3. Chills: Often accompanying hot flushes, chills can exacerbate the discomfort associated with these sudden heat waves.

4. Night Sweats: Night sweats can disrupt sleep patterns and lead to fatigue and sleep problems.

5. Sleep Problems: The menopausal transition can bring about sleep disturbances, affecting mental and physical well-being.

6. Mood Changes: Black women may experience more pronounced mood swings and emotional fluctuations during menopause.

7. Brain Fog and Concentration Problems: Cognitive challenges such as brain fog and difficulty concentrating can be more prominent during this phase.

8. Weight Gain and Slowed Metabolism: Menopause can contribute to weight gain and changes in metabolism, impacting overall health.

9. Loss of Skin Elasticity and Breast Fullness: Changes in skin elasticity and breast fullness are common concerns for Black women.

Difference Between Perimenopause and Menopause

It’s crucial to recognise the difference between perimenopause and menopause. Perimenopause is the transitional phase leading up to menopause and typically begins in a woman’s 40s. During this time, you may experience irregular periods and various symptoms. Menopause, on the other hand, is the point when your menstrual cycles cease entirely, usually around the age of 51 for White women and approximately 49 for Black women. In menopause, most symptoms experienced during perimenopause usually subside, but some challenges like vaginal dryness and hot flashes may persist.

Potential Complications of Perimenopause & Menopause

While the change is a natural phase, it can bring complications:

1. Heart and Blood Vessel (Cardiovascular) Disease: Decreased oestrogen levels increase the risk of heart disease, making regular check-ups and a heart-healthy lifestyle essential.
2. Osteoporosis: Oestrogen supports bone health. As oestrogen levels drop, bones can become brittle and weak, increasing the risk of fractures.

3. Genito-urinary Syndrome of Menopause: Reduced estrogen can lead to issues such as frequent, abrupt urges to urinate, stress incontinence, and an increased risk of urinary tract infections.

4. Sexual Dysfunction: Vaginal dryness and reduced libido can affect sexual function. Lubrication and treatment can enhance comfort and pleasure.

5. Heavy Bleeding: Changes in bleeding patterns can impact daily life. Black women, due to a higher prevalence of fibroids, may experience heavier bleeding, leading to complications like fatigue, lightheadedness, and palpitations from anaemia.

 Steps for a Healthier Transition

To navigate this transition and mitigate its challenges, consider the following steps:

1. Prioritise Physical Activity: Engaging in 30 to 45 minutes of physical activity at least 5 times a week can improve heart health, reduce hot flushes, boost mood, and help maintain a healthy weight. We encourage women to build it into their lifestyle in a way that works for them. Strength-building and flexibility exercises are also important for overall health.
2. Manage Your Mental Load: Assess and reduce your mental load, both at home and in your professional life. Share responsibilities, delegate tasks, and educate your support network about menopause’s impact on your well-being.

3. Self-Care: Prioritise protected “me-time” for personal enjoyment and relaxation. Build a network of family and friends who can offer support during this phase.

4. Lifestyle Changes: Quit smoking to reduce the risk of cancers, heart disease, stroke, and diabetes. Maintain a healthy diet and consider vitamin D and calcium supplements if necessary.

5. Minimise Triggers: Reduce your intake of spicy, fatty, and processed foods, as well as alcohol and caffeine, which can worsen hot flushes.

6. Positive Outlook: Embrace a positive outlook on menopause, as negativity can be associated with more frequent and severe symptoms.

Treatment Options for Black Women

In addition to these steps for a healthier transition, consider treatment options tailored to the specific needs of Black women:

1. Hormone Replacement Therapy (HRT): HRT is one of the most effective treatments for managing menopausal symptoms, including hot flashes, mood swings, and reduced libido. However, Black women should discuss HRT with their healthcare provider, considering individual health history and any increased risks related to heart disease and other health factors.
2. Supplements and Herbal Treatments: While natural remedies like primrose oil, black cohosh, and red clover can help manage symptoms, consultation with healthcare professionals trained in herbal medicine is advisable due to the lack of definitive scientific data.

3. Vaginal Oestrogen: These treatments provide direct relief from vaginal dryness and discomfort during intercourse, particularly beneficial for managing genitourinary syndrome of menopause.

4. Low-Dose Antidepressants: For women who cannot take oestrogen or need antidepressants for mood disorders, low-dose antidepressants can help control hot flashes. The choice of antidepressant should be made based on an individual’s specific health needs and in consultation with a healthcare provider.

In conclusion, menopause for Black women is a unique journey, marked by disparities and resilience. It is also a moment for self-empowerment, self-care, and the strength of community support. Seek help when needed, celebrate your resilience, and embrace this phase as an opportunity for personal growth and well-being. Together, we empower Black women to navigate menopause with grace and strength, ensuring that their journey through this transformative phase is one of self-discovery and empowerment.