Menopause Hits Black Women Harder

Research shows menopause starts earlier and is more challenging for Black women than for other races and ethnicities. 

By Selene Yeager 

February is Black History Month in the U.S. (It’s October in the U.K. and July in Australia) — an annual celebration of achievements by Black Americans. It's also a good time to take a closer look at the racial inequities that still exist in the realm of menopause.

A 2022 scientific review of 25 years of research based on the multiracial/ethnic Study of Women’s Health Across the Nation (SWAN) reported that Black women reach menopause 8.5 months earlier than White women and have worse symptoms such as hot flashes, depression and sleep disturbances, but are less likely to receive hormone therapy, as well as medical and mental health services. This report echoes earlier SWAN findings that Black women were 50 percent more likely than White women to have vasomotor symptoms like hot flashes and night sweats and also endure hot flashes longer – 10 years versus 6.5 for non-Hispanic White women.

“Our analysis suggests that the enduring influence of structural racism — differential access to the goods, services, and opportunities of society by race — is a major contributor to the health disparities between Black and White women in midlife,” said lead author Siobán Harlow, professor emeritus at U-M’s School of Public Health in a press release, noting that Black women have “greater probability of hot flashes but less probability of treatment for hot flashes, greater risk of hypertension but less treatment for hypertension, greater risk of depression but less treatment for depression.”

At last year’s North American Menopause Society’s (NAMS) Annual Meeting Tené Lewis, associate professor in epidemiology at Rollins School of Public Health at Emory University, and one of the investigators involved in SWAN gave a presentation on how “everyday discrimination” also helps drive the elevated cardiovascular risk among Black women in midlife.

By definition, everyday discrimination is day to day forms of interpersonal mistreatment, which are chronic, ongoing stressors that can have a deleterious impact on health. It’s been linked to elevated blood pressure, atherosclerosis, higher levels of inflammation (as measured by C-Reactive Protein) and premature death. Research also shows that higher levels of stress in daily life can accelerate the onset of menopause. Though all women can experience everyday discrimination (and we’ll be sure to cover other races in upcoming blogs), the findings have been particularly pronounced for African-American populations.

A 2021 paper published in the Journal of Women’s Health reports that Black women still have less access to care, lower quality of care, receive care in a less timely manner, and experience poorer outcomes than White women. 

Working for a Better Future

This is all part of a larger historical picture where racism has led Black women to be disregarded, mistreated, and in some cases outright abused by the medical system. In our Unwell Women Hit Play Not Pause episode with historian Elinor Cleghorn, PhD, she explained how one 19th Century doctor infamously performed experimental surgeries on Black women without anesthesia because it was believed they felt less pain than White women.  

Unsurprisingly, all of this can lead to Black women being reluctant to speak up and seek care, as this week’s guest sports manager, model, 2x Olympian, and former TV Gladiator Jennifer Stoute, said during our interview.

“Just because we don't speak out, doesn't mean to say we're not going through it,” Stoute says. “Because of the way the world has been for Black people in general, we just put our heads down and get on with it and muscle our way through life. Instead of putting ourselves out there and getting slapped down, we just soldier on. I think Black women, myself included, should stand tall and stand up in front and be able to say, ‘This is not working for us. We’re having a bad time. Like, we can put our hands up and say, enough's enough.’”

Stoute also emphasized the importance of being seen. “We have to change the narrative and make everything as equal as we can. We have to stand forward and make ourselves be seen. And to group with others that are going through exactly the same thing,” she says.

It goes without saying, but needs to be said, this also means that we need to keep working towards establishing a culture that supports equity and for the medical community to recognize and address these disparities. That’s especially important as research increasingly links severe menopause symptoms with chronic health conditions like heart disease, dementia, and early mortality.

We’ll be sure to continue covering research in this area as it evolves and to use this platform to increase awareness. For more resources on communities talking about the experience of Black women in menopause, check out:

Black Women in Menopause 

Menopause Whilst Black 

Black Menopause and Beyond

Black Girl's Guide to Menopause 

Black Women's Health Imperative (BWHI)