Health gap: menopause and black women

Explore this resource to learn more about the health disparities in symptoms and care faced by Black women going through menopause

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Illustration by Tara Anand for Verywell Health

Medically reviewed by Jessica Shepherd, MD

Menopause is a significant transition in a person’s life. Menopause is defined as the period after the end of menstruation and usually occurs between the ages of 40 and 58. Symptoms of menopause include vasomotor symptoms (hot flashes and night sweats), sleep disorders, mood swings, urogenital syndrome, cardiovascular and metabolic changes, and loss of bone mineral density.

While everyone experiences menopause differently, black women can experience the change earlier, be more physically and emotionally demanding, and cause more severe symptoms compared to white women.

Reportedly, black women experience more vasomotor symptoms (such as hot flashes and night sweats), poorer sleep quality and duration, and increased risk of depression during menopause. Black women in premenopause or early perimenopause experience vasomotor symptoms more frequently than white women, and over a longer period of time. Black women are also more likely to experience depressive symptoms during menopause, due in part to socioeconomic factors such as increased stress and lower levels of social support than their white counterparts. Combined, these factors can also negatively impact sleep quality.

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Illustration by Mira Norian for Verywell Health

This inequality is due to a combination of environmental and socioeconomic factors. The increasing stress and trauma experienced by black people from persistent discrimination, limited access to health care, and varying degrees of economic advantage play a large role in the disparity of experiences. Black people face daunting barriers to caregiving because of structural racism in the medical community, which affects risk factors and lifestyle factors that impact menopause. All of this makes it harder to get symptom relief.

To better understand these inequalities, our Menopause and Black Women Health Divide offers:

  • Discussing the primary symptoms of menopause and how they affect black women

  • Expert knowledge from Dr. Monique Rainford, gynecologist, clinical assistant professor at Yale Medicine and member of Verywell Health’s Medical Expert Board

  • Personal stories from four people with menopause experiences related to our partner Let’s Talk Menopause

Read on to learn more about the challenges black women face during menopause.

– dr Jessica Shepherd, gynecologist and chief medical officer of Verywell Health

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Illustration by Mira Norian for Verywell Health

Menopause Symptoms

Ask the expert

How is the experience of menopause different for black women?

Rainford: Black women are 50% more likely to have vasomotor symptoms such as night sweats and hot flashes, have symptoms on average 3.5 years longer than white women, and are less likely to receive hormone therapy. However, although they have more symptoms and last longer, they are less likely to receive treatment. This means that during these years they carry a higher burden of suffering from these symptoms.

Learn more: Menopause Symptoms

How Do Problems Accessing Health Care Affect Black Menopausal Women?

Rainford: Blacks are one and a half times more likely than whites to not have insurance, and are more likely than whites to have Medicaid or public insurance (38% to 20% in 2021). Research has shown that people with Medicaid coverage are 1.6 times less likely to successfully book a primary care appointment and 3.3 times less likely to book a specialty appointment. Therefore, both overall lower insurance premiums and lower private insurance premiums limit access to primary health care to treat problems such as menopause. And since Medicaid is less widely accepted than private insurance, that means not only less access to primary care choice, but likely less access to providers who specialize in treating menopause. In addition, both implicit and explicit biases can affect how seriously their concerns about their menopausal symptoms are taken and how effectively they are addressed.

Learn more: How racism affects black people’s health experiences

What treatment options are available to treat menopausal symptoms?

Rainford: Treatment options for menopause include hormone therapy, usually in the form of estrogen. If a woman still has a uterus, progestogen is often added to protect the lining of the uterus from abnormal changes. Treatment can be through oral or topical medications such as patches, gels, or sprays. Other options include certain medications that are typically used to treat depression. These antidepressants can improve menopause symptoms in women who do not have depression. Also, because alcohol and caffeine can make symptoms worse, women with symptoms can try to reduce them to improve their well-being.

Learn more: What’s the best way to treat menopause?

How would you recommend women talk to their healthcare providers about menopause?

Rainford: Women should voice their concerns if their menopausal symptoms are bothersome. If they find that their symptoms are not being adequately addressed at a particular visit, they should schedule a follow-up visit. If they are not comfortable with their provider or feel that it is not responsive to their needs, they should consider another provider as well. Women should not give up treating their symptoms. Sometimes it takes persistence and multiple visits or getting a second opinion from another provider.

Learn more: Signs your body is entering menopause

personal stories

Learn more about menopause

About our partner

Let’s Talk Menopause is a national 501(c)(3) non-profit dedicated to transforming the way menopause is discussed so women get the information and health care they deserve. The organization empowers women to navigate all stages of menopause, advocates for change in the medical community’s investment in menopausal care, and facilitates community and support by bringing women together during the transition to menopause. “Let’s Talk Menopause” provided Verywell Health with the personal storytelling context for this health gap.

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Health gap: menopause and black women

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