Menopause is a near-universal experience for women in quarantine. And most women will experience physical, mental, and emotional changes in the years before and after their menstrual cycle ends.
While vasomotor symptoms Such as night sweats and hot flashes are common in most women, their duration and severity vary by race and ethnicity. Cultural norms can also have a significant effect on how women experience menopause.
Read: Menopause symptoms are far from universal >>
“I had a Latina patient who was having a hard time dealing with what was happening physically in terms of hot flashes and night sweats, but also feeling like she had no one she could turn to to talk about how she was feeling emotionally,” said Makeba L. Williams, MD, professor in the department of obstetrics and gynecology at Washington University School of Medicine in St. Louis. “She said her village was there for her when she gave birth, but no one talked to her about what to expect during menopause. She was almost afraid to tell her mother that she was considering hormonal therapy because it was countercultural to her.
As with other health issues, racial, ethnic, and cultural disparities can make a difference in menopause care. We spoke with Williams about the connections between racial disparities in menopause and what women can do to ensure they receive care that respects their personal and cultural needs.
This interview has been lightly edited for clarity and length.
Healthy women: What data exist on racial differences in menopausal symptoms?
Makeba L. Williams: In the SWAN Women’s Health Study, we found that African American women report having more hot flashes and night sweats. They get them more frequently and also for a longer duration. longer duration — on average 10 years. That’s nearly 9 years for Hispanic women, 6.5 years for non-Hispanic white women, and even less for Asian women.
Healthy women: Do we know the reasons for these racial differences?
Makeba L. Williams: We don’t know exactly what motivates them. But if we look at the health of women transitioning from midlife in a holistic way, vasomotor symptoms like hot flashes and night sweats can be alleviated. cardiovascular disease markers. When we look at who is most affected by cardiovascular disease, we come back to African American women. This connection leads to more overall health disparities for African American women.
Healthy women: Living in neighborhoods with higher concentrations of air pollution And less green spaces may be associated with younger age at menopause. What could be the correlation between these factors?
Makeba L. Williams: We are still trying to understand how the environment affects the menopausal transition. Is there a direct relationship? Or is it a factor that is affected by other factors, where exposure to air pollution and reduced access to green spaces cause other conditions that lead to a younger age at menopause? This is an area to explore, but we know that socioeconomic disadvantage, stress, caregiving responsibilities, and chronic exposure to racism and discrimination are associated with worsening symptoms. We see many of these factors among African Americans who experience disproportionate levels of menopausal symptoms.
Healthy women: What other links did the SWAN study uncover?
Makeba L. Williams: We found increased cigarette and tobacco use among African American women and decreased physical activity. Hot flashes and longer night sweats were associated with stress, lower education, anxiety, financial difficulties, low social support, obesity, smoking and not have a partner. There’s still a lot we don’t know because women of color have been excluded in large numbers from menopause research. We need to be more inclusive in our recruitment of diverse research populations to better understand the causes of these disparities.
Watch: HealthyWomen Congress Briefing: Women in Clinical Trials >>
Healthy women: Can cultural frames of menopause affect women’s physical, mental and emotional symptoms?
Makeba L. Williams: Culture can make a difference in what women reveal to others, what they talk about, and what is normative. White women could be more likely to seek treatment, while some women of color may feel like they have so many other things that worry them and don’t seek treatment. Overall, the thought might be, “Do I have time to worry about a hot flash or night sweats? Or a little weight gain in my abdomen even if I work out? We can also think about differences in body shapes, which bodies are celebrated in different communities, and how weight is distributed, meaning weight gain might not be seen as problematic in some non-white cultures. While 80% of postmenopausal women If you experience hot flashes and night sweats, the level of discomfort can be very different and what these symptoms represent can mean different things in different cultures.
Healthy women: In many Western countries, menopause is often described as a negative experience. Does this differ outside of Western contexts?
Makeba L. Williams: A common theme in the literature is that many minority women perceive this transition as positive. They adopt a posture of acceptance and make fun of their symptoms because, overall, they feel they have all these other positive benefits of being in midlife and menopause. Many will feel liberated for the first time in their lives because they will not face some of the challenges associated with the childbearing period, such as pregnancy or bleeding. If you are African American and disproportionately affected by fibroids, when your period stops, you no longer worry about having to remember a second pair of clothes or modify your daily activities because you don’t know when your period might appear. Additionally, in many cultures, reaching a certain age and point of maturity comes with respect. You feel like you have reached this vaunted station in life.
Healthy women: What is the best way to prepare for menopause, regardless of your cultural background?
Makeba L. Williams: Every woman deserves to benefit from the best menopause care. This might look like asking your doctor for advice about menopause in general. This might sound like a plea and saying, “I know there are differences between people and how they experience menopause. Tell me more.” I hate to see women continue to suffer in silence because their mothers or aunts did, and because their own healthcare providers don’t bring up the subject. I want patients to have the power to seek out information and then decide what is best for them.
This resource was created with the support of Astellas.
