What Black Women Need to Know About Perimenopause – They Might Be Hit Harder

Are you a Black woman noticing changes in your body that seem to whisper of menopause’s approach, perhaps sooner and more intensely than you expected? You’re not alone. While the journey into menopause is a path all people with ovaries will eventually walk, for Black women, their symptoms often begins earlier, stretches longer, and is more intense than it is for white women. If you’ve been searching for insights into why your menopause journey feels different than what you were expecting, we’ve got the answers you need. Here’s what Black women need to know about perimenopause…

A Unique Journey for Black Women

A 2022 scientific review analyzed 25 years of data from the Study of Women’s Health Across the Nation (SWAN). The SWAN study‘s primary goal was to explore how menopause unfolds naturally and how it impacts women’s health. It revealed some interesting facts about how Black women experience menopause, including:

Menopause Starts Earlier

A key focus of the SWAN study was on understanding the age when the final menstrual period (FMP) occurs, signaling the end of a woman’s ovulation cycle. This  is an important when studying the aging of ovaries and its implications.

What they found was that Oover an 11-year span, on average, Black women reached menopause about 8.5 months earlier than white women –  52.17 years vs. 52.88 years, respectively. Interestingly, when factors like health status, smoking, alcohol use, education levels, employment, past contraceptive use, body weight, and physical activity were considered, the gap between Black and white women narrowed to just 3.1 months. This adjusted difference wasn’t significant enough to be considered a statistical disparity.

Note: In the SWAN study, the age of the FMP is a key factor. However, surgeries like hysterectomy or oophorectomy can obscure this milestone. Notably, Black women are more likely to undergo these procedures compared to white women, with 30% of Black women having had either surgery compared to 15% of white women. 

This difference affects the ability to observe natural menopause and influences the reported age at FMP in Black women. In the SWAN study, those who underwent such surgeries were excluded from the natural menopause age calculations, highlighting how surgical interventions can shape the understanding of menopause experiences among Black women.

Their Symptoms are More Severe

One of the key findings of the SWAN study was that Black women’s symptoms are often more severe than those of white women. Some of these symptoms include:

Hot Flashes and Night Sweats (Vasomotor Symptoms – VMS) 

Common in perimenopausal, these symptoms affect about 80% of women. What the SWAN study found however, was that Black women were 50% more likely to suffer from VMS and that they consistently reported more severe and bothersome symptoms, compared to white women. Further, Black women experienced VMS for an average of 10 years, significantly longer than the 6.5 years for White women.

Despite the higher burden of symptom and the fact that Hormone Replacement Therapy (HRT) is an accepted treatment for hot flashes and night sweats, Black women are less likely to use hormone therapy. This underscores the importance of ensuring Black women have better access to effective treatment options for menopause.

Depression

It turns out that Black women in menopause are more likely to experience new depression cases – 20% compared to white women 13%. And Black women tended to go through repeated bouts of depression more frequently. 

The causes of this depression also varied: for Black women, things like struggling in their roles and feeling down from the start played a bigger part, while for White women, issues with sleep and feeling less hopeful were key factors. 

A particularly important finding was that Black women were far less likely to get treatment for their depression. Again revealing a real gap for Black women getting the mental health care they need.

Sleep Disturbances. 

In the SWAN study, a curious pattern emerged around sleep. Black women were less likely to report sleep problems, yet sleep tests showed poorer sleep quality. Black women had lower sleep efficiency (less time in bed), took longer to fall asleep, and spent more time awake after initially falling asleep. Their deep sleep phase was shorter, and they experienced more brain arousal during sleep.

The study also showed something telling about sleep and health. For Black women, not getting enough sleep was linked to higher levels of C-reactive protein, a sign of inflammation. This highlights how closely linked our sleep patterns are with our overall health, and how this can be influenced by race and life circumstances, especially for women going through menopause.

Diabetes

The risk of type 2 diabetes increases after menopause in all women. What the SWAN study revealed, however, was that Black women faced a higher chance of developing diabetes compared to white women. Depression was a big factor here, especially for Black women, who were 2.5 times more likely to develop diabetes if they were dealing with depression – a connection not seen in white women. Black women also tended to experience these health issues earlier.  One reason  for this that the study pointed  to was their larger waist sizes. 

Heart Disease

As estrogen levels fall during menopause, you risk of coronary heart disease, heart attack and stroke increases. And according to the study, Black women had a higher 10-year risk of heart issues compared to white women. Interesting, Black women had less carotid plaque but greater common carotid artery thickness. 

They’re Symptomatic Longer

The SWAN Study also revealed that menopausal symptoms will last longer for Black women. They endure symptoms for about 10 years, in contrast to 6.5 years for white women. 

A Concerning Healthcare Gap for Black women

The SWAN study shed light on the concerning gap in healthcare for Black women. Their symptoms are often overlooked, and they’re not receiving the same treatment options as white women. 

Moreover, research suggests that these disparities are influenced by environmental factors and systemic racism. This extends beyond menopause, with Black women facing higher risks of fibroids, increased mortality in childbirth, more frequent cases of high blood pressure, and greater incidence of heart disease. 

This issue is compounded by a startling fact: about 80% of OB-GYNs admit to lacking training in menopause and perimenopause. Until this changes, it’s crucial for women to become advocates for their own health. Awareness that these symptoms are linked to hormonal changes and menopause is the first step.

These insights highlight the need for more tailored and accessible healthcare for Black women during menopause. And understanding this can be a game-changer in getting the right support and keeping health concerns at bay.

Owning Your Menopause Journey

With this early arrival of menopause, being proactive about health risks becomes even more important. Especially since Black women are not offered the same care as white women. And their symptoms are more often dismissed and they’re not given treatment options.  

Stay informed and tuned into your body’s signals. And when you need support from your healthcare provider, ask for it. Don’t let them dismiss you. Make this chapter one of empowerment and wellbeing.

Want to learn more? Check out these great resources: Black Girl’s Guide to Menopause or Black Women in Menopause.