Health Divide: Menopause and Black Women

Explore this resource to learn about the health inequities in symptoms and care that Black women face during menopause

Health Divide: Menopause and Black Women

Menopause is a significant transition in a person’s life. Defined as the period of time after a person has stopped menstruating, menopause usually occurs between the ages of 40 to 58 years old. Menopause-related symptoms include vasomotor symptoms (hot flashes and night sweats), sleep disturbances, mood changes, genitourinary syndrome, cardiovascular and metabolic changes, and the loss of bone mineral density.

While everyone experiences menopause differently, for Black women, the change can start sooner, be more physically and emotionally challenging, and cause more severe symptoms compared to White women.

Throughout menopause, Black women are reported to experience higher levels of vasomotor symptoms (such as hot flashes and night sweats), poorer sleep quality and shorter sleep duration, and an increased risk of depression. Black women in pre-menopause or early perimenopause experience vasomotor symptoms at a higher rate than White women and experience them for a longer period of time. Black women also have higher rates of depressive symptoms during menopause, which are due in part to socioeconomic factors like increased stress and less social support than their White counterparts. In combination, these factors can also negatively impact sleep quality.

Menopause Health Divide statistics: 1-2

Illustration by Mira Norian for Verywell Health

This disparity is due to a combination of environmental and socioeconomic factors. The increased stress and trauma Black people face as a result of ongoing discrimination, reduced access to health care, and varying degrees of economic advantage play a large role in the disparity of experiences. Black people are met with discouraging barriers to care due to structural racism in the medical community, which influences risk factors and lifestyle factors that impact menopause. All of this leads to a harder time getting symptom relief.

For Black women, menopause can start sooner, be more physically and emotionally challenging, and cause more severe symptoms compared to White women.

To help understand these inequities, our Health Divide on menopause and Black women provides:

  • Discussion of the primary menopause symptoms and how they impact Black women
  • Expert insight from Dr. Monique Rainford, OB-GYN, Assistant Clinical Professor at Yale Medicine, and member of Verywell Health’s Medical Expert Board
  • Personal stories from four people with menopause experiences in connection with our partner, Let’s Talk Menopause

Read on to learn more about the challenges impacting Black women in menopause.

Dr. Jessica Shepherd, OB-GYN and former Chief Medical Officer for Verywell Health

Menopause Health Divide statistics: 3-4

Illustration by Mira Norian for Verywell Health

Menopause Symptoms

Symptom Management Options

Ask the Expert

Monique Rainford, MD

Obstetrician-Gynecologist, Assistant Clinical Professor
Monique Rainford, MD
Monique Rainford, MD, is board-certified in obstetrics-gynecology, and currently serves as an Assistant Clinical Professor at Yale Medicine. She is the former chief of obstetrics-gynecology at Yale Health.
Read more

How is the experience of menopause different for Black women?

Dr. Rainford: Black women are 50% more likely to have vasomotor symptoms such as night sweats and hot flashes, experience symptoms for on average 3.5 more years than White women, and are less likely to get hormone therapy. However, despite having more symptoms and a longer duration of symptoms, they are less likely to receive treatment. That implies they bear a higher burden of suffering from these symptoms during those years.

How do access to care issues impact Black women going through menopause?

Dr. Rainford: Black people are one and a half times more likely to be uninsured compared to White people and more likely to have Medicaid or public insurance compared to White people (38% to 20% in 2021). Research has shown that with Medicaid insurance, individuals are 1.6 times less likely to successfully schedule a primary care appointment and 3.3 times less likely to schedule a specialty appointment. Therefore, both the overall lower insurance rates and lower rates of private insurance translate into less access to primary care to address issues like menopause. And since Medicaid is less widely accepted than private insurance, it not only means less access to choices of primary care providers but likely less access to providers who specialize in menopause treatment. Additionally, both implicit and explicit biases can affect how seriously their concerns about their menopause symptoms are taken and how effectively they are addressed.

What treatment options are available to help manage menopause symptoms?

Dr. Rainford: Treatment options for menopause include hormone therapy usually in the form of estrogen and if a woman still has a uterus, progestin is often added to protect the lining of the uterus from developing abnormal changes. The treatment can be oral or topical medications such as patches, gels, or sprays. Other options include certain medications that are usually used to treat depression. These antidepressants can improve menopause symptoms for women who do not suffer from depression. Also, since alcohol and caffeine can make symptoms worse, women with symptoms can try to cut these down to try to improve how they feel.

How would you recommend women discuss menopause with their healthcare providers?

Dr. Rainford: Women should bring up their concerns if their menopause symptoms are bothersome. If they find that their symptoms are not adequately addressed in a particular visit, they should schedule a follow-up. Similarly, if they are not comfortable with their providers or do not think their provider is addressing their needs, they should seek another provider. Women should not give up on getting their symptoms addressed. Sometimes it requires persistence and multiple visits or getting a second opinion from another provider.

Key Terms

Personal Stories

Frequently Asked Questions

  • When does menopause start?

    Menopause naturally happens for many people when they are between the ages of 40 and 58. In the United States, the average age for menopause to start is 52 years.

  • What signals the end of menopause?

    Menopause marks the end of menstruation. After this occurs, the most common symptoms during postmenopause are hot flashes, night sweats, mood swings, and vaginal dryness.

  • Can periods restart after menopause?

    Postmenopausal bleeding is not your period returning. While postmenopausal bleeding often stems from benign (noncancerous) conditions, it can be the first sign of endometrial (uterine) cancer. As such, vaginal bleeding after menopause requires prompt medical attention from a healthcare provider.

  • What does a hot flash feel like?

    Hot flashes include symptoms such as sweating on the face, neck, and chest and a burning sensation. The warmth of a hot flash is often accompanied by flushing, which is redness of the affected areas. You may also experience heavy sweating, tingling of your fingers, and palpitations.

Learn More About Menopause

About Our Partner

Let's Talk Menopause logo

Let’s Talk Menopause is a national 501(c)(3) nonprofit organization invested in changing the conversation around menopause 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 menopause care, and facilitates community and support by connecting women in the menopause transition. Let's Talk Menopause provided Verywell Health with the personal story connections for this Health Divide.

More Resources

8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. North American Menopause Society. Menopause 101: a primer for the perimenopausal.

  2. National Institute on Aging. What is menopause?

  3. Harlow SD, Burnett-Bowie SAM, Greendale GA, et al. Disparities in reproductive aging and midlife health between black and white women: the study of women’s health across the nation (SWAN). Women’s Midlife Health. 2022;8(1):3. doi:10.1186/s40695-022-00073-y

  4. Avis NE, Crawford SL, Greendale G, et al. Duration of menopausal vasomotor symptoms over the menopause transition. JAMA Intern Med. 2015;175(4):531. doi:10.1001/jamainternmed.2014.8063

  5. Cortés YI, Marginean V. Key factors in menopause health disparities and inequities: Beyond race and ethnicity. Current Opinion in Endocrine and Metabolic Research. 2022;26:100389. doi:10.1016/j.coemr.2022.100389

  6. KFF. Health coverage by race and ethnicity, 2010-2021.

  7. Hsiang WR, Lukasiewicz A, Gentry M, et al. Medicaid patients have greater difficulty scheduling health care appointments compared with private insurance patients: a meta-analysis. Inquiry. 2019;56:46958019838118. doi:10.1177/0046958019838118

  8. Shifren J, Gass M. The North American Menopause Society recommendations for clinical care of midlife womenMenopause. 2014;21(10):1038-1062. doi:10.1097/gme.0000000000000319