Menopause 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 By Team Verywell Health Updated on April 29, 2024 Medically reviewed by Jessica Shepherd, MD 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. 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. — DR. JESSICA SHEPHERD 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 Illustration by Mira Norian for Verywell Health Menopause Symptoms What Are Vasomotor Symptoms During Menopause? Everything You Need to Know About Menopause and Sleep Can Menopause Cause Depression? Vaginal Dryness and Menopause: What You Need to Know Symptom Management Options 15 Supplements for Menopause Symptoms Progesterone Cream Benefits, Risks, and Alternatives Evening Primrose Oil and Menopause What Is Estroven? Ask the Expert Monique Rainford, MD Obstetrician-Gynecologist, Assistant Clinical Professor 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. Menopause Symptoms 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. How Racism Affects the Black Health Experience 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. What's the Best Way to Treat Menopause? 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. Signs That Your Body Is Entering Menopause Key Terms Menopause Perimenopause Hormone Therapy Hot Flashes Night Sweats Menopause Menopause is the biological process marked by a hormonal decline that causes menstruation to end. It is diagnosed when a person has not had a period for 12 consecutive months. What Is Menopause? Perimenopause Perimenopause is the stage before menopause that is marked by a gradual, natural decline in estrogen hormones and the beginning of menopause symptoms. What Is Perimenopause? Hormone Therapy Hormone therapy is a medical treatment used to increase or decrease hormone levels. In menopause, hormone therapy can replace declining estrogen and progesterone to help improve symptoms. Hormone Therapy for Menopause Symptoms Hot Flashes Hot flashes are brief periods when a person suddenly feels warm and develops sweating and flushing, usually on the face, neck, and chest. They are most common during menopause. What Are Hot Flashes? Night Sweats Night sweats are experiences of sweating at night while sleeping. They are a common symptom of menopause. What to Know About Night Sweats Personal Stories How I'm Helping Women Feel Empowered During Menopause and Beyond The symptoms of menopause can be as diverse as the women experiencing them. — LORRIE KING How I Overcame a Lack of Resources for Black Women in Menopause My goal is to empower women to take control of their own health and well-being during menopause, regardless of their race, age, or background. — KAMILI WILSON How Self-Advocacy Transformed My Experience With Menopause It took a lot of self-advocacy to get to this point in my menopausal journey, but it has been worth it. — DR. STACIA ALEXANDER How My Menopause Experience Inspired Me to Start My Own Company Women don’t want to just listen to a conversation around menopause; they want to be a part of it. — JULIE GORDON WHITE 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. Learn More What Is the Average Age for Menopause to Start? 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. Learn More Symptoms of Postmenopause 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. Learn More Postmenopausal Bleeding: When Are Symptoms Concerning? 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 Hot Flash Symptoms Learn More About Menopause Menopause Supplements for Managing Symptoms Menopause Brain Fog: Is It Real? Mood Swings During Menopause? You're Not Alone Why Does Menopause Cause Nausea? Sedentary Lifestyle Linked to Nighttime Menopause Hot Flashes Is Menopause on the Horizon? What Are the Symptoms of Menopause? Hot Flashes: Symptoms, Causes, and Treatment How Much Do You Really Know About Menopause Symptoms? 5 Signs That Signal Your Body Is Entering the Menopause Transition Premenopause: Signs, Symptoms, and Complications How Long Will Menopause Last for You? Hot Flashes After Menopause What's the Best Way to Treat Menopause? About Our Partner 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. Learn more More Resources National Menopause Foundation Black Girl’s Guide to Menopause North American Menopause Society American College of Obstetricians and Gynecologists 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. North American Menopause Society. Menopause 101: a primer for the perimenopausal. National Institute on Aging. What is menopause? 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 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 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 KFF. Health coverage by race and ethnicity, 2010-2021. 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 Shifren J, Gass M. The North American Menopause Society recommendations for clinical care of midlife women. Menopause. 2014;21(10):1038-1062. doi:10.1097/gme.0000000000000319