The Experience of Menopause for People of Color

Forty-three-year-old Priya never imagined she'd experience menopause prematurely. A few years back, she suffered from intense pelvic pain that prompted an MRI and revealed stage 3 cancer.

What happened next was a blur. She needed an emergency hysterectomy to stop the cancer spread, plunging her into early menopause in her late 30s.

Many miles away, Ayla was also experiencing early menopause after struggling for many years with hormonal imbalances and painful periods. But, as she grappled with this new reality, she became more alarmed about her unique, sudden experience with menopause.

Both Priya and Ayla are not only undergoing menopausal symptoms but also have lived shared experiences of this condition as immigrants.

Of course, these are just two of numerous stories in our multicultural society that touch on menopause, but how culture impacts our experience with it remains to be thoroughly explored.

It is projected that there will be over 60 million peri and post-menopausal women in the U.S. by 2030 and about 1.2 billion worldwide. Unfortunately, very little is known about ethnic diversities and variations in menopausal symptom experiences. However, new research has shown that culture can indeed affect how we live and approach menopause. 

Moreover, the world's population is rapidly aging, and women make up the majority of older adults in every country due to their higher life expectancy. 

For example, in the U.S., the average life expectancy for women is 81 years, five years longer than the average for males. Population aging will have vast implications on menopause rates, cultural expectations, and how we navigate this natural state. 

In addition, the rapid growth in older populations will challenge health care professionals and policymakers alike. Older adults, in general, will be more racially and ethnically diverse. 

By 2044, researchers suggest that the U.S. will be a majority-minority nation, meaning that the sum of various minorities will be more significant than the "majority" white population. 

Further, in the older population, racial minorities will account for 39.1 percent by 2050. As the population becomes increasingly diverse, the social and economic burden of menopause on minority communities is expected to become overgrown, and their care needs will continue to increase. 

In light of the above, understanding the various cultural factors influencing menopause is paramount to supporting individuals experiencing this natural process.

In many minority communities, the family is considered the primary support system. For instance, Latino culture is built around families, and they are more likely to live in multigenerational households.

The experience of menopause, as a result, may not be an isolated event, and it may affect how others in the family view menopause.

Multiple studies suggest that women who live in environments that negatively perceive menopause experience stronger physical and mental challenges.

A recent Pre-Collegiate Global Health Review article found that pressures from different societies and cultures impact the menopausal experience and its symptoms. Additionally, it has been shown that certain ethnicities in the U.S. are more prone to menopausal symptoms.

For instance, a new study in the journal menopause reported that non-Hispanic/Latinx Black women veterans had lower odds of documented menopause symptoms than non-Hispanic/Latinx White women. 

Moreover, non-Hispanic/Latinx Black women and Hispanic/Latinx women had a lower likelihood of being prescribed menopausal hormone therapy as well as higher probabilities of prescribed vaginal estrogen than non-Hispanic/Latinx White women. Lastly, non-Hispanic/Latinx Black women had a lower likelihood of estrogen use than non-Hispanic/Latinx White women.

Despite evidence suggesting a higher menopause symptom burden among Black women, documented menopause symptoms and hormone therapy were less common among Black women compared with white women veterans. 

While these findings suggest disparities in menopausal symptom reporting and documentation, symptoms vary across ethnic groups and may be strongly influenced by the cultural environment and its effect on women.

Significant differences exist across several ethnic groups within the U.S. and the women experiencing menopause. These distinctions can target efforts to promote strategies that reduce menopausal symptoms and make the best use of health promotion efforts, such as getting quality sleep and leading an active lifestyle.

But to do so, the need for cultural competence in health care is critical. Racial and ethnic disparities still exist. Minority populations may face barriers to accessing services and dealing with bias, language barriers, and cultural conflicts. This can lead to detrimental impacts on personal well-being and less usage of formal health services. 

In short, menopause is not just a natural process with one categorized experience. Instead, it affects a diversity of women, and no one has a single isolated story.