Perimenopause and Black Women: Navigating a Unique Journey
[Estimated reading time: 4 minutes, 48 seconds.]
For Black women, perimenopause can be more complex than expected. While all women experience changes during this time, Black women often face:
Earlier Onset: Black women tend to experience menopause on average eight months earlier than white women.
More Intense Symptoms: Vasomotor symptoms like hot flashes and night sweats tend to be more frequent and severe than for women of other races.
Healthcare Bias: Culturally insensitive providers may dismiss symptoms or offer inadequate care. Go Long covered this in August when talking about general inequalities in research by race, especially for Black women.
Photo credit: kali9
This lack of understanding and support can have real consequences:
Increased Risk of Chronic Disease: Unmanaged symptoms like sleep disturbances are linked to higher risks of heart disease and dementia.
Reduced Quality of Life: Persistent discomfort can affect mental health and daily activities.
Higher Rates of Depression and Anxiety: Systemic stressors and historical discrimination may contribute to these mental health challenges.
Researchers are exploring the reasons behind these disparities. Potential factors include:
Social Determinants of Health: Limited access to quality healthcare, higher stress levels, and socioeconomic disadvantages.
Genetic Factors: Individual genetic variations may play a role.
Impacts to Treatment
A recent study from the Menopause Society investigated racial disparities in hormone therapy access for Black and white women during menopause. The study included nearly 66,000 diverse women, with a significant Black participant population. Despite the high number of Black participants, documented menopause symptoms were only reported by 11%, much lower than previous studies showing rates up to 80%. Researchers suggest this discrepancy could be due to:
Underreporting by Black women: Cultural factors, historic racial discrimination or discomfort discussing symptoms might lead to underreporting.
Insufficient questioning by doctors: Doctors may neglect to properly inquire about menopause symptoms in Black patients.
Missed documentation by doctors: Even if discussed, symptoms might not be accurately documented in records.
“I had noticed for years that Black women were very quick to deny menopause symptoms unless specifically asked if they had X, Y, or Z symptoms and even less likely to admit that symptoms were interfering with daily life. This study really solidified what I had observed in clinical practice and that is that many Black women downplay and normalize menopause symptoms even when their quality of life is impacted,” says Dr. Sally MacPhedran, co-author of the study and an associate professor in the Department of Reproductive Biology at Case Western Reserve University School of Medicine.
How does this impact osteoporosis risk for Black women?
Go Long has discussed the risks of sarcopenia, osteopenia and osteoporosis as women go through perimenopause.
Black women tend to have higher bone mineral density than white women, which helps with staving off the above three health conditions. However, they face health disparities and other issues that put them at high risk for developing and suffering complications from them:
Compared to white women, Black women with postmenopausal osteoporosis experience worse outcomes after sustaining hip and other fractures.
Black women are more likely to have lupus or sickle cell anemia, both linked with a higher osteoporosis risk.
The Black community is 8-10% less likely to get screened for osteoporosis, and therefore more likely to go undiagnosed.
Black Americans have a higher rate of lactose-intolerance than other races. This can prevent consumption of dairy products—an excellent source of bone-strengthening calcium and Vitamin D.
Black women are less likely to receive medication to treat osteoporosis and prevent fractures.
In one study, Black patients were at greater risk for delayed surgery following a hip fracture.
In another study, Black patients had 30% higher odds of not receiving physical therapy following a hip fracture.
Women in the Black community also tend to have less awareness about osteoporosis than white women, which can delay prevention and treatment.
And more specifically on type 2 diabetes as it relates to osteoporosis:
Diabetes itself can increase the risk of osteoporosis in both Black and other women. It disrupts bone formation and metabolism, leading to bone loss.
Black women have a higher risk of developing type 2 diabetes compared to white women. This difference is partly attributed to social determinants of health, like limited access to quality healthcare and healthy food options.
[Side note: Type 2 diabetes is also more prevalent for Asian-Indians and Asian-Americans.]
What to do to combat this?
Obviously we need more research in this area so contacting your elected officials is one place to start. But that doesn’t help you now.
Get a DXA bone scan: You can’t hit what you can’t see. Talk to your doctor about getting scanned if you have a family history of osteoporosis or have some of the risk factors mentioned above. This is different than the body composition DXA scan I talked about here, which I still recommend. Both will help you establish a baseline for where your body is at.
Start resistance training: If you’re not doing resistance training, you should start. You can’t cardio your way out of osteoporosis. You may look hot in that outfit but if you take a fall, your body will not be strong enough to protect you if you only do cardio.
Re-think your food intake: For starters, think about how to incorporate more calcium and Vitamin D in your diet.
Don’t be shy about your symptoms: Advocate for yourself when you communicate with your healthcare team. If you’re unsure of the questions to ask to ensure you’re getting the right care, this is a great place to start.
Need help tying it all together?
Go Long can help.
You may already have a healthy nutrition regimen. But maybe you need help staying on track with some accountability texts.
Perhaps you’re overwhelmed by all of the strength training programs on Instagram, Facebook and TikTok. And you’re afraid of getting hurt. Completely understandable. Go Long can help you find the right training program for you.
It’s possible you need help triangulating what your primary care doctor is saying, what your physical therapist is saying and what you’re seeing on social media. Go Long can pull it all together for you.
Packages start at $99. You can do this.