New Study Highlights Poorer Quality of Life, Health Outcomes for African American Women During Menopause

Black women are more likely to encounter health disparities including physical, psychological, social and overall lower quality of life as they transition to and experience menopause versus white women, according to, “A review of African American women’s experiences in menopause,” recently published in Menopause Journal.

Co-authors, Makeba Williams, MD, Gloria Richard-Davis, MD, Peter L Williams, MD, Leslie Christensen, MD, Earlise Ward, MD and Sarina Schrager, MD found that African American women continue to experience poorer health outcomes than their white counterparts regarding maternal health, cardiovascular disease, depression, mortality related to diabetes, breast and gynecologic cancer and menopause. The racial disparity in health conditions is attributed to poverty-induced trauma, lack of access to health insurance, chronic stress and dietary choices. All are reported to have a significant impact on overall health and have led to the identification of racism as a public health crisis.

Much of what is known about racial and ethnic differences in the menopausal transition is from SWAN. The cross-sectional screening survey evaluated responses from approximately 16,000 women, 28.1% of whom were African American. Researchers found African American women start menopause earlier, have the highest rates for early onset menopause and experience longer transition periods than other races.

“Educating clinicians about differentiated menopausal experiences and developing standardized approaches to assess and discuss menopausal symptoms may optimize menopausal care and treatment for African American women,” says Dr. Richard-Davis, Professor and Executive Director for the UAMS Division of Diversity, Equity and Inclusion, Division Director for Reproductive Endocrinology.

Approximately 84% of African American menopausal women experience chronic and progressive changes due to a variation in hormone levels related to a complex interaction of race and ethnicity. Quality of life and sexual function is impacted due to vulvar, lower urinary tract and vaginal tissue changes. Unfortunately, many patients do not recognize that these signs are associated with menopause and do not see a healthcare provider to assess their symptoms.

Symptoms for African American women were also found to be more extensive and severe including hot flashes, dizziness, poor coordination and/or clumsiness and urine leakage. These symptoms, particularly hot flashes, increase with age in black women, while white women often report a decrease in menopausal symptoms with age. They also reported significantly more vaginal dryness than white women and often suffer in silence as they are less likely to seek help from a healthcare provider as they typically view menopause as a private matter to be discussed with same-race, same-sex allies and friends.

Serious health factors associated with declining estrogen levels are decreased cognition and memory along with increased rates of depression and sleep deprivation. Quality of life factors like marital status, tobacco use, depression and medical comorbidities can all exacerbate the menopausal experience and lead to a formula for misery.

Low-dose estrogen creams, tablets and rings are effective treatment options to relieve vaginal and vulvar dryness, itchiness, soreness, and pain during sex, but require a prescription by a healthcare provider.

In addition, symptoms of menopause can be controlled with a trip to the drug store as many solutions can be obtained without a prescription like Replens, a clinically tested, FDA cleared, hormone-free, long-lasting vaginal moisturizer that alleviates vaginal dryness due to menopause or as a result of cancer treatment.

“There is a complex interplay between sociodemographic, health-related and acculturation factors that work together to affect the menopausal experiences of African American women,” adds Dr. Richard-Davis. “Educating clinicians about differentiated menopausal experiences and developing standardized approaches to assess and discuss menopausal symptoms may optimize necessary care and treatment. And, as estrogen levels lower with age, African American women can treat vaginal dryness with Replens as an alternative or in addition to hormone therapy to avoid more serious complications like vaginitis, bleeding, urinary discomfort, bladder infections and painful intercourse to restore vaginal moisture and repair dry or damaged vaginal tissues.”

Riley DeWolf

riley@gcomworks.com

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