Did you know that people who menstruate can spend up to a third to half of their lives experiencing some stage of menopause? Medical professionals are still learning about menopause and utilizing ways to normalize this period of life for their patients — making it possible to uncover inequities in menopausal care and discoveries in how different demographics experience “the change” in America.
Dr. Makeba Williams, associate professor and vice chair of professional development and wellness in the Department of Obstetrics and Gynecology at Washington University’s School of Medicine, has been interested in Black Americans’ menopause experience since she began her residency about 20 years ago. Now she has published a review in Menopause: The Journal of the North American Menopause Society detailing the health disparities and social ills that change the way Black Americans go through and are treated for menopause.
“Going back to the 1800s, we’ve been interested in hormone therapy. And in part, we had been basing how we care for women off of how we care for men,” Williams said on Wednesday’s St. Louis on the Air. “Research was not being invested into women's health. And it really took some political and social capital — the change of who was being represented, even in Congress — and we started looking at how women were being included in research studies that led to the Women's Health Initiative.”
While the implementation of the Women’s Health Initiative was a sign of progress in medical research and advocacy, it centered on white women’s health and initially failed to address the lack of access to care for women of color, specifically Black women. Williams was one of six doctors who reviewed 20 years of literature on menopause, and they were able to find just 17 studies that addressed or included experiences of women of color.
“We found that African American women had an earlier onset of menopause, they had a longer menopausal transition, what we often term as the perimenopause, and that their symptoms are different,” Williams said.
The earlier onset of menopause means the common belief that menopause starts around age 45 to 55 could be earlier for Black Americans. Furthermore, Black Americans experience a higher rate of vasomotor symptoms, commonly known as hot flashes. Williams and her research partners also found that African American women experience menopause symptoms longer than white women, an average of 10 years compared to six years. Black Americans are also less likely to receive treatment for their menopause symptoms.
“That is problematic because many of these symptoms are associated with poor health outcomes,” she said. “[Symptoms] can be markers of cardiovascular disease, and we see that there is a disparity in who bears the cardiovascular disease burdens along the lines of race and ethnicity.”
To hear more from Dr. Makeba Williams on health disparities related to menopause and why everyone should pay attention to menopause research, listen to St. Louis on the Air on Apple Podcast, Spotify, Google Podcast, Stitcher, or by clicking the play button below.
“St. Louis on the Air” brings you the stories of St. Louis and the people who live, work and create in our region. The show is produced by Miya Norfleet, Emily Woodbury, Danny Wicentowski, Elaine Cha and Alex Heuer. Avery Rogers is our production assistant. The audio engineer is Aaron Doerr. Send questions and comments about this story to talk@stlpr.org.
