Racial Disparities in Menopause Treatment: Black Women Deserve Better

Race and Mental Health Play a Role in Hormone Therapy Disparities

Menopause isn't a one-size-fits-all experience. While hot flashes and night sweats are often the punchline of jokes, the reality is that symptoms can go beyond the physical and manifest as serious mental health issues. According to a recent study, women in menopause are nearly 30% more likely to experience psychiatric conditions (PsyCs) along with menopause symptoms. This statistic is a powerful reminder of how disruptive menopause can be.

Fortunately, there are numerous treatments available to women, either from a healthcare provider via prescription or via non-prescription and over the counter options. Clinically speaking, menopause hormone therapy (MHT) is the most effective treatment for symptoms.

But what if access to that treatment wasn't equal?

As a researcher focused on women's health, I recently presented our concerning findings at the Menopause Society’s Annual Meeting: Race may play a factor in getting the care you deserve.

Black Women Experience More Symptoms, Receive Less Treatment

Imagine experiencing more severe menopause symptoms, only to find out access to treatment might be limited based on your race. That's the concerning reality our research suggests. 

We analyzed medical records of over 65,000 women, specifically looking at how race plays a role in MHT prescriptions for women with both menopause symptoms and diagnosed psychiatric conditions (PsyCs). While overall MHT prescription rates were lower than expected, the most striking finding was the significant disparity between Black and White women. Black women, who often experience more severe symptoms, were prescribed MHT at a much lower rate than their White counterparts. This raises a critical question: is the care we receive during menopause truly equitable?

This disparity extends to women with PsyCs, which can be exacerbated during menopause due to hormone fluctuations. While MHT is not FDA approved to treat depression, it can have antidepressant effects for women with depression and VMS.  However, White women with PsyCs and VMS were 40% more likely to receive MHT than Black women in the same situation. 

What’s Behind the Disparity?

The gap in MHT access for Black women is a complex issue, but our research points to a few key factors:

Under-reporting

Black women may be less likely to report symptoms or downplay their severity, leading to missed diagnoses and treatment opportunities.

Implicit bias

Unconscious biases might influence how healthcare providers discuss MHT with patients of different races.

Lack of education

Both patients and healthcare practitioners (HCPs) may not be fully aware of how MHT can improve quality of life during menopause, particularly for women with mental health conditions. 

Closing the Gap

So how can we do better and ensure racial equity in menopause care so all women have access to effective treatment options? Bottomline: education. 

According to a Mayo Clinic survey, only 7% of women’s HCPs  feel equipped to treat menopause. To start, healthcare providers need ongoing education to ensure culturally competent care and eliminate unconscious bias in treatment decisions. HCPs should ask targeted questions about symptoms and explore treatment options, including MHT, to ensure all women have the opportunity to improve their quality of life during menopause.

Empowering women is crucial to facilitating open communication.

Women experiencing menopause symptoms, especially Black women, should be encouraged to discuss their experiences with their doctor. The key is to advocate for yourself by asking questions about treatment options, as well as expressing your preferences.

You're Not Alone

Beyond race, education level and the specialization of the HCP are also significant factors affecting menopause treatment rates. And, as mentioned before, MHT prescription rates are low across the board.

This highlights a universal need for improved menopause care. By working together, we can ensure all women receive the information and support they need to navigate menopause comfortably and confidently.

Author Note: This blog post is intended for informational purposes only and should not be interpreted as medical advice. Please consult with your healthcare provider for personalized recommendations.