We’ve all heard our mothers, aunties, friends, grandmothers speak of “the change.” Then, we reach this period of transition, and we’re still like, “What in the world is happening?” No matter what we think we know, it still catches us off-guard. That’s how the conversation starts with many of my patients, and that’s certainly how I felt when I started to notice that something felt different with me. But what I have learned and share with all my patients is that there is a joy in understanding and embracing the change…
“The change,” or menopause, happens for most women by the age of 51. For many, the change does not happen abruptly, but gradually over time. To be fully menopausal, a women has to not have a menstrual cycle for 12 months. However, menopausal symptoms can last from 4 to as long as 10 years, especially for some Black/African American women (whew—10 years is a long time!). Symptoms can include hot flashes, night sweats, memory changes, sleeplessness, vaginal dryness, feeling less sexually aroused, irregular periods which are often very heavy before the very last period, mood changes, weight gain; these symptoms are all due to our ovaries shifting to deliver less estrogen than ever before in our lives.
And we’re learning more about how the menopause transition process is different for many Black women and Latinas. Several research studies show that Black women and Latinas often begin perimenopause earlier, experience menopause symptoms more intensely, and have longer transition periods. One national, longitudinal study of women and menopause, the Study of Women’s Health Across the Nation (SWAN), has found that Black women and Latinas reach menopause 2 years earlier (age 49) than the median age of 51 years. Earlier menopause has implications for increased risk of heart disease, stroke, bone fractures, altered sexual experiences, and decreased life expectancy. For women of color in the United States, data suggest that long-term, cumulative effects of systemic racism and long-term stress are negatively affecting our overall health, including an earlier median age at menopause. That’s a lot to take in, Sisters…
So, here’s how we navigate and embrace this change. First, if you don’t already have one, find a healthcare provider who listens to you, I mean really HEARS you and your concerns. You need to be able to have real talk with them. Second, write down your questions and include a description of any symptoms you might be feeling or have felt recently. This will help you remember those things you may want to discuss with your doctor, nurse practitioner or physician’s assistant, and these details will help your healthcare provider determine which options to consider and discuss with you. Third, if your healthcare coverage options limit your ability to select a preferred provider, then engage an advocate (someone who can help you get your concerns addressed and questions answered) during your health visits. This advocate can be a friend, family member, a hospital employee who is there to help patients, or even a paid professional. Fourth, be open to discussions that may include low-dose hormone replacement therapy (HRT). Ask questions to be sure you understand what are myths and what are facts regarding HRT. For many patients, starting a low-dose HRT regimen, even for a short-term, is extremely helpful for symptom relief. Fifth, let’s be open to lifestyle changes—if you smoke cigarettes, find help to stop; if you haven’t had much body movement, find a walking path or take the stairs; if your food is often heavy with cholesterol, replace a few meals with more baked foods and vegetables. If you’ve never had therapy, go talk to someone; processing long-term stress and systemic racism is real, and we need to deal with that. All of these affect how we go through menopause.
And ladies, embracing the change also means maintaining your sexy. I want you to always hold onto the part of you that is sexual; she doesn’t go away just because you’ve gone through the change. So whether that means new lingerie, a fancy pair of shoes, a self-care adventure for you, a new sex partner or new games with a current sex partner, make sure that you are not sacrificing something that you may desire. Talk with your health care provider, get what you need, and continue living your best life while embracing the change. You might find that life after the change is even better than what came before it…
