123103724 Does race or ethnicity affects your experience of menopause?

As crazy at it may seem, it turns out women’s experience of menopause, both how we perceive this transition, and even which symptoms affect us most, is influenced by our race and cultural heritage.

According to the SWAN (Study of Women’s Health Across Nations) longitudinal study* begun in 1994, which surveyed over 16,000 women between the ages of 40 -55 and studied 3,300 who were pre- and perimenopausal over a period of more than eleven years, showed that race and ethnicity are a considerable factor in women’s experience of the symptoms of menopause.

The study shows:

  •  African American and Hispanic women are forty percent more likely to experience an early menopause, defined as having their final menstrual period before age forty, than Caucasians. On the other hand, Chinese and Japanese women are very unlikely to have an early menopause.
  •  Hispanic women experience menopause about six months earlier than women in the other ethnic groups studied, while Japanese women have a later menopause by approximately three months.
  •  Forty-six percent of African American women and over thirty percent of Hispanics and Caucasians report hot flashes and night sweats, but only about twenty percent of Chinese and Japanese women do.
  • Caucasian women are more likely to report being irritable, nervous or depressed, or to have sleep problems or stiffness and soreness than women of other races or ethnicities. In fact women in the other ethnic groups had twenty to fifty percent fewer of these symptoms than Caucasians.

The SWAN study also contains one piece of great news; for decades it’s been generally accepted that Asian women suffer more from bone loss due to lowered estrogen levels during perimenopause and menopause. This turns out to be a myth:

It has been widely believed that Asian women have lower bone density than Caucasian women, but that is not correct… After differences in body size are taken into account, bone density in Asian women is actually higher than in Caucasian women. (African American women are already known to have higher bone density than Caucasians.) Ignoring differences in bone size makes the bones of Asian women appear less strong that those of Caucasians. This discrepancy may explain why Asian women actually suffer fewer fractures than Caucasian women.

The study also notes, interestingly, that African American women are more positive towards the idea of menopause than women of other ethnicities, while Chinese and Japanese women are the least positive.

The Boston Women’s Health Book Collective, in its book Our Bodies Ourselves: Menopause suggests “African-American women seem more likely to view the cessation of menstruation as a relief and look forward to not worrying about pregnancy after menopause. By contrast, white women perceive menopause as more of a medical problem and seek prescription therapy and written resources for information more readily.”

The news isn’t all good for African Americans, however. The authors go on to point out, “The traditional role of black women as the pillars of our families and communities can result in black women jeopardizing their health by “overdoing it.” One African-Canadian woman says she cannot show her feelings openly even when she feels vulnerable because she is expected to be the “strong” one.

They suggest cultural differences may also play a role in how Hispanic women, in this study Mexican-Americans, experience menopause:

In Mexico, as in many other Latin American countries, women are unlikely to discuss menopause with others, including with their daughters, so the sensations and changes associated with menopause may come as a surprise to many women.

In addition, modesty is an important value in many Latina communities. Therefore, midlife Latina women find consulting a medical practitioner, especially to discuss personal or sexual matters, rather uncomfortable.

By contrast, they note that American women are expected, and likely expect, to be more forthcoming with their doctors about the details of their symptoms.

Once again, these studies point out what every woman should remember: Perimenopause and menopause can be different for every woman. Whether you have many symptoms or few, more good or bad days, your personal experience is important and valid. You should feel free, not only to consult a medical professional about any concern you may have, but to be open and honest about any symptoms you may be experiencing.

* SWAN study co-sponsored by the National Institute on Aging (NIA), the National Institute of Nursing Research (NINR), the National Institutes of Health (NIH), Office of Research on Women?s Health, and the National Center for Complementary and Alternative Medicine.