Women of Color Experience Menopause Differently

Navigating the shift

Kristen Fischer,

AARP

Comments

En español

Published May 14, 2026

AARP (Getty Images)

Key takeaways

Black women report higher rates of hot flashes, depression and sleep problems and are less likely to receive hormone therapy or related care than other groups.
Women of color tend to reach menopause earlier and spend longer in perimenopause than non-Hispanic white women.
Knowledge gaps, chronic stress, health care access and provider bias can compound symptoms, delay treatment and raise health risks.

Menopause — and everything leading up to it — varies for every woman, but it can affect women of color differently. Black and Hispanic women often begin menopause earlier than others, and the disparities don’t stop there.

The disparities for Black women compound on top of one another, says Dr. Sharon Malone, chief medical advisor at the telehealth menopause clinic Alloy Health, who highlighted the issue at a recent AARP Women in Wellness webinar. “Not only is the transition that goes from periods to no period take 10 year on average … they tend to last longer, they start earlier and they're more severe.”

Black and Hispanic women reach menopause — when periods stop for 12 months in a row — at age 49 on average, which is two years earlier than the national median age. Black women spend more time in perimenopause, which happens when hormone levels fluctuate and ultimately decline ahead of menopause, compared with non-Hispanic white women. Chinese, Japanese and white American women report the shortest hot flash symptom duration; Black and Latina women experience menopause symptoms longer, too, studies show.

Sharon Malone attends the Women’s Luncheon during the 2022 Martha’s Vineyard African American Film Festival in Massachusetts.

Getty Images for MVAAFF

Black women reached menopause 8.5 months earlier than white women and reported worse symptoms, according to a 2022 report in Women's Midlife Health. At the start of that study, 46 percent of Black women said they experienced vasomotor symptoms (hot flashes and night sweats), compared with 37 percent of white women; 27 percent of Black women had depressive symptoms, compared with 22 percent of white women.

A 2024 study in Menopause found that Black women had some of the highest rates of hot flashes, night sweats and sleep disruption. Researchers think the differences are influenced by biology, stress, structural inequities, health care access, environmental exposures and cultural experiences. The disparities extend to treatment. Black women were less likely to take hormone therapy — the gold-standard treatment — according to a small 2022 study in Menopause, and were less likely to be offered the treatment, according to an older report in Preventive Medicine.

Unique factors affecting Black women

Perimenopause can hit Black women especially hard, says Malone.

This is partly because Black women have the highest incidence of fibroids, and they’re more likely to have a hysterectomy as a result of the condition, she notes. As a result, Black and Hispanic women have their uterus and ovaries removed earlier and more often than other groups, which causes them to go into menopause, according to a 2023 report in the International Journal of Epidemiology.

Menopause doesn’t begin after a hysterectomy unless the ovaries are removed (that’s called an oophorectomy), says Dr. Lauren Streicher, a professor of obstetrics and gynecology at the Northwestern University Feinberg School of Medicine. If the ovaries are taken out, women stop producing estrogen and progesterone hormones. If they don’t start hormone therapy to replenish them, it dramatically increases the risk of cardiovascular disease, stroke and bone issues, Streicher says.

Another factor affecting Black women differently: When they experience abnormal bleeding due to perimenopause hormone fluctuations, they’re often told fibroids are to blame. This means health care providers can miss uterine precancers and cancers, which are rising particularly in Black women, Streicher says.

Menopause: A timeline

Perimenopause can start in your mid to late 30s. This period, which often lasts until the mid 40s, is a very misunderstood phase, Malone says. A 2025 report in Women said perimenopause lasts anywhere from four to eight years on average, with the length depending on a variety of factors like age, race and ethnicity, as well as smoking. During the AARP event, moderator Kamili Wilson, senior vice president of program development and management at AARP, said the word “perimenopause” never came up during discussions with her doctor. “I was surprised at how unprepared my doctor seemed to be to support me through this time,” Wilson added.

Kamili Wilson

Courtesy Kamili Wilson

In the U.S., the average age of menopause is 51 and most women reach menopause between 45 and 55.

“Menopause is not just about when your period stops,” Malone says. Estrogen affects your entire body, and the transition into menopause is years in the making, she says.

The haze and cascade of perimenopause

Perimenopausal women may not realize they’re in perimenopause because they’re still having periods. They may have symptoms they don’t think are related to menopause, like sleeplessness or rage.“That’s why the perimenopause era is confusing,” Malone says. “When you think about menopause, how we have been so sorely ill-informed about what happens at this point in your life ... to walk into that phase of life with no knowledge about what’s happening is really a travesty.”

Perimenopause symptoms can have a cascade effect, for example, when disrupted sleep caused by hormonal changes leads to fatigue and bad moods. As a result, women may not want to exercise or may eat more than normal and gain weight. Hormonal changes can also shift weight to the midsection, which increases inflammation and can set women up for health issues like hypertension and heart disease, Malone notes.

More women need to know symptoms of perimenopause and talk to their doctors in their 30s so they can proactively address them, she says.

Demanding better menopause care

If you’re lucky, you will spend about 40 percent of your life in menopause, which is why it’s important to be aware of what’s happening and insist on good care, Malone says.

Women largely accept not feeling good or energetic, but they don’t have to if they take charge of their health. “We as women, and Black women in particular, we have gotten really sort of comfortable with this notion of suffering,” Malone says.

A lot of health care providers don’t know how to treat menopause, Malone points out. “They are as fearful of hormone therapy as a lot of women are, and that’s why the message has not gotten through. But it’s changing,” she says.

Finding menopause care

More doctors and other types of health care providers are completing formal education about perimenopause and menopause, but there’s still a long way to go. The Menopause Society’s database is a good place to find a Menopause Society certified practitioner (MSCP). Telehealth menopause clinics are also bringing access to more women, Malone notes. Seek out doctors affiliated with academic medical centers or menopause clinics, Streicher adds.

Understanding hormone therapy

Hormone therapy is the most common and effective treatment for menopause symptoms, but it got a poor reputation after a study in the early 2000s found it raised risks for cardiovascular disease, breast cancer and dementia. This led to a sharp decline in use. More current research found the risks were overstated and the treatment is beneficial for many women. The FDA announced last year it would remove references to risks of those diseases on product packaging.

The earlier you begin hormone therapy, the longer you’ll reap its benefits, Malone says.

In fact, women who go into early menopause (before age 45) or premature menopause (before age 40) have higher risks for dementia, osteoporosis and cardiovascular disease due to the absence of estrogen, Malone notes. Research largely supports hormone therapy for these women, but the decision needs to made on an individual basis.

Having a family history of breast cancer doesn’t mean you can’t take hormone therapy, Malone says. If your hypertension is controlled, you may be a candidate, she adds.

Don’t take hormone therapy if you have:

Breast or uterine cancer, and are in treatment
Active liver disease
Blood clots in your legs or lungs
Undiagnosed bleeding after menopause
Had a stroke or heart attack

There are also nonhormonal options, such as elinzanetant (Lynkuet) and fezolinetant (Veozah), that can help with symptoms, Streicher points out.

Cardiovascular health in focus

Especially if you’re having hot flashes, do all you can to lower your cardiovascular risk factors — such as eating well and exercising — because hot flashes aren’t the only thing that raise your risk for cardiovascular problems, Streicher says. Obesity and sleep apnea, among other issues, can increase your cardiovascular risk and also disproportionately affect Black people.

“Hot flashes are not harmless,” Streicher says, adding that they’re linked with increases in cardiovascular disease, stroke and heart attacks.

Also, if you experienced pregnancy complications like preeclampsia or preterm birth — these also affect women of color disproportionately — you’re at a higher risk for heart problems later in life. Consider seeing a cardiologist in addition to your gynecologist, Streicher recommends.

Even if you’re past menopause, you may still benefit from hormone therapy. “It just needs to be evaluated individually,” says Streicher, adding that there’s no set timeline on how long a woman can use it.

When to seek care

Feeling bothered by symptoms? Head to your doctor and ask questions, Malone says. She doesn’t usually recommend hormone tests unless you’re on birth control or using an intrauterine device and you’re not sure if you’ve reached menopause, she notes.

Ask the provider if they prescribe hormone therapy and which forms they offer, Streicher recommends.

See your gynecologist yearly if you use hormone therapy or if you’ve already reached menopause, Malone says. If you’re over 65, you should still have a breast and pelvic exam at least every other year, if not every year, she adds.

%{postComment}%

The key takeaways were created with the assistance of generative AI. An AARP editor reviewed and refined the content for accuracy and clarity.

Kristen Fischer is a contributing writer at AARP based at the Jersey Shore. She has also written for Health, WebMD, and McKnights and is the author of Zoo Zen: A Yoga Story for Kids.