Donna Adams-Pickett, PhD, MD, FACOG, explains why menopause is often underdiagnosed in Black women, contributing to disparities in health outcomes during the significant hormone transition. Many women may underreport symptoms, while some clinicians may view them as isolated complaints rather than recognizing them as part of menopause.
She further explains that the menopause transition can begin as early as the 30s, underscoring the importance of earlier screening, counseling, and symptom recognition — especially for women of color. With greater awareness of estrogen’s role in cardiovascular health, bone preservation, and mental well-being, earlier intervention may help reduce poorer outcomes for Black women.
Menopause is often misdiagnosed in Black women because we underreport our symptoms. Black women tend to say, “Hey, we got this. I’m okay. I’m really only going to express those symptoms that are incredibly severe.”
Because they’re mentioned kind of as a “one-off,” it’s very rare for the clinician to put them all together and say, “Hey, a number of these things are happening at the same time. When is it that one patient can experience so many different things at the same time?” And that is when they should consider this could be menopause.
Early screening and counseling is especially important in women of color. What people don’t realize is that you begin the menopausal process in the 30s. So, a lot of times we think about menopause as simply something that happens in the 50s, or even late 50s or early 60s, but the whole process really can begin in the mid-30s. We know the benefits of estrogen in terms of cardiac prevention, bone health prevention, and mental acuity prevention, so if we screen for it early, we can prepare these patients to intervene early, and we won’t be so overrepresented in these adverse outcomes.
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