When the Symptoms Don’t Make Sense: Menopause in Black Women Is Being Missed—and Dismissed
The first sign for Carla wasn't a hot flash or missed period. It was something subtler—a sudden spike in anxiety so intense she thought she was having a heart attack. Her chest clenched, her breath shortened, and the walls of her Brooklyn brownstone bedroom seemed to close in. But when the tests came back normal, her doctor told her it was "probably just stress."
It wasn't. It was perimenopause.
Like many Black women, Carla wasn't prepared for the way menopause would enter her life—not with a bang, but with a whisper: insomnia, heart palpitations, itchy skin, sudden bursts of rage, thinning edges, and a creeping fogginess that made her question her sharpness. At 46, she felt like a stranger in her own body. And worse, she felt invisible in the exam room.
The Unseen, Unheard Transition
For Black women, the menopause journey is often a lonely and overlooked one. We are more likely to experience an earlier onset of menopause, more intense symptoms, and longer durations of discomfort. And yet, we are less likely to be diagnosed, treated, or even acknowledged when we bring our concerns to healthcare providers.
Dr. Anika Lewis, an OB/GYN who's served urban and rural communities in Georgia for over two decades, puts it plainly: "Black women are expected to be strong. That strength has come at the expense of being believed."
Despite having higher rates of vasomotor symptoms like night sweats and hot flashes, Black women are less likely to be prescribed hormone therapy or referred to menopause specialists. Too many of us suffer in silence, convinced by providers—or even by our own families—that what we're experiencing is 'just life.'
When Our Hair Talks Back
"I thought I needed a new shampoo," says Malika, a 52-year-old photographer. "But no matter what I used, my curls felt brittle, my edges kept thinning, and my scalp itched like I was back in second grade with a bad perm."
It wasn't a haircare issue—it was hormonal. Estrogen depletion can affect our skin, our mood, and, yes, our follicles. Researchers are now investigating whether certain products commonly used in Black haircare routines might exacerbate hormonal shifts. But even without those external triggers, the body is changing. And too often, we're the last ones told why.
The Toll of Weathering
Public health researcher Dr. Arline Geronimus coined the term weathering to describe the premature aging Black bodies undergo due to systemic racism, economic inequality, and generational trauma. It's why a 45-year-old Black woman may have the heart health profile of a 55-year-old white woman. Menopause doesn't arrive in a vacuum; it comes after decades of pushing through, caretaking, code-switching, and being "the strong one."
Dr. Jayne Morgan, a cardiologist and the Chief Medical Officer of Hello Heart, explains that declining estrogen has cardiovascular consequences. "Estrogen relaxes arteries. When it drops, blood pressure rises, inflammation increases, and heart disease risk goes up—especially for Black women who already face elevated risks."
Self-Advocacy as Survival
If there's one consistent message from Black female physicians and health advocates, it's this: You have to be your own fiercest advocate. If a doctor dismisses your symptoms, find another. Ask questions. Request a hormone panel. Speak up when you're feeling off.
"Too many of us think it's weakness to complain," says Dr. Sharon Malone, who has treated thousands of women over her 30-year OB/GYN career. "But untreated menopause symptoms—especially severe hot flashes, insomnia, and depression—are not just nuisances. They're warnings."
Nourishing Our Next Chapter
We cannot control the biological timeline, but we can influence how we navigate it. Here's how Black women can reclaim power during perimenopause and beyond:
1. Reimagine Your Plate
Traditional Black Southern foods are rich in anti-inflammatory goodness—featuring collards, black-eyed peas, okra, and sweet potatoes. Bring them back, minus the excess salt and sugar. Pair them with lean proteins and healthy fats.
2. Move With Intention
Weight-bearing exercises, such as resistance training, Pilates, or even gardening, help preserve bone density and boost mood. Walking and dancing count, too—joyful movement is medicine.
3. Cut the Processed Crap
Ultra-processed foods—especially those marketed as "quick fixes"—can disrupt hormone balance. Get reacquainted with real food, the kind your great-grandmother would recognize.
4. Prioritize Mental Health
Anxiety, sadness, and rage during menopause aren't signs you're unraveling. They're signals. Therapy, meditation, journaling, or simply finding a sister circle can help.
5. Ask About Hormone Therapy
The fear of HRT still looms large in Black communities, but modern treatments are safer and more customizable than ever. Talk with a menopause-literate provider about your options. Knowledge is liberation.
The Whisper Becomes a Roar
There's a cultural reckoning happening. Black women are reclaiming their voices, their health, and their hormonal truth. Whether it's through podcasts, online communities, or grassroots health summits, we are telling new stories about aging, power, and presence.
Because this phase of life—though shrouded in silence for too long—is not an end. It's a rebirth—one where strength is embodied in rest, nourishment, and joy. Where saying "something doesn't feel right" is not weakness—it's wisdom.
Follow These Menopause Warriors:
@drjaynemorgan
@dallasgynecologist
@smalonemd
@omisadeburneyscott