Black and Menopausal: Intimate Stories of Navigating the Change

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You can take HRT for as long as you need it. You can discuss this with your doctor or nurse at your yearly review. Complementary and alternative therapies Another option is combined HRT, which includes estrogen and progesterone. If you have a low sex drive, your doctor may also suggest testosterone HRT. Medications A GP can prescribe oestrogen treatments you can insert into your vagina, as a tablet, cream or ring. This can also improve any urinary symptoms caused by menopause and perimenopause, like discomfort when you pee. A more open public conversation around menopause – and the often strange, hard time leading up to it, perimenopause – has been ignited in recent years. Celebrities from Davina McCall to Gwyneth Paltrow have discussed the realities of hormone replacement therapy, irregular cycles and trippy mood swings; a nascent industry selling supplements, creams and hot flush-proof pyjamas has risen. The biggest challenges she sees that affects the mental health of women managing menopause. [18:38]

Vitale SG, et al. (2022). Abnormal uterine bleeding in perimenopausal women: The role of hysteroscopy and its impact on quality of life and sexuality. Self-care is essential for your overall health and well-being. Self-care tips for menopause include: Your doctor can discuss the best dosage for your unique needs. Oestrogen HRT comes in many forms, including: Bisphosphonates or denosumab are first line for most women. For those at very high risk, anabolic therapy should be used first for rapid reduction of fracture risk and BMD improvement, followed by potent antiresorptive agents. 144 145 146 147 148 149 Adverse events of bisphosphonates and denosumab include osteonecrosis of the jaw and atypical femur fracture, both of which are rare. 150 151 Discontinuation of denosumab increases risk of vertebral fracture. 149

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This aligns with what we know about the wider healthcare system, where structural barriers, racism or implicit bias can shape treatment options and influence future interactions and trust in health services.”

Depending on your specific symptoms, your doctor may prescribe medication. Here’s an overview of some options and what they’re used for: Confirmation from the GP that I was experiencing menopause symptoms gave an explanation for the persistent fluctuations in my body temperature, but my mind took a leap into the future and landed in a place of fear and uncertainty, a place where I suddenly felt great discomfort in my body, conjuring up images of decrepitude because then my only understand­ing of menopause was that it was a gendered, age­ related illness spoken about in hushed tones, and overhearing gossip about a person who disgraced herself by having a ‘menopause baby’, someone whose husband left her because she could no longer have sex, or about the co­worker who wore wigs to cover up menopause hair loss. In 2021 an estimated 1.02 billion women were postmenopausal globally, with 1.65 billion anticipated by 2050. 15 The menopause transition consists of perimenopause and the first 12 months after the final menstrual period (FMP). Menses stop when the ovaries have insufficient follicles to respond to and sustain the hypothalamic-pituitary-gonadal axis. The onset of the transition is marked by changes in menses and/or development of hypoestrogenic symptoms such as hot flashes, mood changes, impaired concentration and memory, sleep disturbance, fatigue, reduced libido, joint pain, and increased central adiposity. The average age of menopause is 51 years. 16 Seven per cent of women enter menopause early between ages 40 and 45, and 1.9% enter before age 40, which is considered premature menopause. 17 Talk with a GP about these medicines and their side effects, and if they might be suitable for you. Mood symptoms Cortés YI, Marginean V. Key factors in menopause health disparities and inequities: Beyond race and ethnicity. Current Opinion in Endocrine and Metabolic Research. 2022;26:100389. doi:10.1016/j.coemr.2022.100389Some complementary and alternative therapies can also interact with other medicines and cause side effects. I didn’t realise I was going through menopause at all. I thought because I was in university, I was stressed, but I knew something wasn’t right with my body,” Adelay told The Voice. https://journals.lww.com/menopausejournal/Citation/2022/07000/Racial_ethnic_disparities_in_the_diagnosis_and.15.aspx Chronic fatigue syndrome: Women who have myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) are more likely to have premature menopause. These can includeirregular bleeding,vaginal dryness and painful sexor problems controlling your bladder, for example.

The menopause marks the end of a woman’s periods meaning she can no longer become pregnant naturally, usually occurring between the ages of 45 and 55 years old. The main medicine treatment for menopause and perimenopause symptoms is hormone replacement therapy (HRT), which replaces the hormones that are at low levels. In the UK, as evidence mounts for hormone replacement therapy (HRT) - considered the most effective treatment for menopausal symptoms - several changes are scheduled to make it easier and cheaper for women to access treatment. As a double board-certified specialist in female pelvic medicine and reconstructive surgery, the work of Rolston and Christie was eye opening, fresh, and fervently relevant to the women I have cared for over the course of my career. This is a must read for any practitioner in the female intimate wellness space as well as the women of color who are so often disregarded and seen as both trivial and strong. This is the connection we have been waiting for to shed light on a buried subject matter!!Menopause is nothing to be ashamed or frightened of," she says. "Getting help and advice doesn't always have to mean HRT - it's just about getting a better understanding of menopause and knowing how to improve what you're already doing.

The work I’ve been doing is travelling around the world to find out what those experiences are. For some people it’s eldership; you get older, you become wiser. That’s the interpretation in some communities, and therefore it’s not a medical thing.” Local low dose vaginal estrogen and vaginal dehydroepiandrosterone therapy have a safer risk profile than systemic hormone therapy. 12 They are associated with low circulating estradiol concentrations and have not been shown to increase the risk of incident breast, endometrial, ovarian, or colorectal cancer or of cardiovascular disease, stroke, or venous thromboembolism. 12 They are thought to mainly act locally, although a systematic review found that vaginal estradiol absorption varies by formulation, dose, and placement within the vagina. 161 This is likely why breast tenderness and vaginal bleeding may rarely occur. 12 Fezolinetant is an oral neurokinin-3 receptor antagonist under FDA review. The phase 3 trial randomized women aged 40-65 and averaging seven or more moderate-to-severe hot flashes a day 1:1:1 to placebo, fezolinetant 30 mg, or fezolinetant 45 mg. At week 12, the difference in the least squares mean frequency of vasomotor symptoms for fezolinetant 30 mg compared with placebo was –2.39 (standard error 0.44) hot flashes (P<0.001) and –2.55 (0.43) hot flashes (P<0.001) for fezolinetant 45 mg compared with placebo. Severity also decreased significantly. The most frequent adverse effects were headache and nausea. 187 Women who reach a higher educational level, are employed and consider themselves in good general health also appear to reach menopause at a later age.Therefore, both you and your doctor may not immediately consider your symptoms related to menopause. One paper on menopause and Asian American women found that these women experienced different symptoms, depending on what sub-ethnic group they belonged to 5. It concluded that these experiences are highly influenced by cultural attitudes towards symptoms. I asked people who told me you shouldn’t talk about menopause, it’s private and personal. The book is to be used as a conversation starter for people who are still ashamed to talk about menopause so people do not feel they are alone and isolated,” she says. We’re very complex beings. So we need to proactively protect our mental health but at the same time, understands that it is okay not to be okay. We would welcome dedicated investment across the health system in anti-racist and culturally safe education, training and practice.”