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Celebrating Our Sistahs Colourless menopause

Nina Kuypers started her menopause at the age of She

On The

of Black women from the debate

LET’S BE frank, the menopause canvas is colourless. It is dominated by white women who are usually professional, often portrayed with grey hair or a white ‘celebrity’ with long hair usually blonde.

These narratives do not provide reflections of Black women or Black people who have a uterus and the failure to consider such variations not only diminishes the importance of our experiences, but also leaves understanding of menopause research data as biased and distorted.

We could question, does the menopause not happen to Black women? Menopause is being shaped as a disastrous life sage by some journalists and celebrities. Whereas in other (nonwestern) countries menopause is seen as empowering.

Yes, the canvas is slowly having a splash of colour added to its pallet, mainly from US celebrities such as Oprah Winfrey, Michelle Obama, Erykah Badu and Viola Davis, yet where are the UK ‘celebrities? There are a few, but not enough given the opportunity to paint their stories.

My narrative isn’t unique as many may resonate with some elements of my Black menopause. I was officially told that I was perimenopausal aged 43. Medically — I am now post menopause and have been for several years. What does perimenopausal even mean? When the GP handed me this oneway perimenopause ticket, the words didn’t register. I was there for another reason. The diagnosis had come due to my having several miscarriages and the results of previous blood tests.

This was my first experience of it being brought to my attention. On reflection, it was a missed opportunity by health care professionals to inform me about perimenopause.

Equalities

They had conducted fertility tests, but at no point during these discussions was perimenopause mentioned. What had or may seem like a short chapter in the perimenopause phase was prolonged. I had been back and forward to the GP for several years, with what I now realise were menopause symptoms.

The constant back and forth may be attributed to health inequalities. It may also be down to health care professionals not understanding or recognising menopause in general nor for somebody so ‘young’, whatever ‘too young’

It could also be lack of symptomatic changes to Black people’s skin or hair and let’s not forget being a ‘strong Black woman’ who does not suffer pain nor does her appearance crack

Menopause is intertwined with a historical context of racism. We need to build proper and serious approaches to being diverse and inclusive about menopausal experiences. We know that there is a plethora of research which shows that people’s/health professionals’ beliefs, and biases about Black women are linked to racial disparities in health and health care.

Often, these biases are unconscious, but they still affect the care and recommendations provided, and the trust that person has in the recommended treatment.

I don’t have all the answers, what I can do is speculate from my own lived experiences, reflect on the limited data that is out there and conclude from those women who I have spoken to and listened to.

The biggest study to date, the American Study of Women’s Health Across the Nation (SWAN), reported that Black women reach menopause 8.5 months earlier compared to white women. Black women may also have a longer transition and experience more severe symptoms.

The reasons are not clear, nor has the research investigated further on the possibility(ties) of this. Some attribute this to Black women entering menopause earlier to social weathering or allostatic loading. The research also found that Black women are less likely to receive hormone replacement therapy (HRT).

HRT is an interesting topic although coupled with being Black most definitely needs more scrutiny. Why?

I was excited to be asked to participate in a clinical trial for new HRT medication.

I was rejected on medical grounds due to blood conditions which are common in Black people and are a safety concern when testing experi- mental drugs. The concern is the result of marketed medicines which may not accurately treat a marginalised group. These companies may also be leaving people with unmet medical needs behind.

How many even consider the absorption of transdermal formulations, as according to research, it can differ based on ethnicity, skin hydration, age, and application site. This may also be a fundamental factor as to why so many may prefer herbal remedies.

It is also very disconcerting that the most relevant research conducted on UK Black women was published in 2007 on 22 BME women aged 45 – 61 years from a range of minority ethnic groups in Northampton. Research issues matter, and this is integral to historical distrust in the medical profession.

Privilege

Another issue is the increasing number of reports building about how the workplace is failing women, and that these services have been created by men for women, then being a Black woman in the workplace has an extra dimension, from which we need to untangle the misogyny and privilege.

If we combine this with the menopause, we add additional levels of bias/prejudice that spreads into and informs accessing appropriate menopause support or being taken seriously. Menopause happens to all women regardless of race, ethnicity, economic status, and education, yet how a person responds and experiences it, are poles apart due to many conflicting factors. Some factors are adult child experiences (ACEs), genetics, diet, religion, social weathering, allostatic loading and culture. Sharing menopausal stories within our communities is a must for past, present, and future generations, as this affects everybody directly and indirectly, and nobody should be blind-sided no matter what age this life stage begins. flow temperature down to 60° off lights and you’re not using, for a new energy-saving

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