Understanding Menopause: Symptoms, Equity, and Access to Care with Dr. Dina Gordon
"Menopause is different for every person. It's a unique and individual journey.”
Menopause is a unique and individual journey for every person, with symptoms varying widely. Common symptoms include vasomotor symptoms such as hot flashes and night sweats, which affect up to 70-80% of individuals. Other frequent symptoms include genital urinary syndrome, which encompasses bladder changes, vaginal dryness, and pain with intercourse, affecting about 50% of people. Additional symptoms can include brain fog, mood changes, joint pain, weight gain, and vertigo.
"Significant vasomotor symptoms can be an indicator of potential cardiac issues down the road."
Anxiety and depression are also common during menopause, especially in those with a history of hormonal mental health issues. Mood symptoms can appear before changes in menstrual periods, making it challenging to identify menopause early. Early signs may include subtle mood changes or brain fog, even if periods remain regular.
"A very small percentage of research funding is dedicated to women's health."
Research funding for women's health is limited, with only a fraction of the NIH's budget dedicated to it. This lack of funding extends to understanding how menopause symptoms impact different cultures and populations. The SWAN study, a longitudinal, multi-ethnic study funded by the NIH, has provided valuable insights into these differences.
Key findings from the SWAN study include:
Vasomotor symptoms are more prevalent and severe in women of color.
Libido changes are more common in Asian women.
Black and Hispanic women reach menopause 8.5 months earlier than white women, with longer symptom duration.
Black and Hispanic women experience worse vasomotor symptoms, depression, and sleep disturbances but are less likely to report these symptoms or receive treatment.
The average age of menopause in the U.S. is around 52, with menopause before 40 considered atypical. Vasomotor symptoms can last a median of 7.5 years, with longer durations for Black and Hispanic women.
Structural racism, poor access to healthcare, toxic work environments, and other social determinants contribute to these disparities. Hysterectomy rates are higher among Black women, leading to earlier menopause and associated symptoms.
Cardiovascular disease is the leading cause of death for women, and menopause can exacerbate risk factors such as high blood pressure and cholesterol. Pregnancy complications like preeclampsia and gestational diabetes are predictors of future cardiovascular disease.
"There are treatments, multiple choices for what you could do, and not suffering in silence."
Hormone therapy can be beneficial for treating vasomotor symptoms and protecting cardiovascular health when started at the right time. Non-hormonal treatments like gabapentin and Paxil can help with symptoms but may not offer the same cardiovascular protection as estrogen.
In conclusion, understanding and addressing menopause symptoms, especially in diverse populations, is crucial. Women should advocate for their health, seek knowledgeable providers, and share their experiences within their communities to spread reliable information and improve overall health outcomes.
