Black and Menopausal: Intimate Stories of Navigating the Change

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Black and Menopausal: Intimate Stories of Navigating the Change

Black and Menopausal: Intimate Stories of Navigating the Change

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Women reach peak bone mass around age 30, followed by relative stability and then a 2% annual bone mass loss starting one to three years before menopause and lasting for five to 10 years. This results in a 10-15% average reduction in bone mineral density (BMD) across the menopause transition. 141 After this period, BMD declines by 0.4% annually. 142 In the US, more than half of all women 65 and older have osteopenia, and nearly one quarter have osteoporosis. 143 These progress with aging, and more than one third of women have osteoporosis by age 80. 143

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.2022.100389 You can choose to continue taking HRT. The doctor or nurse prescribing your HRT can discuss with you the benefits and risks, so you can decide what’s right for you.


Compounded bioidentical hormones are sometimes offered in private clinics as HRT. They are not recommended because it's not known how well they work or how safe they are. They are not available on the NHS. In 2021, I attended the multipart conversation ‘Bloody Tran­sitions: Queers Decolonizing Menopause’ with moderators M’Kali Hashiki and Syd Yang. In this conversational series, we explored the nuances of sex, gender, race and menopause.In that space, I felt brave enough to experience and reflect on my body as it is, and not how it should be. Research from the SWAN study suggest certain habits or practices may mean a woman experiences her FMP later than usual. 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

A Cochrane review including 19 good quality trials of hormone therapy use with more than 40 000 participants showed that risks of cardiovascular adverse events differed by age. 33 In a subgroup analysis with more than 9600 women from six RCTs who started hormone therapy within 10 years of menopause, use of hormone therapy was associated with reduced incidence of CHD (risk ratio 0.52, 95% confidence interval 0.29 to 0.96) and all cause mortality (0.70, 0.52 to 0.95), no change in stroke risk, but an increased risk of venous thromboembolism (1.74, 1.11 to 2.73) compared with placebo. 33 In absolute terms, for every 1000 women taking hormone therapy, eight fewer cases of CHD, six fewer deaths from any cause, four additional strokes, and five additional venous thromboembolisms occurred. These trials used oral estrogens and progestins, both of which may impose greater risk of venous thromboembolism and cerebrovascular disease than transdermal or intravaginal estrogens or micronized progesterone.During menopause, your body needs extra nutrients to help your body adapt to the changes it’s going through. Here are some healthful choices to fill your plate with: Self-care is essential for your overall health and well-being. Self-care tips for menopause include: Waetjen LE, et al. (2018). Factors associated with developing vaginal dryness symptoms in women transitioning through menopause: a longitudinal study.

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