Break The Silence

Why Menopause Care Must Put Black and Minority Ethnic Women At the Centre.

There is a growing roar, an unapologetic, powerful sound rising from the hearts and voices of Black and minority ethnic (BME) women across the UK.

These are women who have endured the silent struggles of perimenopause and menopause, often in isolation, often misunderstood and too often dismissed. But now, they are challenging the assumptions made about their bodies, their pain and the support they receive.

This is not just a health issue, it is a cultural reckoning.

For generations, Black women have been expected to carry on, to be strong, to endure. Menopause, with its emotional, physical and psychological toll, have been treated as a private burden, not a public concern. But the silence is breaking. Women are speaking out, demanding culturally competent care, equitable access to treatment and recognition of their lived experiences.

These are not just biological transitions, they are deeply social, cultural and emotional experiences. Yet, the message seems to be loud and clear; the health system continues to fall short in recognising and responding to the unique needs of these women.

Recent data and research paint a troubling picture. From systemic biases to cultural taboos, the barriers to equitable menopause care are layered and persistent. But the tide is turning. Black academics, health professionals and community leaders are raising their voices, demanding real change. It’s time we listen and act.

This blog explores the systemic gaps in menopause care for Black and Minority Ethnic women. The voices of Black academics leading the charge for change and the urgent need for inclusive support. It’s time to listen, learn and act.

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1. Discrimination and Distrust in Primary Care

A study by the NHS Race and Health Observatory revealed that nearly half of Black patients felt they were treated differently in primary care due to their ethnicity.

For women navigating menopause, this often translates into their symptoms being dismissed or misinterpreted. Pain, fatigue and emotional distress are too frequently and consistently minimised, especially when intersecting with gender and race.

The University of Oxford’s WEAVE study found that Black and South Asian women were less likely to seek help for menopausal symptoms, partly due to a lack of trust in the system. 

Many reported feeling unheard, particularly by male clinicians and struggled to access female practitioners who might better understand their experiences.

“We have the right to speak openly. To be heard. To be seen and have the right to be understood and believed too.” - Emma Lady

In the words of Emma Lady, a highly respected menopause wellness advocate for Black women and founder of the Relentless Boss^TM actively advocates for women to have safe spaces to share their menopause stories without judgement, without shame and without the weight of cultural silence.

2. Cultural Silence and Stigma

Menopause remains a taboo subject in many minority ethnic communities. In focus groups conducted by Oxford researchers, women described menopause as something to “just get on with.” Talking about it was seen as embarrassing and mental health symptoms were even more stigmatised than physical ones and runs across all cultures.

When I asked my mother about not explaining the menopause journey she was clear and measured in her Jamaican response. "Wah mi know. Mi mother dead since I was seven!"

When I spoke to my Polish friend about this taboo subject she said simply "I just thought my mum was miserable!"

This silence is not accidental, it’s cultural. As Dr. Brandy Harris Wallace and colleagues argue, Black women often carry the burden of caregiving and community leadership, leaving little room for self-care because of the expectation to be strong, nurturing and resilient often makes it difficult to acknowledge vulnerability or seek help.

3. Inequitable Access to Treatment and Services

The Fawcett Society’s 2022 report highlighted stark disparities in menopause care. Black and minoritised women reported, delayed diagnoses at a rate of 45%, compared to 31% among white women. HRT uptake was just 8% for ethnic minority women, compared to 15% for white women.

These figures reflect more than just clinical oversight, they reveal systemic neglect.

The postcode lottery in accessing HRT and specialist services disproportionately affects women from lower socioeconomic and ethnic minority backgrounds. Training gaps among clinicians and a lack of culturally sensitive care compound the problem.

4. Communication Barriers and Misdiagnosis

Language and cultural differences in symptom expression often lead to misdiagnosis. While clinicians expect terms like “hot flushes,” many Black and South Asian women describe their symptoms differently, “aching all over,” “itching,” or “feeling heavy”. 

These expressions, rooted in cultural idioms, are frequently misunderstood or dismissed.

The WEAVE study found that these communication gaps, combined with short consultation times and language barriers, often result in delayed or inadequate treatment. The need for translated, visual and culturally relevant health education materials is urgent.

5. Lack of Representation and Culturally Relevant Resources

Too often, menopause support materials, leaflets, videos, posters, fail to reflect the diversity of women’s experiences. As one participant in the Oxford study put it, menopause messaging feels like it’s “for white people.”

This lack of representation reinforces exclusion and discourages engagement. Black women are left to navigate menopause alone, often turning to self-help strategies like herbal remedies or lifestyle changes before seeking medical support.

As part of the Nudispray.com campaign for their ground breaking HRT Patch Glue Remover, Emma was one of the diverse models in the campaign and was able to share her  own menopause story to a wider audience.

“For me, this wasn’t just about a product. It was about visibility. Menopause affects Black women differently" explained Emma. “From the symptoms we experience, to the cultural silence; to the medical disparities we face. Far too often, our stories are not told and our faces aren’t seen in these conversations."

“That’s why I’m deeply grateful to Founders Lisa Farley and Amy Simpson. They understood the assignment. They didn’t just talk about inclusion, they 𝘱𝘳𝘢𝘤𝘵𝘪𝘴𝘦𝘥 it. By including women from BAME (Black, Asian and Ethnic minority) communities in this campaign, they sent a powerful message. Every woman matters in the menopause conversation.”

What Black Academics Are Saying

Black scholars are leading the charge to reframe menopause care through a lens of equity and cultural competence.

The following highly acclaimed Dr. Brandy Harris Wallace is a sociologist and gerontologist at the University of Maryland, Baltimore County (UMBC). Dr. Cassandra Ford is an Associate Professor at the University of Alabama’s Capstone College of Nursing and Dr. Tamara A. Baker is a Professor in the Department of Psychiatry at the University of North Carolina at Chapel Hill.

And a little sideline. They are published extensively in journals around health disparities research. They bring a greater and wider understanding on how social determinants of health, cultural sensitivity and systemic inequities affect aging and pain management in Black women advocate for a Black Feminist health equity approach to menopause research. They argue that Black women’s experiences must be understood within the context of historical mistreatment, social disadvantage and intersecting identities

Their work spotlights how Black women are more likely to experience severe vasomotor symptoms, suffer higher rates of depression and anxiety and greater disease complications. Yet, their voices remain underrepresented in research and policy.

These scholars call for:

• Culturally competent healthcare services

• Better training for healthcare professionals

• Community-based interventions

• Inclusive research methodologies

Their message is clear. Black women must be recognised as experts of their own health. Their lived experiences should be respected and inform the design of services, education, research and policy.

You have to admit, together, these scholars are pushing for a paradigm shift in menopause care. One that is inclusive, culturally competent and more importantly, rooted in the lived realities of Black and women of colour.

A Practitioner’s Perspective: What Needs to Change

As someone deeply embedded in community work and having a deep interest in the menopause agenda, I am pleased with how Emma Lady has led the charge under the Menopause, Mindset and Me banner. These webinars give women a safe space where they feel heard.  So, based on this, I believe the path forward must be collaborative, inclusive and unapologetically bold. Whilst not a health practitioner, advocate or menopause specialist, it is clear that we need:

Safe spaces for women of colour to share their menopause journeys without shame or judgement.

Clinician training that goes beyond clinical symptoms to understand cultural narratives and communication styles.

Representation in health campaigns, materials and leadership.

Policy reform that prioritises equity in access, treatment and research.

This is not just a health issue, it’s a justice issue.

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Join the Movement

If you care about health equity, wellbeing and culturally competent care, then this conversation is for you.

Breaking the Silence: Real Support, Real Change!

📅 Tuesday 26 August 2025 | 12:00pm – 1:30PM (UK)

🔗 Register here

Emma Lady, the Relentless Boss^TM

Led by Emma Lady, this interactive and informative webinar offers a safe and empowering space to explore the menopause experiences of women of colour, with a focus on real solutions and inclusive support. You’ll hear from experts, practitioners and women with lived experiences.

Together, we’ll challenge the silence and build a future where every woman is seen, heard and supported.

Let’s make menopause care equitable and let us continue to break the silence.

Reserve your seat now!

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Sources:

Bridging the gap in menopause care for minority ethnic women at phc.ox.ac.uk

Advancing the Inclusion of Black Women in Studies of Menopause at academic.oup.com

From Menarche to Menopause: A Systematic Review of Black and Asian at repository.uwtsd.ac.uk

Emma Lady, the Black Woman's Guide to Perimenopause at https://themenopausetoolkit.myflodesk.com