The Frame: The Dominant Narrative on Menopause

Currently, the mainstream menopause conversation often centres on the experiences of white, middle-class women in Western societies. This focus influences media representation, research priorities, and healthcare policies. For example:

• Media representation: TV shows, books, and public discussions about menopause often feature white women, with little mention of the challenges faced by Black, Asian, or LGBTQ+ individuals.

• Medical research: A study published in the Journal of Women’s Health found that clinical trials on menopause hormone therapy overwhelmingly included white participants, making it difficult to generalise findings to other racial or ethnic groups.

• Healthcare disparities: Black women often face higher rates of medical dismissal or misdiagnosis of menopause-related symptoms. For instance, studies show that Black women are more likely to experience severe menopausal symptoms like hot flashes and night sweats but are less likely to be offered hormone replacement therapy (HRT).

The Picture Details: Diverse Experiences of Menopause

When we move beyond the frame and look at the details within the picture, we uncover the rich, varied experiences of menopause, shaped by cultural, social, and biological factors:

1. Cultural perspectives:

• South Asian women may view menopause differently due to cultural taboos or religious beliefs that discourage open discussion about aging and reproductive health.

• In some African cultures, menopause can be seen as a rite of passage, but stigma around seeking medical help persists.

2. Healthcare barriers:

• LGBTQ+ individuals often face unique challenges during menopause. For example, trans men undergoing menopause might not feel comfortable seeking care due to discrimination or lack of provider knowledge.

• Socioeconomic factors also play a role - women from low-income backgrounds may struggle to access menopause care due to cost or limited healthcare availability.

3. Intersectionality of symptoms and misdiagnoses:

• Night sweats, fatigue, and mood swings are often misattributed to conditions like diabetes or depression, especially in women of colour, who are more likely to face diagnostic bias.

• Black women and South Asian women are more likely to enter menopause earlier and experience more severe symptoms, yet they often lack the same access to treatments as their white counterparts.

The Call to Action: Moving Beyond the Frame

The goal is to move beyond the narrow “frame” of menopause discussions and include the diverse “details in the picture” by:

• Improving representation: Sharing stories of menopause from women of colour, LGBTQ+ individuals, and other marginalised groups in the media and public discourse.

• Advocating for inclusive research: Demanding clinical trials and studies that reflect the true diversity of the population. For instance, ensuring that HRT research includes Black and Asian women to understand its efficacy across different groups.

• Equitable healthcare: Training healthcare providers to recognise and address the unique barriers faced by marginalised communities and provide culturally competent care.

By broadening the lens, we create a fuller, richer understanding of menopause -one that serves everyone, not just those within the narrow confines of the frame. This leads to better support, treatment, and outcomes for all.

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