Semin Reprod Med 2013; 31(05): 380-386
DOI: 10.1055/s-0033-1348897
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Racial and Ethnic Differences in the Physiology and Clinical Symptoms of Menopause

Gloria Richard-Davis
1   Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences (UAMS), Little Rock, Arkansas
,
Melissa Wellons
2   Division of Diabetes, Endocrinology and Metabolism, Department of Medicine, Vanderbilt University School of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
› Author Affiliations
Further Information

Publication History

Publication Date:
09 August 2013 (online)

Abstract

More than 4 million menopausal women are from ethnic minority groups. Over the past 25 years, recognition of the importance of social, emotional, and physical changes of midlife to women's long-term health and well-being has emerged. Multiple factors influence how a woman perceives menopausal changes and what she addresses as associated symptoms. Factors such as educational level to socioeconomic status, health-related factors, stress, and marital status influence these choices. Increasingly, researchers are reporting on the impact of race and ethnicity on menopausal symptoms. Understanding similarities and differences among women's perceptions, attitudes, and expectations surrounding menopause improves delivery of culturally appropriate care and promotes lifestyles that may decrease symptoms and increase quality of life. Historically, the majority of the research in this area has been conducted in Western countries with clinical samples of women predominantly from European backgrounds. Thus, this population has shaped the emerging clinical picture of the midlife menopausal transition. Recently, studies of non-European women, both in the United States and internationally, indicate significant variations in their experiences during this transition, but these cultural differences have not broadened the understanding of the meaning of this universal experience. To date, there are still large knowledge gaps in race, ethnic, and cultural differences in menopausal health. The content of this review summarizes the current body of knowledge on racial differences in the menopause experience.

 
  • References

  • 1 Gold EB. The timing of the age at which natural menopause occurs. Obstet Gynecol Clin North Am 2011; 38 (3) 425-440
  • 2 Stanford JL, Hartge P, Brinton LA, Hoover RN, Brookmeyer R. Factors influencing the age at natural menopause. J Chronic Dis 1987; 40 (11) 995-1002
  • 3 McKinlay SM, Brambilla DJ, Posner JG. The normal menopause transition. Maturitas 1992; 14 (2) 103-115
  • 4 Luoto R, Kaprio J, Uutela A. Age at natural menopause and sociodemographic status in Finland. Am J Epidemiol 1994; 139 (1) 64-76
  • 5 Bromberger JT, Matthews KA, Kuller LH, Wing RR, Meilahn EN, Plantinga P. Prospective study of the determinants of age at menopause. Am J Epidemiol 1997; 145 (2) 124-133
  • 6 Sowers M, Crawford S, Sternfeld B , et al. SWAN: a multi-center, multi-ethnic, community-based cohort study of women and the menopausal transition. In: Lobo R, Kelsey J, Marcus R, , eds. Menopause: Biology and Pathobiology. New York, NY: Academic Press; 2000: 175-188
  • 7 Gold EB, Bromberger J, Crawford S , et al. Factors associated with age at natural menopause in a multiethnic sample of midlife women. Am J Epidemiol 2001; 153 (9) 865-874
  • 8 Luborsky JL, Meyer P, Sowers MF, Gold EB, Santoro N. Premature menopause in a multi-ethnic population study of the menopause transition. Hum Reprod 2003; 18 (1) 199-206
  • 9 Matthews KA, Crawford SL, Chae CU , et al. Are changes in cardiovascular disease risk factors in midlife women due to chronological aging or to the menopausal transition?. J Am Coll Cardiol 2009; 54 (25) 2366-2373
  • 10 Freeman EW, Sammel MD, Lin H, Gracia CR. Anti-mullerian hormone as a predictor of time to menopause in late reproductive age women. J Clin Endocrinol Metab 2012; 97 (5) 1673-1680
  • 11 Henderson KD, Bernstein L, Henderson B, Kolonel L, Pike MC. Predictors of the timing of natural menopause in the Multiethnic Cohort Study. Am J Epidemiol 2008; 167 (11) 1287-1294
  • 12 Perry III HM, Horowitz M, Morley JE , et al. Aging and bone metabolism in African American and Caucasian women. J Clin Endocrinol Metab 1996; 81 (3) 1108-1117
  • 13 Pinheiro SP, Holmes MD, Pollak MN, Barbieri RL, Hankinson SE. Racial differences in premenopausal endogenous hormones. Cancer Epidemiol Biomarkers Prev 2005; 14 (9) 2147-2153
  • 14 Haiman CA, Pike MC, Bernstein L , et al. Ethnic differences in ovulatory function in nulliparous women. Br J Cancer 2002; 86 (3) 367-371
  • 15 Marsh EE, Shaw ND, Klingman KM , et al. Estrogen levels are higher across the menstrual cycle in African-American women compared with Caucasian women. J Clin Endocrinol Metab 2011; 96 (10) 3199-3206
  • 16 Woods MN, Barnett JB, Spiegelman D , et al. Hormone levels during dietary changes in premenopausal African-American women. J Natl Cancer Inst 1996; 88 (19) 1369-1374
  • 17 Sowers MR, Wilson AL, Kardia SR, Chu J, Ferrell R. Aromatase gene (CYP 19) polymorphisms and endogenous androgen concentrations in a multiracial/multiethnic, multisite study of women at midlife. Am J Med 2006; 119 (9) (Suppl. 01) S23-S30
  • 18 Manson JM, Sammel MD, Freeman EW, Grisso JA. Racial differences in sex hormone levels in women approaching the transition to menopause. Fertil Steril 2001; 75 (2) 297-304
  • 19 Freeman EW, Sammel MD, Lin H, Gracia CR. Obesity and reproductive hormone levels in the transition to menopause. Menopause 2010; 17 (4) 718-726
  • 20 Randolph Jr JF, Sowers M, Gold EB , et al. Reproductive hormones in the early menopausal transition: relationship to ethnicity, body size, and menopausal status. J Clin Endocrinol Metab 2003; 88 (4) 1516-1522
  • 21 Randolph Jr JF, Sowers M, Bondarenko IV, Harlow SD, Luborsky JL, Little RJ. Change in estradiol and follicle-stimulating hormone across the early menopausal transition: effects of ethnicity and age. J Clin Endocrinol Metab 2004; 89 (4) 1555-1561
  • 22 Avis NE, Brockwell S, Colvin A. A universal menopausal syndrome?. Am J Med 2005; 118 (Suppl 12B): 37-46
  • 23 Im EO, Lee B, Chee W, Brown A, Dormire S. Menopausal symptoms among four major ethnic groups in the United States. West J Nurs Res 2010; 32 (4) 540-565
  • 24 Melby MK, Lock M, Kaufert P. Culture and symptom reporting at menopause. Hum Reprod Update 2005; 11 (5) 495-512
  • 25 Obermeyer CM. Menopause across cultures: a review of the evidence. Menopause 2000; 7 (3) 184-192
  • 26 Pham KT, Grisso JA, Freeman EW. Ovarian aging and hormone replacement therapy. Hormonal levels, symptoms, and attitudes of African-American and white women. J Gen Intern Med 1997; 12 (4) 230-236
  • 27 Avis NE, Stellato R, Crawford S , et al. Is there a menopausal syndrome? Menopausal status and symptoms across racial/ethnic groups. Soc Sci Med 2001; 52 (3) 345-356
  • 28 Dennerstein L, Lehert P, Koochaki PE, Graziottin A, Leiblum S, Alexander JL. A symptomatic approach to understanding women's health experiences: a cross-cultural comparison of women aged 20 to 70 years. Menopause 2007; 14 (4) 688-696
  • 29 Lerner-Geva L, Boyko V, Blumstein T, Benyamini Y. The impact of education, cultural background, and lifestyle on symptoms of the menopausal transition: the Women's Health at Midlife Study. J Women's Health (Larchmt) 2010; 19 (5) 975-985
  • 30 Sievert LL, Morrison L, Brown DE, Reza AM. Vasomotor symptoms among Japanese-American and European-American women living in Hilo, Hawaii. Menopause 2007; 14 (2) 261-269
  • 31 Anderson DJ, Yoshizawa T. Cross-cultural comparisons of health-related quality of life in Australian and Japanese midlife women: the Australian and Japanese Midlife Women's Health Study. Menopause 2007; 14 (4) 697-707
  • 32 Im EO, Ko Y, Hwang H, Chee W. “Symptom-specific or holistic”: menopausal symptom management. Health Care Women Int 2012; 33 (6) 575-592
  • 33 Friedman-Koss D, Crespo CJ, Bellantoni MF, Andersen RE. The relationship of race/ethnicity and social class to hormone replacement therapy: results from the Third National Health and Nutrition Examination Survey 1988-1994. Menopause 2002; 9 (4) 264-272
  • 34 Crespo CJ, Smit E, Snelling A, Sempos CT, Andersen RE. NHANES III. Hormone replacement therapy and its relationship to lipid and glucose metabolism in diabetic and nondiabetic postmenopausal women: results from the Third National Health and Nutrition Examination Survey (NHANES III). Diabetes Care 2002; 25 (10) 1675-1680
  • 35 Haas JS, Kaplan CP, Gerstenberger EP, Kerlikowske K. Changes in the use of postmenopausal hormone therapy after the publication of clinical trial results. Ann Intern Med 2004; 140 (3) 184-188
  • 36 Bair YA, Gold EB, Zhang G , et al. Use of complementary and alternative medicine during the menopause transition: longitudinal results from the Study of Women's Health Across the Nation. Menopause 2008; 15 (1) 32-43
  • 37 Hirata JD, Swiersz LM, Zell B, Small R, Ettinger B. Does dong quai have estrogenic effects in postmenopausal women? A double-blind, placebo-controlled trial. Fertil Steril 1997; 68 (6) 981-986
  • 38 Tode T, Kikuchi Y, Hirata J, Kita T, Nakata H, Nagata I. Effect of Korean red ginseng on psychological functions in patients with severe climacteric syndromes. Int J Gynaecol Obstet 1999; 67 (3) 169-174
  • 39 Newton KM, Buist DS, Keenan NL, Anderson LA, LaCroix AZ. Use of alternative therapies for menopause symptoms: results of a population-based survey. Obstet Gynecol 2002; 100 (1) 18-25