Cultural, social and economic factors impact how we experience menopause differently.

First, let’s paint an accurate picture of who is affected by menopause. Widely accepted demographic models estimate that 1.1 billion women worldwide will be menopausal by 2025. Impressive, but let’s first recognize that “women” is insufficient to represent all of us who experience menopause. Nonbinary individuals and trans men go through menopause, as do women for whom surgery has brought menopause earlier in life than statistical models might consider. Anyone who has, or at one time had, ovaries may have menopausal symptoms during their lives. Equity demands that all of us be seen and acknowledged.

For too long, public narratives, popular culture and health research have focused on the menopausal experiences of cis-het white women, relegating the stories of BIPOC women and trans and gender-nonconforming people to the margins. Structural racism, discrimination and other factors affect how we experience the up to thirty-four symptoms of menopause and the treatments we may pursue and have access to. 

One of the most common medical interventions, hormone replacement therapy (HRT), offers a lens through which to consider a few of these differences. For example, Black women typically experience more intense and prolonged symptoms yet receive HRT at lower rates than their white counterparts. Because contributing factors may include cultural differences in patient preference for other remedies, higher prevalence of cardiovascular disease that may contraindicate HRT, and documented racial biases in the medical profession, there is a need to better understand how to make access to care more equitable. It should also not escape us that HRT is essential to trans health and, as such, is under attack by transphobic rhetoric and policy. In this social and political moment, when all facets of reproductive health and body autonomy are at risk, acknowledging such connections lifts up the importance for us to be in solidarity with one another.

The menopausal experience also has alignments with disability rights, as people with disabilities face unique challenges with menopause and access to care. For example, for neurodiverse people, menopause can exacerbate ADHD. It can even mimic ADHD among menopausal people who are neurotypical. The connection is so profound that some people don’t get diagnosed as neurodiverse until they reach menopause and experience the increased sense overwhelm, difficulty focusing, memory issues, low mood and/or anxiety.

Finally, the menopausal journey is a transition into life as an older adult. In an ageist society that devalues seniors, this is another intersectionality that can make the menopausal experience a bridging one, making us more aware of, sensitive to, and in support of aging issues and the quest for equitable health and wellness in later life.