Doctors have a lot to learn about communicating with black women about menopause, a new study shows.
Ivy M. Alexander, PhD, of Yale University, and Coralease C. Ruff, DNSc, RN, of Howard University, conducted a series of seven focus groups for 43 generally healthy black women in two cities. All identified themselves as experiencing menopause symptoms.
All of the women had access to health care, yet most of them said their best sources of information about menopause didn't come from doctors or nurses. Instead, these women turned to other women in their communities, self-help literature, and the Internet.
It's not that the women didn't trust doctors. The doctors, it seems, simply weren't on the same page.
"As clinicians, we need to recognize that culture and life events affect how women perceive various treatment options," Alexander and Ruff write in the April issue of Menopause Management. "The women in our study put great stock in how their mothers or other older women in their communities had managed menopause symptoms."
Like white women, the black women in the study had most of the common menopause symptoms. But many women had other symptoms — such as body odor, hot feet, and bloating — that they associated with their menopause.
"It is critically important that we clinicians explicitly ask women experiencing menopause to describe their symptoms," Alexander and Ruff write. "The symptoms they identify as most bothersome may be different from those we think might be troubling them the most."
One of these symptoms is rage.
"The women said they had taken enough and had earned the right to be respected and treated well and not have to take 'crap' from others anymore," Alexander and Ruff note. "But frequently rude or irreverent treatment by others was experienced, and this produced a 'rage' in the women."
The researchers note that white women have described similar experiences. They suggest that rage is more a part of "coming of age" than of menopause itself.
No Hormones for Me
The black women in the study were very reluctant to treat their menopause symptoms with hormone therapy. Only 32 percent had tried it, and only 16 percent were using it.
"Most avoided hormone therapy because they felt it was not natural, didn't like to take pills, or had fears about side effects," Alexander and Ruff note. "Several noted that 'my mother and grandmother didn't need it, so neither do I.'"
Instead, the women seemed to prefer nondrug menopause treatments such as changes in clothing, diet, and exercise; alternative/complementary therapies; and prayer and spirituality.
Tips for Docs
Alexander and Ruff offer tips for doctors treating black women with menopausal symptoms:
— Identify what symptoms the individual woman is experiencing.
— Focus on the symptoms a woman identifies as most distressing.
— Provide clear and accurate information regarding menstruation and menopause.
— Provide clear and accurate information about treatment options.
— Support healthy lifestyle changes that might reduce menopause symptoms.
— Develop group information sessions for women to share with one another.
SOURCES: Alexander, I. and Ruff, C. Menopause Management, April 2005; vol 14: pp 22-26. News release, Yale University.