A BLACK AFRICAN WOMEN RISING INITIATIVE
Decolonising Menopause
Menopause is often presented as a universal experience. But for Black and Black African women, it is not. Our attitude and response to menopause is influenced by our backgrounds, our cultures, and our lived realities.
At The Ketura Woman Movement, we highlight the way that Black African women experience menopause. Of course, every woman will transition into menopause should they live long enough, but we all experience it differently. We have discovered that different ethnicities respond differently to the menopause experience.
As Black African women, our attitude and response to menopause is influenced by our backgrounds and cultures. I come from a culture that did not talk about menopause, and this created and fostered a culture of silence around the subject, perpetuating many myths and old wives’ tales.
Because of this lack of knowledge, women are caught unawares when they reach this season and are pretty much uninformed about what causes it.
Research
Research conducted in South Africa and Zimbabwe established that most women experience mood changes, sleep disturbance, decreased libido, hot flushes and night sweats. Weight gain was also a concern.
They also found that most women in these countries did not know what caused menopause but were aware of this stage of life. The research established that they attributed the stop of their menstrual cycle to an act of God, witchcraft, or did not know.
The Study of Women’s Health Across the Nation (SWAN) found significant differences in how Black women experience menopause:
Sources: Nelson (2008), SWAN Study
Earlier that Black women reach menopause compared to white counterparts
Of hot flushes for Black women, compared to 6.5 years for white women
Time spent in perimenopause than white counterparts
Rates of joint pain and more severe hot flushes compared to white women
Key Concept
To fully understand these differences, we must understand weathering. First introduced by Arline T. Geronimus, weathering describes how the body ages more rapidly due to long-term exposure to stress.
The body carries what life demands. Over time, it shows.
Weathering helps explain why Black women may:
Menopause, then, is not just a biological shift — it is a reflection of lived experience.
Healthcare Inequality
Research shows that Black women are significantly less likely to receive menopause treatment such as HRT.
A large UK study found that white women were far more likely to be prescribed HRT, while Black African women had some of the lowest prescribing rates.
Lower treatment rates do not mean lower need — they reveal deeper gaps in care.
This is not because the need is lower. It reflects:
Gaps in access to healthcare
Lack of culturally competent care
Communication barriers
Systemic inequality
For many Black women, the relationship with the medical establishment is shaped by historical and ongoing experiences of dismissal, bias, and harm. This mistrust is not irrational — it is grounded in lived reality.
Building trust requires healthcare providers who listen, understand cultural context, and treat each woman as a whole person — not just a set of symptoms.
Understanding Menopause
Knowledge that empowers. Awareness that transforms.
Stage 1
Can begin 8–10 years before menopause when the ovaries gradually produce less oestrogen. Usually starts in your 40s. In the last 1–2 years, the drop in oestrogen accelerates. You are still having menstrual cycles during this time.
Stage 2
The point when you no longer have menstrual periods. Your ovaries have stopped releasing eggs and producing most of their oestrogen. Diagnosed when you’ve gone without a period for 12 consecutive months.
Stage 3
The rest of your life after going through menopause. Symptoms like hot flashes may ease for many, but some continue for a decade or longer. Increased risk of osteoporosis and heart disease due to lower oestrogen levels.
OUR APPROACH
The healthcare system was designed around the average white woman’s experience. But our bodies, our cultures, our histories, and our needs are different.
Decolonising menopause means recognising these differences, advocating for culturally competent care, and building knowledge within our own communities.
When we know better, we do better — and we make informed choices for our health and wellbeing.
Whether you are just beginning to notice changes or are deep into the transition — you deserve knowledge, support, and a community that understands your experience.