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Race matters when it comes to treatment of menopause symptoms. While Black patients have more severe symptoms, they tend to receive less treatment, according to Danette Conklin, PhD, Assistant Professor of Psychiatry at Case Western Reserve University School of Medicine, Cleveland, Ohio.
Dr Conklin shared results from a new study of racial disparities among menopausal women with psychiatric conditions during a presentation at the 2023 Annual Meeting of the Menopause Society, held September 27-30, in Philadelphia, PA.
Previous research has shown that menopause symptoms vary across racial groups, with Black women experiencing more severe hot flashes and other symptoms than White women. Menopause can also be complicated by the presence of psychiatric conditions, which can worsen moods and vasomotor symptoms during the menopause transition, and psychiatric conditions can be exacerbated by menopausal changes. Though menopause hormone therapy (MHT) is shown to improve responses to psychiatric medications during menopause, there is limited data on the rate of MHT prescribing.
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Dr Conklin and her colleagues presented results of a new study looking at 65,762 female patients aged 45 to 60 years to assess the rate of MHT prescribing of menopausal Black women vs White women, both with and without psychiatric diagnoses, with the aim of determining if there were racial disparities in prescribing rates of MHT.
The researchers found that 20.7% of women with menopausal symptoms and a psychiatric condition received MHT, vs 16.9% of women with menopausal symptoms but no psychiatric conditions. The study also found that Black women were more likely to have menopause symptoms than White women, but less likely to receive MHT, and that among women with psychiatric conditions, White women were 40% more likely to receive MHT than were Black women.
The study also showed a low rate (11%) of documented menopause symptoms in Black patients vs prior reports of up to 80%, a discrepancy that may be due to patient reporting, physician inquiry, or physician documentation of menopause symptoms.
“I had noticed for years that Black women were very quick to deny menopause symptoms unless specifically asked if they had X, Y, or Z symptoms and even less likely to admit that symptoms were interfering with daily life. This study really solidified what I had observed in clinical practice and that is that many Black women downplay and normalize menopause symptoms even when their quality of life is impacted,” said Dr. Sally MacPhedran, co-author of the study and Associate Professor in the Department of Reproductive Biology at Case Western Reserve University School of Medicine.
“This study reinforces that health care professionals must ask patients about their specific menopause symptoms so they can discuss the options that could help them improve their quality of life,” according to Stephanie Faubion, MD, medical director of The Menopause Society. “Black women should have the same access as White women to the available treatment options.”
Takeaway:
- Menopause hormone therapy (MHT) is prescribed at low rates to menopausal patients overall, with Black women with psychiatric diagnoses receiving MHT significantly less often than White women.
- Educating clinicians on disparities in care among menopausal women, particularly with psychiatric conditions, may aid in addressing this health care inequity.
Source
Conklin D, Gaboury E, Cantu-Weinstein A, Pulling S, MacPhedran S. Racial Disparities Among Menopausal Women with Psychiatric Conditions. Presentation given at: The Menopause Society 2023; September 27-30, 2023; Philadelphia, PA.
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