Symptoms of menopause differ among persons of different race/ethnicity with Black and Hispanic persons being most likely to report severe symptoms, according to findings from a large cross-sectional study presented at the 2022 North American Menopause Society (NAMS) Annual Meeting held October 12 to 15 in Atlanta, Georgia.

Although the study was not designed to determine the causality of symptom severity and frequency, “It is likely that genetics, environment, and cultural influences play a role in the disparate symptomatology of women from different racial and ethnic backgrounds,” said lead author Leah Millheiser, MD, NCMP, chief medical officer of Evernow.

The findings are based on responses from 44,678 patients to an online intake questionnaire from Evernow, a menopause-focused telemedicine service, taken between May 2020 and March 2022. The patients were primarily White women (75.2%) followed by Hispanic (10.9%), Black (8.6%), and East Asian (0.32%) women.

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Intake questionnaires that used the Menopause Rating Scale (MRS) were evaluated for ethnicity-specific trends. Moderate to severe symptoms were defined as an MRS score of 3 or 4.

Patterns in Menopause Symptoms Among Black, Hispanic Persons

Black women were less likely to report severe weight changes (adjusted odds ratio [aOR], 0.6) but more likely to report severe hot flashes (aOR, 1.64), night sweats (aOR, 1.52), heart discomfort (aOR, 1.37), mood swings (aOR, 1.27), painful sex (aOR, 1,26), joint and muscular discomfort (aOR, 1.26), skin and hair changes (aOR, 1.24), sleep disruption (aOR, 1.23), increased facial hair and acne (aOR, 1.19), and vaginal dryness (aOR, 1.14) compared with White women and after adjusting for body mass index.

Hispanic women were more likely to report severe skin and hair changes (aOR, 1.37), mood swings (aOR, 1.25), bladder issues (aOR, 1.24), heart discomfort (aOR, 1.24), joint and muscular discomfort (aOR, 1.23), vaginal dryness (aOR, 1.22), and anxiety or depression (aOR, 1.21) compared with White women.

The East Asian women were less likely to report heart discomfort (aOR, 0.43), night sweats (aOR, 0.5), and sleep disruption (aOR, 0.56) than White women.

“Our study reproduces the findings of the pivotal SWAN study, but in a much larger cohort of patients,” Dr Millheiser said in an interview. “The data can be used to help inform the conversation and counseling around the experience and treatment of menopausal symptoms that health care providers have with their patients.”

The findings may have been limited by the reliance on self-reported symptoms. Additional research is needed to investigate ethnicity-specific trends to inform treatment paradigms and patient counseling, the study authors concluded.

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Disclosure: Multiple authors declared affiliations with Evernow.


Millheiser L, Morris JR, Jackson A, et al. Racial and ethnic difference in menopausal symptoms: a cross-sectional study of 44,678 women. Poster presented at: 2022 NAMS Annual Meeting; October 12-15, 2022; Atlanta, GA.