Is the Menopause Conversation Limited to Just The White Middle Class?
In recent years, menopause has climbed higher on the public and healthcare agenda, gaining momentum in dialogues across mainstream media. In fact, menopause has been having its moment for more than a moment now - but while awareness is growing, and brands are embracing the movement, this does not go hand in hand with systematic change. This is mostly seen in lower socio-economic groups and ethnic minorities who have less accessibility to menopause information relevant to them, and while they’re not excluded from the menopause conversation - it doesn’t seem that the menopause conversation considers their challenges.
Understanding the Systemic Challenges
Menopause narratives have traditionally been dominated by white, middle-class perspectives, often sidelining the unique experiences of women of colour and those from lower socioeconomic groups. This focus reflects broader societal structures where those with more resources, typically middle to upper-class individuals, have better access to healthcare resources and platforms to share their experiences.
A recent study by Menopause Support discovered that around half of women suffering worrying menopause symptoms say they had no option but to pay for private healthcare. Women are increasingly finding, that despite the conversation in the media, NHS doctors are not providing correct prescriptions or support, or even at times, diagnosing the condition. Menopausal symptoms tend to be hugely under-treated and under-reported, often as a result of misconceptions that menopause symptoms start when regular periods wean off. In reality, the term “menopause” but menopause is actually only a period of 24 hours. Menopause marks the day when you haven’t had your period for 12 months, everything before this day is peri-menopause and everything after this day is postmenopause. This means, that most women with menopause symptoms are in perimenopause and might still be getting regular periods - without knowing and attributing their symptoms to menopause.
With a menopause diagnosis and a first prescription from a private doctor, the road becomes easier to ensure further treatment, but to do so requires a certain level of financial stability and privilege, and for many working-class women - visiting a private doctor, even as a one-off consultation, is not affordable. This leaves them to rely on a severely underfunded NHS, where according to Health Watch Hertfordshire, 52% of women had to speak to healthcare professionals about their menopause symptoms multiple times. Many spoke to several different doctors before they were taken seriously and some were initially misdiagnosed. The systemic issues within the NHS concerning the recognition and treatment of menopause symptoms can be narrowed to one very basic fact - NHS GPs receive no mandatory menopause-specific training. The government has rejected recommendations from the Women and Equalities Committee to make menopause training a compulsory aspect of continuing professional development for GPs. This decision has sparked considerable debate, with critics arguing that a more structured approach to menopause education would improve the consistency and quality of care provided to women experiencing menopause symptoms. It is no surprise then that the socio-economic chasm has led to a “postcode lottery” with regard to prescriptions for menopause medications, with an analysis of NHS data showing menopausal women three times more likely to be offered hormone replacement therapy (HRT) in some parts of the country (such as the South West of England and Cornwall) than others.
The Cultural Menopause
The experience of menopause among ethnic minority women is markedly different and less discussed in public health narratives. Lower-income women might spend less time on social media and reading magazines to give them access to the right information. Cultural perceptions significantly shape how symptoms and the overall condition are understood and managed. In many South Asian communities, for example, there is often no specific terminology for menopause, which is frequently dismissed as a natural and enduring aspect of womanhood, not recognized as a condition requiring medical attention. Many women in these communities suffer in silence, their menopausal symptoms cloaked in stigma and misunderstanding. Misconceptions about treatments, like HRT — coupled with a historical mistrust in predominantly white healthcare systems—further inhibit these women from seeking the help they need.
Research indicates that ethnic minority women in other regions like the US tend to enter perimenopause earlier and experience more intense and prolonged symptoms compared to their white counterparts, with black women starting menopause an average of 8.5 months earlier than white women. Black and South Asian women in the UK are often embarrassed to discuss menopausal symptoms due to cultural taboos, and their experiences can be further complicated by language barriers and a lack of culturally relevant healthcare information.
The Real Cost of Beauty
Beyond medical health services - menopause is often dealt with through the beauty industry. While brands are working toward greater education and support within the industry for clients, low-income families will find they do not have the disposable income for stress-releasing massages or menopause-friendly skincare.
The multibillion-dollar cosmetic and skin care industry is a money making machine and anti-aging skincare products, often marketed as menopause-friendly due to their benefits for aging skin, are typically priced higher than regular skincare products. There are two reasons for this - the first, anti-aging products often contain specialized ingredients like peptides, retinol, and hyaluronic acid, which contribute to their higher price points. The second, however, is that brands know that mature women tend to have more disposable income, and they can therefore set a higher price point for their target audience - even if this trend is not the case across the board.
This pricing of anti-ageing products (for example, comparing an anti-ageing moisturising mask to simply, a moisturising mask) makes them less accessible to lower-income families, who already struggle with accessing basic healthcare services. The disparity in product pricing reflects a broader issue where menopause care and associated products are not economically feasible for all, adding another layer of inequality to an already complex issue.
Without a doubt, there are efforts being made to bridge these gaps, with campaigns and healthcare initiatives increasingly aiming to tailor resources to be more inclusive, such as the PPC initiative from the NHS to make HRT more affordable. But expanding this dialogue to inclusively cover the diverse experiences of all women is crucial for enriching our understanding and ensuring that every woman receives the informed support and care she deserves during menopause. As we move forward, it is vital to address these disparities through targeted efforts in healthcare education, policy, and community support to truly make every menopause matter. This broadening of perspectives is essential not just for healthcare equity but also for fostering a more comprehensive understanding of what menopause means for every woman, regardless of her background.