Black History Month Means Doing Better in Black Women’s Health
Fibroids, Surgery, Menopause and the Trust We Have to Rebuild
Black History Month is a time to celebrate brilliance, leadership, culture, and resilience.
It is also a time to tell the truth.
In reproductive health, Black women carry a heavier burden with fibroids, surgery, and menopause symptoms. Too often, they also carry dismissal.
If we are going to honor Black women well, we have to look honestly at those patterns.
The Fibroid Burden Is Real
If you are a Black woman, there is a strong chance you or someone you love has dealt with fibroids.
Fibroids can mean bleeding so heavy you plan your life around it. Chronic pelvic pressure. Iron deficiency and deep exhaustion. Fertility challenges. Being told, “It’s common. It’s normal.”
Black women are about two to three times more likely to develop fibroids than White women. They tend to develop them earlier, and the fibroids are often larger and more symptomatic.
That reality alone deserves attention. But what happens after diagnosis matters just as much.
Surgery Is Often Offered, Sometimes Too Quickly
Black women have higher rates of hysterectomy for fibroids.
Hysterectomy can absolutely be the right decision. For many women, it brings long-awaited relief. But it should always be a fully informed choice.
Depending on the situation, uterus-preserving options may include myomectomy, uterine artery embolization, radiofrequency ablation, focused ultrasound, or medical therapies such as hormonal treatments or GnRH antagonists. These are not appropriate for everyone, but patients deserve to know they exist.
Because surgery has long-term implications.
What We Now Understand About Hysterectomy and Menopause
Many women are told, “We’re leaving your ovaries, so you won’t go into menopause.”
The truth is more nuanced.
Research suggests that hysterectomy with ovarian preservation may increase the risk of earlier ovarian insufficiency and may shift menopause slightly earlier, on average about one to two years earlier. Some studies show nearly a twofold increase in ovarian failure risk. Other long-term data show no clear acceleration in hormonal decline compared to natural menopause.
The evidence is mixed, and the mechanism is not fully understood. But the possibility of earlier menopause is real enough that it deserves discussion.
Why does this matter?
Menopause before age 45 is associated with significantly higher risks of cardiovascular disease, osteoporosis, depression, and cognitive decline. Large studies show early menopause is linked to roughly 30 to 50 percent higher cardiovascular risk.
Black women are more likely to undergo hysterectomy at younger ages. That makes thoughtful counseling even more important.
Menopause Symptoms Are Not Experienced Equally
When it comes to hot flashes, the data are clear.
Black women experience more hot flashes and for longer than White women.
The long-running Study of Women’s Health Across the Nation, known as SWAN, found that Black women had the highest rates of vasomotor symptoms across racial and ethnic groups. They were more likely to report severe hot flashes, and the median duration was 10.1 years, compared to 7 years for White women and 5 years for Asian women. In some studies, Black women were about twice as likely to report severe hot flashes compared to White women.
That is not a subtle difference. It is consistent across decades of research.
And yet Black women are significantly less likely to use menopausal hormone therapy. National data show striking disparities in prescription rates, as well as in the likelihood that a hormone therapy prescription will be filled.
That gap cannot be explained by biology alone.
We Cannot Talk About This Without Talking About Trust
Medical mistrust in Black communities is not irrational. It is rooted in history.
The Tuskegee Syphilis Study.
Henrietta Lacks.
Forced sterilizations.
Pain dismissed.
Symptoms minimized.
When a system has harmed your community, hesitation is rational.
So you may hesitate to fill a prescription. You may question whether risks and benefits are being presented fairly. You may wonder whether surgery is being recommended because it is easier, not because it is best.
Trust cannot be demanded. It has to be earned.
What Equity Actually Looks Like
Health equity is not a slogan. It is how we practice.
It looks like clearly explaining the potential long-term effects of hysterectomy, even when ovaries are preserved.
It looks like discussing conservative fibroid treatments when appropriate.
It looks like reviewing the risks and benefits of hormone therapy in a balanced, personalized way.
It looks like taking symptoms seriously and documenting them carefully.
And it looks like slowing down enough to listen.
Celebrating Black History Month Means Doing Better
Black women have shaped medicine and public health in profound ways. They advocated for reproductive justice long before it was a mainstream term.
Celebrating Black History Month means honoring that leadership and committing to better care moving forward.
Black women should not have to fight to be believed.
Their symptoms deserve acknowledgment.
Their menopause deserves treatment.
Medical Disclaimer:
This article is for educational purposes only and is not individual medical advice. It does not replace care from a licensed healthcare professional. Always consult your own clinician before making medical decisions.
References
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