By Jo Lavan –

Guest Writer and Licensed Hypnotherapist Jo Lavan highlights the unequal experiences of menopause care in the UK, emphasising the urgent need for culturally competent, inclusive support for women from ethnic minority backgrounds.

As a white British woman who has been through the menopause, I’ve had my fair share of challenges — night sweats, brain fog, moments of inexplicable anxiety, mood swings, and sleepless nights. But I’ve also had options: a GP who listened, support systems, and discussions that acknowledged my experience.

It’s only recently that I’ve begun to understand that this version of menopause support is not shared by all women in this country, particularly not by women from ethnic minority backgrounds.

The Unequal Landscape of HRT Access

Hormone Replacement Therapy (HRT) is the most commonly prescribed treatment for menopause symptoms, especially for those experiencing moderate to severe symptoms.

Academics at the University of Oxford examined HRT prescriptions issued in England to almost 2 million women aged 40 to 60 over a 10-year period.

Their findings, published in the Health of the Nation Report in Relation to Hormone Replacement Therapy, revealed a troubling reality.

The report analysed data for 1.85 million women aged 45 to 55 and showed:

• Approximately five times fewer Black women (5.2%) and four times fewer Asian women (6.2%) are on HRT compared to white women (23.3%).

• Nearly twice as many women from the most affluent groups are on HRT (23%) compared to those from the most deprived groups (12%).

These aren’t just numbers, they represent real women facing real, untreated symptoms in silence.

Disparities in Diagnosis and Treatment

The Fawcett Society’s 2022 report, Menopause and the Workplace, highlights further disparities:

• Delayed diagnosis is reported more frequently among Black and minoritised women (45%) than white women (31%).

• HRT uptake is also lower (8% vs. 15% in white women).

Access to medication is a clear issue, but it’s not just about availability. It also relates to how symptoms present and are interpreted, or, in some cases, misinterpreted.

Cultural Variations in Experience and Perception

Different communities experience menopause differently:

• Afro-Caribbean women often report more severe and prolonged hot flushes and night sweats.

• South Asian women may reach menopause earlier, sometimes years before the UK average age of 51.

• Chinese and Japanese women may experience hormonal shifts differently, including longer menstrual cycles.

Despite growing awareness of menopause in the UK, many women from ethnic minority backgrounds face a cultural silence that leaves them struggling alone.

In communities where menopause is not openly discussed, stigma, modesty, and traditional roles continue to prevent access to vital support and information.

The Weight of Cultural Silence

In South Asian communities, particularly among Pakistani, Bangladeshi, and Indian women, menopause is often seen as a private or even shameful transition. It’s rarely discussed, even within families, and many lack the vocabulary to describe their symptoms in their first language.

Cultural taboos around ageing and female health, combined with a lack of translated or culturally relevant resources, leave many suffering in silence.

For Black African and Afro-Caribbean women, a culture of stoicism often prevails. Seeking help can be seen as weakness, with a strong expectation to “just get on with it”.

In East Asian communities, such as among Chinese women, modesty and cultural norms around ageing discourage open discussion. Some women turn to traditional remedies, bypassing conventional healthcare altogether.

Health Consequences of Silence

This silence isn’t just cultural, it has real health consequences.

Women who don’t talk about menopause are less likely to seek medical advice, receive HRT, or feel empowered to manage their symptoms. This leads to a widening health gap that urgently needs addressing.

I’ve read stories of Bangladeshi women describing hot flushes as “fevers” — language shaped by culture but misunderstood by clinicians. Without culturally competent care and effective communication, symptoms are dismissed or misdiagnosed.

The British Menopause Society has published a resource, Menopause for Ethnic Minority Women, to help clinicians understand and address these disparities.

A Call for Inclusive Change

As someone who benefits from a healthcare system that often recognises my needs, I’m beginning to question what inclusivity really means.

We can’t champion women’s health and only mean some women. The conversation about menopause has gained welcome traction in recent years, but it must expand, urgently, to reflect the full diversity of women’s experiences.

Menopause isn’t a white woman’s issue — it’s every woman’s issue.

Healthcare professionals and campaigners are rightly calling for:

• Better cultural competence

• More inclusive public health messaging

• Greater representation in research and resources

These aren’t optional extras — they are essential if we’re serious about equality in women’s health.

The menopause journey is challenging enough. No woman, regardless of her background, should have to face it alone, misunderstood, or unheard.