I am loving the part of my practice where I care for peri- and menopausal women. I am acutely aware that every woman’s menopause experience is different.

While menopause happens to all women, the way it feels can be very different from person to person. Studies show that women of color often start menopause earlier and go through a longer perimenopausal transition. For example, Latina and Black women report more hot flashes, mood changes, and trouble sleeping. Asian women tend to have fewer or milder symptoms. These differences are not only about biology—they also come from things like genetics, where someone lives, culture, and access to healthcare.

Menopause doesn’t happen by itself. It’s part of a woman’s life story. Things like money, stress, culture, and even the air she breathes can all make a difference. Women with lower incomes or less access to good housing, healthy food, and doctors may start menopause earlier and have stronger symptoms. They may also have higher risks for heart problems. Women who speak little English or have trouble understanding health information can also face challenges, since most menopause materials are written only in English.

Being an immigrant can make things harder too. Many immigrant women in the U.S. can’t easily get the care they need. Research shows that the longer they live in the U.S., the more stress, sadness, and sleep problems they may experience. Racism, discrimination, and trauma add to these problems. Black women often face more stress and unfair treatment but are less likely to get help for hot flashes, depression, or high blood pressure.

Habits and environment matter too. Eating a lot of junk food, not getting enough sleep, or smoking can make menopause symptoms worse. Not being active can lead to tiredness and mood changes. People who live in areas with little green space or more pollution often go through menopause earlier and have more health issues. These patterns reflect long-standing inequalities in race, money, and city planning.

A woman’s health and reproductive history also play a role. Starting periods early, having fewer pregnancies, or not breastfeeding can lead to earlier menopause. Getting regular checkups and having insurance can help women get treatments that ease symptoms. Women without insurance often have stronger symptoms and fewer options.

Doctors can help by listening and showing care. Menopause is a chance for women and their doctors to work together—talking openly about symptoms, needs, and choices. Teaching both patients and doctors about menopause, culture, and bias helps make care fairer and more personal.

In the end, menopause care should fit each woman. Understanding how race, culture, environment, and stress affect menopause helps doctors give better, kinder care. Every woman’s story matters, and every doctor visit is a chance to close the gap in menopause health.

I am seeing Menopause patients at our University Health office in Reno, Nevada. Call 775 657 2025 for an appointment with me.