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Secret Keepers: African American Women and Menopause

I come from a family where we didn't talk about biological functions. In fact, we didn't talk about much, but that's a story for another day. Because of this lack, I did not receive the "birds and bees" conversation. So, when I started my menstrual cycle, I had no idea what to expect. The internet wasn't a thing; I was too embarrassed to search for anything on the topic at the library and really didn't know who I could turn to. I was left with telling my mother that I was bleeding, at which time she gave me a booklet about it and a sanitary napkin. I've been on my own ever since. I have yet to have a conversation about women's health with my mother, my grandmother, or the plethora of aunts and cousins in my family. Not one.

Three and a half decades later, I missed my first menstrual cycle outside of pregnancy in the middle of winter. I was perplexed. Not being sexually active, I assumed it was yet another change my body was going through. I noticed over the years that a woman's body, well, at least mine, changes every few years; hormonal changes that felt different as I aged. I think this is a normal part of the aging process, sort of like, how amazing my knees were when I was younger and how now if I "sleep wrong," those same knees require lubrication - - a lot of lubrication. What struck me odd was the following month, when I missed another menstrual cycle. Then another. And another.

I didn't look or feel different, but this had to be a big deal, right? No. Not a big deal at all. I scheduled a doctor's appointment, and I informed them that I hadn't had a cycle, and the response, "...yes, this is around the time that menopause begins." I asked, "Should I be doing something in particular?" I received a response of "No, but since you aren't sexually active, no longer are having a cycle, and don't have a history of cancer, etc., you no longer have to have an annual pap smear."

Well damn. That's it. No, how do you feel? No particular exam for women who are going through menopause? No wellness check for us? No, this is what to look out for next?

Let me be clear, the physician is quite lovely, but there was a disconnect. I felt like something was over for me, but I couldn't put my finger on it. I was no longer of use as a woman. Since I wasn't using my vagina for sex or childbirth, the system said, I no longer needed to check in as frequently.

I'm not a woman or matter any longer.

So, I left thinking there isn't much to talk about, I guess. Just keep living life.

But as time progressed, I began to feel somewhat alone on this island of menopause. No one I know was talking about it. Not. One. Woman. Not. One. African American. Woman.

Wait… Is this a secret? As I noticed a colleague experiencing a hot flash, I asked how she was doing. Fine, was the response. I broached the subject by sharing that I, too, am going through menopause. The discussion only went as far as tips for hot flashes. I hadn't experienced one of those yet; therefore, I could not connect on that level. However, I was thirsty for more information.

Want to know what I found when doing my research? Statistics. The average age of menopause. Information about hormone replacement therapy (HRT) and tips on hot flashes. Want to know what I found when researching specifically about African American Women? Doom and Gloom! It's worse for us. We have comorbidities. Our symptoms are more severe than our peers. Articles on Racial and Ethnic disparities in menopause. Menopause is and has been treated by antidepressants and advised to seek clinical treatment.

What I was looking for? Meaningful conversations, resources, information about connecting with myself as a woman at this phase in my life. Things like that.

Yes, the information that reinforces the health disparities I already knew existed helped but what about the good stuff?

I went nearly a year before having a hot flash. It was debilitating. I almost called 911 because I didn't know what was happening to me. In truth, I had a fear that I was dying. That's how serious it was. It was accompanied by severe nausea and vomiting. I was drenched within minutes. It then turned into diarrhea. My level of anxiety was through the roof, my heart was pounding, and my head was spinning. Once it was over, I was exhausted. The women around me didn't say much of anything.

I didn't know how to recuperate from that experience. I now realize, maybe they didn't either.

I'm an introvert and tend to be somewhat introspective. I spend a lot of my personal time being quiet, but even in that quietness, I don't understand keeping secrets on something everyone will experience. Is this rooted in generational trauma? Is it rooted in society's overall position on women and women's health? Does race, class, or culture factor into this? How is it that we are not discussing something that will happen to every woman who has a menstrual cycle? Like, every single one. It's inevitable.

It's been a few years since the first hot flash, and I had one other as well but, knock on wood, I won't experience those again or at least not as intense as they were. That's two hot flashes in almost four years. That doesn't seem normal, but since the secret keepers are still keeping secrets, I simply have to remain in the constant pursuit of knowledge.

In the interim, while I am looking for my tribe, I'm still living life; still seeking knowledge. I recently got excited when I saw a video on social media regarding a small group of women fighting back against the quietness, misdiagnosis, and overmedicating of pre or peri-menopausal women. A movement regarding medical health and wellness. There wasn't a person of color in the bunch. It reeked of the suffragette movement, but that too is an opinion for another day. Also, I'm discussing this with my sister, my daughter, and even my son. I've shared tidbits with friends, but they seem to shy away from the discussion.

What I won't do is keep quiet, and my family will be informed by my experiences. Perhaps, mine will be the generation that dismantles some of that suspected generational trauma. I know that they won't go without all the information I have at my disposal. If a woman asks me about it, I am spilling all the tea. I also don't plan on waiting for people to ask.

This is a courageous conversation I want to have.

I couldn't think of a way to end this piece, but something continued to stick out. A phrase that embodies how I feel about the whole situation. By a formerly enslaved and savior of the enslaved, Isabella Baumfree, better known as Sojourner Truth - "And ain't I a Woman?"

Along with being an introvert, I love my femininity and womanhood. There is power there. I've been blessed with the ability to have birthed two children, and I'm not giving up my womanhood because I can't biologically create others.

Let's speak up, let's speak out, let's help each other, and remember, "And ain't I a Woman?"


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