How Ethnicity Shapes the Perimenopause Experience — Let's Talk About It

Written by Francesca Liparoti, a registered nutritional therapist specialising in perimenopause.

If you’ve spent any time reading about perimenopause, you’ll have noticed something’s off: the conversation assumes it’s the same for everyone. Yet the reality is different. The timing, severity of symptoms, and many other factors can be influenced by race and ethnicity.

Still, to this day, these differences are rarely acknowledged. The result? Many women go unheard, and their symptoms are sadly dismissed or misunderstood.

Timings of perimenopause can vary

The statistics back this up. Black women in the UK reach menopause at an average age of 49.6, nearly two years earlier than the national average of 51​ (1). The Study of Women’s Health Across the Nation (SWAN) (2) found that Black women have their final menstrual period over eight months earlier than white women​. Why is this important? Reaching menopause at an earlier age is associated with increased risks of cardiovascular disease.

Metabolic disease risk may be higher

For South Asian women, the concern isn’t just when perimenopause starts but how it affects their long-term health (3). They are more likely to develop heart disease, insulin resistance, central obesity, and hypertension during this transition​.

Despite these differences, perimenopause care in the UK remains, disappointingly, uniform.

Attitudes to perimenopause and symptom variation 

What could possibly explain this? Firstly, cultural attitudes towards ageing. In many Asian cultures, menopause is seen in a positive light. In Japan, the word for menopause is known as 'konenki', (9) a beautiful phrase that translates to "renewal and energy"​. When the expectation is to ‘transform’ rather than ‘decline’, it is believed to have a profound effect on how symptoms are experienced.

Whether in conventional medicine or complementary practices like mine, it is crucial to work with each person as an individual, offering personalised care and solutions. Here are several practical reasons for personalised care:

Diet and nutrition should reflect cultural needs:

• Phytoestrogens — Women are often advised to increase phytoestrogens to help manage symptoms like hot flushes. However, most recommendations focus on soy, which is not common in the cuisine of various cultures, nor is it always the best option for the individual. In these cases, alternatives such as flaxseed, which is also a source of phytoestrogens, may be more suitable. While flaxseed does not provide the same type or amount of phytoestrogens as soy, incorporating around two tablespoons of ground flaxseed daily can still offer some benefit, along with added fibre and omega-3s.
• Vitamin D deficiency is disproportionately high in South Asians in the UK, affecting up to 94% during the winter months. With many following vegetarian diets that are naturally low in vitamin D, regular supplementation is often necessary. A high-absorption option, such as Valerie’s Daily Essential Liposomal Shot, can support healthy levels year-round.
• Lactose intolerance is more common among Black and Hispanic women, meaning standard calcium advice based around dairy may not always be suitable. Alternatives like fortified plant milks, leafy greens, and sesame seeds can provide calcium without the need for dairy.

These are just some ways in which nutritional advice during perimenopause can and should reflect individual cultural backgrounds and health needs, rather than following a single, standardised approach.

These words are worth repeating:

“A one-size-fits-all approach simply isn’t enough.”

Perimenopause is not the same for everyone. Assuming that is simply it leaves too many women struggling to get the care they need. 

Let’s demand better, more research, broader healthcare training, and an open conversation that reflects the reality of perimenopause for all women.

Francesca Liparoti is a BANT and CNHC Registered Nutritional Therapist with a specialism in perimenopause. 

“I help women 35+ support their hormones and optimise their health so they can THRIVE through perimenopause and love life again! Book an exploratory call with me today and start your journey to flipping this all on its head!”

Visit: francescaliparoti.com

@perimenopausenutritionist_fl

If your perimenopause experience feels different from what you’ve been told to expect, chances are you are not imagining it.

Watch this space as we reveal more insights in coming blog posts, featuring more experts and making the conversation around perimenopause symptom variations bigger and bolder. Let’s make some noise!

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