More focus needed on Black, low-income women to identify, treat common midlife conditions

Key takeaways:

• Beyond hot flashes, midlife women also reported high rates of acid reflux, joint pain and sleep problems. .
• Midlife Black women had higher rates of hypertension and acid reflux at all ages vs. white women

More than 45% of midlife women are diagnosed with several common conditions in addition to menopausal symptoms and data show Black women and those living in high deprivation areas are disproportionately affected, researchers reported.

“We know that women and men age differently, and that women experience a lot of health changes at midlife. However, there are not a lot of studies that focus on middle-aged women, and we don’t really understand how midlife health changes might impact women as they age,” Jennifer L. St. Sauver, PhD, MPH, professor of epidemiology in the division of epidemiology at the Mayo Clinic and Mayo Clinic Women’s Health Research Center, told Healio. “If you are a middle-aged woman, it’s helpful to know that suddenly experiencing these things — when you haven’t had any problems in the past — is really common. It’s helpful for clinicians to understand that many women experience new changes that affect different body systems during midlife — it’s not just hot flashes related to menopause. In addition, these conditions may be linked, and it may be useful to ask about all of these things during clinic visits, since there are effective treatments for a number of these issues.”

St. Sauver and colleagues analyzed data from 86,946 women (90% white) aged 40 to 59 years living in a 27-county region of the U.S. from the Rochester Epidemiology Project to assess the prevalence of midlife conditions by age, race, ethnicity and sociodemographic status. Researchers calculated the prevalence of 424 midlife conditions by age, race, ethnicity and area deprivation index quartiles.

Overall, 28 midlife conditions affected 10% or more women, with musculoskeletal pain (48%), benign neoplasms (27%), anxiety disorders (27%), depressive disorders (25%) and disorders of lipid metabolism (24%) the most common categories.

In addition, disorders of lipid metabolism, hypertension, sleep/wake disorders, thyroid disorders, esophageal disorders, osteoarthritis, tendon and synovial disorders and menopausal disorders affected 45% or more women aged 40 to 59 years.

Compared with white women, Black women had a higher prevalence of hypertension and esophageal disorders at all ages (P < .05 for both). Asian women had lower prevalences of hypertension, sleep/wake disorders, esophageal disorders, osteoarthritis, tendon/synovial disorders and menopausal disorders at most ages compared with white women.

Women living in the most deprived areas demonstrated the highest prevalence of all midlife conditions, except for thyroid and menopausal disorders, at all ages. Women living in more deprived areas demonstrated a higher prevalence of hyperlipidemia, hypertension, sleep/wake disorders and esophageal disorders (P < .05 for all). Women living in less deprived areas demonstrated a higher prevalence of thyroid disorders at age 40 to 44 years and menopausal symptoms at age 50 to 59 years (P < .05 for both).

“Our data suggest that a lot of middle-aged women are having enough physical issues that they are bringing the problems up to their doctors. However, little is known about which women experience the most problems, whether these conditions are all biologically linked and whether having some of these problems at midlife — like joint pain — impact health later in life,” St. Sauver told Healio. “Also, our study only focused on the most common conditions reported to doctors, and there are other symptoms that did not make our cutoff that often appear in women at midlife that deserve further study.”

For more information:

Jennifer L. St. Sauver, PhD, MPH, can be reached at stsauver.jennifer@mayo.edu.