Incorporating menopause history into routine cardiovascular risk assessment may help identify risk-enhancing factors in addition to those captured by traditional cardiovascular risk assessment tools.

 

• Age at menopause onset
• Surgical menopause
• Blood pressure evaluation
• Lipid screening
• Glucose and metabolic health assessment
• Weight and central adiposity evaluation
• Sleep quality and sleep disorders
• Mental health and psychosocial stressors
• Lifestyle factors, including physical activity, nutrition and tobacco use
• Social determinants of health, including education and health literacy, access to general and specialty health care, income and employment status, housing stability, and food security.

Menopause experiences are not uniform, and symptom burden, timing of access to care and health outcomes may vary considerably across populations. Understanding different menopause presentations and the social and cultural contributors to symptom experience, care-seeking behaviors, and treatment access can help clinicians deliver more individualized, equitable care.

Important differences in menopause symptoms have been reported across socioeconomic, racial, and ethnic groups, including:

• Black women experience vasomotor symptoms for longer durations than women from many other racial and ethnic groups.
• Black, Hispanic, Chinese and Japanese women report poorer sleep compared to White women, including shorter sleep duration, poorer sleep quality, and, among Black and Hispanic women, greater sleep interruption during the menopausal transition.
• Hispanic and Black women may experience menopause at younger ages, which may be associated with increased cardiovascular risk.
• Socioeconomic disadvantage has been associated with earlier age at menopausal symptom severity.