One of the only constants in life is change, and no change is often met with greater confusion and a feeling of isolation than going through menopause. That’s why the reality of going a whole year without your cycle, is often referred to as “the change.” So the “Change Room” conversation at Wellness House, at 2025 ESSENCE Festival of Culture, hosted by Kathleen Newman-Bremang, deputy director of global for Refinery29, and esteemed, board-certified obstetrician and gynecologist Kelli V. Burroughs, MD, was not only essential listening but also packed with eager listeners seeking understanding. Black women are often hit the hardest by the experience.
“We know that Black women are disproportionately impacted by just the severity of symptoms when it comes to perimenopause and menopause. We are more likely to have hot flashes earlier. We’re also more likely to have more intense hot flashes. We’re not exactly sure what the pathophysiology is of it, meaning we don’t understand the underlying reason of why that happens. But we do know that we are, unfortunately, impacted,” Burroughs says. “It’s so important to have these conversations because we are at higher risk for experiencing the symptoms of perimenopause and menopause. Therefore, we are more likely to need some type of intervention. But if you don’t know what you’re going through, then it’s going to be hard to actually get the treatment.”
Opening up about what you’re going through, Burroughs says, reduces the confusion of what you’re going through, and what better people to open up to than your friend circle?
“When you’re with your friends, when you’re at happy hour, when you’re ordering your cocktails, there should be conversations among us about what’s happening because you’ll find a support group,” she shares. “You’ll realize that you’re not the only person going through it and that other people are experiencing the same signs and symptoms. And what’s even more important is that sometimes women don’t realize that they’re actually going through menopause or going through perimenopause. They don’t realize what’s happening and therefore they don’t even realize there’s a conversation to be had.”
But shame over conversations regarding reproductive health is real, and as Newman-Bremang noted, they begin as far back as when we get our first periods. Burroughs emphasized the importance of opening up lines of communication with your daughters early, so the stigma that can come with talking about what we’re going through can dissipate, leading to much easier conversations by the time those young girls become grown women going through the change.
To help those listening get more comfortable with this openness, Burroughs asked everyone in the audience if they’d experienced hot flashes, night sweats, vaginal dryness, brain fog, vaginal irritability, a lack of energy, and a lack of motivation. Many women raised their hands and nodded.
“Those are the main signs that a transition could be happening. That hot flashes the night sweats, the decreased energy or what I also call the interest effect. Just walk out here and you could not care. The decrease in libido, you truly just don’t have a desire to regain. So all of those things are signs. And I think that that’s so important that we talk about that today because if you know what’s going on and what’s linked to possible hormonal changes, then you are equipped to actually have a discussion with your doctor.”
She also noted that if you go to your doctor and find that you aren’t heard, don’t be deterred.
“It is okay to go back to that physician and have the conversation again,” Burroughs says. “Many times, patients might feel intimidated or they’re just frustrated, they just don’t want to engage anymore because they didn’t feel seen, they didn’t feel heard. But sometimes it’s not that the physician is actually being dismissive, sometimes it’s that there might not have been a connection or they just didn’t really understand the severity of the issue. And sometimes we just don’t do a good job. So you need to be able to circle back around to your physician and have the conversation again if you feel like your issues were not addressed. And then if that happens, and you still don’t have a resolution, then it’s always great to seek a second opinion, to find another physician who is willing to listen to what you have to say in order to provide some type of recommendation.”
But it’s also important to note that a few symptoms here and there aren’t always a sign that you’re menopausal. Burroughs says if you have gone without your period for a year and your symptoms are truly hurting your everyday life, make that appointment.
“Are the symptoms impacting your quality of life? Are you having hot flashes to the point where it’s impacting how you function at work or impacting your sleep at night? Are you having brain fog to the point where it’s hard for you to complete daily tasks or complete your responsibilities at work? Is your irritability to the level where your children might notice or your husband might have some comments about the irritability? Can you tell that you’re so irritated on a regular basis that you’re having trouble with connections? Your energy level? Is it to the point where it’s impacting how your routine plays out during the day? Are you unable to get things accomplished?
Your lack of motivation, your lack of drive, and the vaginal dryness, is it impacting your relationship at home? If all the symptoms are impacting you, then that’s how you know it’s time to really have a conversation with a provider.”
Paying attention to how you’re feeling, and not being afraid to connect with others to know what’s normal and what’s not goes a long way. To conclude the conversation, a New Orleans native opened up about the need to talk more about how your mental health is affected during the change. She was vulnerable, noting she fell into depression, battled anxiety, and had suicidal ideation. Burroughs thanked her for being so honest.
“I spoke about irritability, but you can also have feelings of severe sadness. It can be feelings of anxiety, feeling overwhelmed, waking up in the morning and just not knowing how to kind of attack the day, feeling like you have so much on your plate that you just do not know where to start. And it just continues to kind of pile on top and on top and continues to accumulate to the point where you feel like you’re suffocating and you are really underwater,” she says. “And those feelings can definitely start in your forties. Perimenopause can start in your fifties or they could be exacerbated, and it could worsen as you are making this transition. And so I am so glad that the young lady today asked the question in our audience, because if you are having those feelings, it is a conversation to be had, with others and with your physician.”