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How Perimenopause/ Menopause Affects Asian Women

  • Dr. Christine Cho ND
  • Oct 2
  • 3 min read

Did you know that your race/ethnicity may affect the way you experience not only what symptoms you might experience during perimenopause, but what health concerns you might be at risk of developing post-menopausally?


Here are a few health/medical concerns that affect Asian women during perimenopause/menopause differently than other groups:

  1. Cardiovascular disease (CVD) risk rises after menopause for everyone, but is more notable in some Asian subgroups. Menopause is an independent marker for higher CVD risk (changes in lipids/cholesterol, blood pressure, etc), and studies involving Korean and South Asian women highlight elevated CVD risk or earlier risk-factor clustering after menopause. This effect is more pronounced in women who enter menopause earlier.

  2. South Asian women show a higher propensity for metabolic syndrome and type 2 diabetes at midlife. South Asian women show earlier and higher rates of metabolic syndrome (dyslipidemia, central adiposity, elevated triglycerides) during the menopausal transition compared with many other groups.

  3. Distinct body-composition shifts (greater visceral adiposity). Studies in East and Southeast Asian women report a higher visceral fat to subcutaneous fat ratio or greater central fat accumulation after menopause even when BMI is similar. The phrase "skinny fat" comes from this phenomenon, meaning you might look thin or be of normal weight, but underneath there is dangerous fat building that will contribute to the development of metabolic syndrome and cardiovascular disease.

  4. Osteoporosis/low bone mineral density is more common among Asian women, but hip fracture risk does not seem to increase while atypical femur fracture risk may. Smaller bone size affects DXA results of bone mineral density and is why more Asian women will be labeled as osteoporotic. My clinical experience also shows me that Asian women are much less likely to engage in weight training/resistance training than other racial groups, which long term will negatively impact lean muscle mass and bone mass.

  5. Vasomotor symptoms (hot flashes/night sweats) are believed to be less prevalent and less intense in East Asian women. South Asian women seem to experience hot flashes at the same rate as North American women. However, there are conflicting studies and likely confounding factors like under-reporting or lack of seeking care from a healthcare provider.


The bottom line is that there are many factors that may contribute to your experience during perimenopause, and what may happen to your metabolic and cardiovascular health long term. However, ethnicity (and genetics) does seem to play at least a small role in likelihood so it's important to understand what your risk factors may be.


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Some of the things I suggest to my patients include:

  • Lab tests and physical exams to assist in risk asssessment and establish baseline metabolic markers (ie blood pressure, cholesterol, glucose markers, etc)

  • Supplements/natural health products to help with symptoms like hot flashes (ie. certain herbs like black cohosh, rhubarb, phytoestrogenic foods), but also to ensure adequate nutrient intake (ie protein powders)

  • High protein and high fibre diets: these 2 things combined are fundamental to long term health for most people for a number of different reasons that I won't go into here, but it is the most common dietary change that I suggest in my patients

  • Hormone replacement therapy (varying forms depending on symptoms/risks/needs)

  • Resistance/weight training: it doesn't have to be super heavy or even in a gym. I often refer to the chiropractors and physiotherapists that I work with to help building a strength program. For cardiovascular health, the magic number seems to be 150 min of moderate activity weekly. Training recommendations vary on your personal goals--for example if you want to lose weight or gain more muscle, you need to train more. If you just want to have good heart health, 150min a week seems to be enough.


If you are interested in learning more about how you can experience perimenopause/menopause more thoughtfully and with long term health in mind, feel free to reach out! I am able to see patients as a naturopath all over Ontario virtually, and have in person clinic availability in North York, Vaughan, and Markham.


Best in health,

Dr. Christine





Dr. Christine Cho-D'Souza is a naturopathic doctor (ND) and Menopause Society Certified Practitioner (MSCP) servicing North York/Toronto, Vaughan, and Markham. For more information, visit DrChristineCho.com.



 
 
 
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