New Non-Hormonal Treatments for Menopause Symptoms: What Black Women Need to Know
Reframing choice, care and credibility in modern menopause medicine Menopause Care Has Long Been Framed by the Wrong Question Menopause care has long been framed around a narrow and often
Reframing choice, care and credibility in modern menopause medicine
Menopause Care Has Long Been Framed by the Wrong Question
Menopause care has long been framed around a narrow and often unhelpful question:
HRT or nothing at all?
For many Black women, that question has never reflected reality.
It has ignored:
- Earlier menopause onset
- More severe and prolonged symptoms
- Higher levels of medical dismissal
- Structural racism within healthcare systems
- The complex health histories many Black women carry into midlife
It has also failed to acknowledge a deeper truth: menopause care has not been designed with Black women in mind.
In 2025, that landscape is finally beginning to shift.
A new generation of non-hormonal, menopause-specific treatments is emerging — not as a compromise or second-best option, but as evidence-based medicine targeting the biological mechanisms driving symptoms such as hot flushes, night sweats, sleep disruption and anxiety.
For Black women who have historically been told to push through, cope, or wait it out, this shift matters profoundly.
Why Non-Hormonal Options Matter for Black Women
Menopause Does Not Exist in a Vacuum
Hormone Replacement Therapy (HRT) remains an effective and appropriate treatment for many women. But research and lived experience consistently show that Black women are:
- Less likely to be offered HRT
- More likely to have symptoms minimised or misdiagnosed
- More likely to experience delayed referrals to menopause specialists
- More likely to navigate menopause alongside chronic health conditions
In my work, I repeatedly see Black women managing menopause alongside:
- Cardiovascular risk or clotting concerns
- A personal or family history of hormone-sensitive cancers
- Fibroids, migraines, lupus, thyroid and autoimmune conditions
- Previous negative or dismissive healthcare experiences
- Limited access to menopause-trained clinicians
For some, HRT is clinically contraindicated.
For others, it is avoided — not through ignorance, but through earned caution.
Until recently, the alternatives were often inadequate:
- Antidepressants prescribed off-label
- Vague lifestyle advice
- “Stress management” replacing medical investigation
- Silence framed as reassurance
That gap has been both clinical and cultural.
It is now, finally, beginning to close.
- Menopause Transition, Hormone Balance, Bioidentical Therapy, Wellness, and Natural Healing
- My Journey from Near-Death to Business Owner and Menopause Coach
- HRT and Menopause: The Hormone Therapy Revolution That’s Helping Women Reclaim Their Lives
A New Generation of Targeted Menopause Treatments
Shifting the Focus from Ovaries to the Brain
One of the most important developments in menopause science has been a clearer understanding of why vasomotor symptoms occur.
Hot flushes and night sweats are not caused directly by low oestrogen alone.
They are triggered by how oestrogen withdrawal affects the brain — specifically the hypothalamus, the body’s temperature regulation centre.
Changes in neurokinin signalling narrow the brain’s thermoneutral zone. As a result, even small temperature fluctuations trigger intense heat responses.
This is:
- Not a flaw in willpower
- Not anxiety
- Not something women can “mind over matter”
It is neurobiology.
New non-hormonal medications work by calming this overactive temperature response, without adding hormones back into the body.
This represents a fundamental shift in menopause care:
Treating the mechanism — not asking women to tolerate the symptom.
What Symptoms Can Improve with Non-Hormonal Treatments
Relief Without Hormonal Alteration
Early clinical data shows that these non-hormonal treatments may significantly reduce:
- Moderate to severe hot flushes
- Night sweats
- Sleep disruption linked to temperature instability
- Secondary anxiety, fatigue and low mood driven by chronic sleep loss
Crucially, they do not:
- Raise oestrogen or progesterone levels
- Require hormone cycling or regular hormonal monitoring
- Interfere with contraception
- Conflict with breast cancer or hormone-sensitive cancer treatments
For many Black women — particularly those previously told they had “no options” — this represents access to treatment for the first time.
Who May Benefit Most from Non-Hormonal Care
When These Treatments Are Particularly Relevant
Non-hormonal menopause treatments may be especially appropriate for:
- Black women with a history of breast cancer
- Women in perimenopause who are not ready for systemic HRT
- Those whose primary symptoms are night sweats and sleep loss
- Women seeking symptom relief without altering hormonal pathways
They are not a replacement for holistic menopause care, which remains essential — but they are a powerful and overdue addition to the menopause toolkit.
What Is HRT? A Clear, Balanced Explanation
Understanding Hormone Replacement Therapy
Hormone Replacement Therapy (HRT) works by replacing oestrogen (and sometimes progesterone) that naturally declines during perimenopause and menopause.
HRT can:
- Reduce hot flushes and night sweats
- Improve sleep, mood and joint pain
- Support bone density
- Reduce vaginal and urinary symptoms
For many women, HRT is safe, effective and life-changing.
However, HRT is not suitable for everyone, and Black women are more likely to have health factors that complicate its use — including fibroids, cardiovascular risk and hormone-sensitive conditions.
This is why choice matters.
Non-hormonal treatments do not challenge the value of HRT — they expand the spectrum of care.
Menopause and Women of Color Around the World
A Global Health Equity Issue
Across the UK, US, Caribbean, Africa and diaspora communities, women of color experience:
- Earlier menopause onset
- Higher symptom burden
- Less access to specialist care
- Cultural silence around menopause
- Medical racism and disbelief
In many cultures, menopause is either stigmatised or dismissed as something women must simply endure.
This global pattern reinforces why non-hormonal, menopause-specific treatments matter, especially in settings where:
- Hormone therapy is unavailable
- Specialist care is inaccessible
- Women are managing multiple health risks
Menopause is not just a biological transition — it is a public health and social justice issue.
What This Shift Really Represents
More Than a Prescription
This development is not just about medication.
It signals a long-overdue recognition that menopause is a condition deserving specific, targeted treatment, rather than repurposed solutions or dismissal.
Black women have long been expected to:
- Normalise pain
- Downplay exhaustion
- Carry on without support
- Accept inadequate explanations
Non-hormonal menopause-specific treatments challenge that narrative.
They reposition symptoms as treatable, not tolerable, and move decision-making away from fear toward informed choice.
As someone who nearly lost my life after years of my own symptoms being misinterpreted and minimised, I am acutely aware of the cost of delayed recognition.
Menopause is not benign when ignored — and Black women are too often asked to endure without options.
A Balanced Perspective on Non-Hormonal Treatments
Choice Must Be Informed, Not Idealised
Non-hormonal does not mean risk-free.
These treatments:
- Are not suitable for everyone
- Require proper medical assessment
- Have evolving long-term data
- May involve cost or access barriers
But choice itself is a form of care.
When Black women are offered multiple evidence-based options — hormonal and non-hormonal — they can make decisions aligned with their bodies, histories and values, rather than being forced into one path or none at all.
The Bigger Picture
Moving Beyond One-Size-Fits-All Menopause Care
Menopause care is finally beginning to evolve.
Non-hormonal treatments represent progress — not because they replace HRT, but because they expand autonomy.
They acknowledge that Black women’s health is:
- Complex
- Nuanced
- Deserving of personalised, credible support
The future of menopause care is not about choosing sides.
It is about having choices.
And for Black women who have waited far too long to be heard — that change cannot come soon enough.
Frequently Asked Questions (FAQ)
1. Are non-hormonal menopause treatments safe?
They are evidence-based and approved for specific symptoms, but suitability depends on individual health profiles.
2. Can I take non-hormonal treatments with cancer history?
Many are specifically designed to be safe for women with hormone-sensitive cancers, but medical guidance is essential.
3. Do non-hormonal treatments replace HRT?
No. They expand treatment options — they do not eliminate the role of HRT.
4. Are these treatments available worldwide?
Availability varies by country, but global access is increasing as menopause medicine evolves.
About the Author
Dr (h.c.) Marva Williams
Dr Marva Williams is an author, menopause coach and counsellor specialising in the psychological, neurological and lived realities of perimenopause and menopause, with a particular focus on Black women’s health.
After surviving a near-death health crisis linked to undiagnosed perimenopausal symptoms, she has become a leading advocate for evidence-based, culturally informed menopause care.
She is the founder of Shhh… Menopause Wellness, a UK-based platform offering education, counselling and natural wellbeing solutions for women navigating midlife.
Marva writes and speaks on menopause as both a biological transition and a social justice issue, challenging outdated narratives and amplifying the need for choice, credibility and compassion in women’s healthcare.
