Hot flashes in Black and Hispanic women

If your hot flashes have outlasted every estimate a friend or a leaflet gave you, the research may simply describe you better than the average does. The NHS symptoms page says ethnic background can affect how severe menopause symptoms are and how long they last, and that women from a Black ethnic background are more likely to have hot flushes that are severe and continue longer. This page sets out the numbers behind that sentence, what the studies say about Hispanic women, the reasons researchers have tested, and what a long run of night flashes means for your sleep and for the conversation with your doctor.

How long do hot flashes last in Black women?

The best figures come from SWAN, the Study of Women's Health Across the Nation, which followed 3,302 women from seven US cities through the menopause transition from 1996 to 2013. A 2015 analysis in JAMA Internal Medicine took the 1,449 women who had frequent hot flashes or night sweats, meaning on six or more days in a fortnight, and measured how long those spells went on.

Across everyone the median was 7.4 years. Broken down by group, as MDEdge's report of the paper lists them, African American women came out longest at 10.1 years, followed by Hispanic women at 8.9, non-Hispanic white women at 6.5, Chinese women at 5.4 and Japanese women at 4.8. African American women also kept having flashes for the longest time after their final period.

A median is the middle of the group. Half of the Black women in that sample had frequent flashes for longer than ten years, and the authors noted that some were still having them when follow-up ended, so the true figure may be higher. A smaller study from Pennsylvania, the Penn Ovarian Aging Study, pointed the same way: African American women, whatever their weight, were among those most at risk of moderate to severe flashes lasting years past menopause.

For an estimate built around when your own flashes started, the hot flash duration estimate uses the same SWAN data.

Menopause symptoms in Black women

Duration is only part of it. An earlier SWAN paper by Gold and colleagues followed 3,198 women for six years and found African American women reported hot flashes, night sweats and cold sweats more often than any other group, with about 1.6 times the odds of white women after allowing for age, education, weight, smoking and anxiety. A 2011 review of SWAN findings adds that African American women were also more likely to call their flashes bothersome, even once the higher number was taken into account.

The rest of the list on the NHS page applies to everyone: palpitations or anxiety during a flush, trouble getting to sleep or staying asleep, low mood, memory lapses, aching joints. The point the research makes is about weight of burden. If you get more flashes, rate them as worse and have them for longer, the nights add up to a much bigger share of your life.

Hot flashes in Hispanic women

Hispanic women sit second on the SWAN duration list, at 8.9 years. How often they report flashes is a different story. The 2011 review says Hispanic and white women in SWAN reported them at broadly similar rates, but with wide variation inside the Hispanic group: women of Central American origin reported the most and Cuban women the fewest. SWAN recruited its Hispanic participants in New Jersey, from Central American, Cuban, Dominican, Mexican, Puerto Rican, South American and other backgrounds, and they could take part in Spanish.

So a single "Hispanic" figure covers very different women. In Gold's analysis, the Hispanic participants also had the highest perceived stress and the lowest incomes of the five groups, two things that travel with longer and more frequent flashes in their own right.

Why they last longer: what has been tested

The honest answer is that nobody knows for sure. The researchers have ruled some things in as factors and shown that none of them closes the gap alone.

Timing comes first. In SWAN the strongest single predictor of a long run was when the flashes started: those that began before periods changed, or early in perimenopause, lasted longest for women of every background.

Mood and stress came next in the 2015 paper. Higher perceived stress, depressive symptoms and anxiety at the time flashes began all went with longer duration.

Money and schooling show up across SWAN. Lower education, lower income and difficulty paying for basics went with more flashes, and that link held after smoking, weight and mood were allowed for.

Body fat and smoke matter too. More body fat, especially around the abdomen, and smoking or second-hand smoke were tied to more flashes, mostly in perimenopause and the first years after.

The 2011 review is clear that the differences between ethnic groups persisted after the researchers controlled for weight, estradiol levels, smoking, hormone use and socioeconomic position. It suggests genetic differences in how the body handles estrogen may play a part, and it also raises how women from different cultures notice, name and report a symptom. Diet did not explain it either: soy intake, once offered as the reason Asian women report fewer flashes, did not hold up in SWAN.

What a decade of hot flashes means for your nights

SWAN tied hot flashes to every kind of sleep complaint the women reported: trouble falling asleep, waking in the night and waking too early. Ten years of that is long enough that short-term fixes stop being enough. It is worth setting the bedroom up as a lasting arrangement: layered bedding you can push off, a fan you can reach without getting up, a cooler room. The bedroom checklist for hot nights collects those steps, and cooling a bedroom without air conditioning covers rooms that hold heat.

A long run also gives broken sleep time to turn into a habit of waking. Sleep-lab work suggests that later in the night the waking often comes first and the heat follows, which do hot flashes wake you, or does waking bring them? explains. If you now wake at the same hour whether or not you are hot, waking at 3am in menopause and menopause insomnia deal with that side of it.

Being heard at an appointment

Longer and more frequent flashes have not translated into more treatment. A study presented at The Menopause Society's 2025 meeting looked at 5,491 women aged 40 to 55 who saw a doctor about menopause symptoms in one large US health system. Black women were 21% less likely than white women to leave with any prescription for their symptoms. The study found no significant gap for Hispanic women overall, and women on Medicaid were less likely to be treated than women with managed-care insurance. The authors wrote that the pattern may reflect bias in prescribing. It is an abstract from one health system, and it has not yet been through full peer review.

You cannot fix a prescribing pattern from the patient's chair, but you can make your symptoms hard to wave away. A doctor weighs what is in front of them, and "I get them a lot" is easy to underrate. Dated notes showing how many flashes came each night, how bad each one was and how often they woke you are much harder to set aside. Bring the year the flashes started too, since a long history is part of the picture.

A paper diary does the job: the printable night diary has a column for each of those things. If you would rather log on your phone, Her Good Days is a free app where you tap in a hot flash or night sweats as mild, moderate or severe with the time, next to your sleep, and it turns the dates you pick into a PDF for your doctor listing each symptom with how often and how strong, marked as reported by you. It is free on iPhone and Android, with the store listings marked coming soon.

Then write your questions down before you go. The question list builder helps you pick the ones that matter most to you, such as what options exist for flashes that have lasted this long and why one would or would not suit you. If you leave without an answer, asking for a second appointment or another clinician is a reasonable request. This site does not advise on HRT, other medicines or supplements: that conversation belongs with your doctor.

My take

I'd read the SWAN numbers as a planning figure. If you are a Black or Hispanic woman whose flashes started early, assume years rather than months and set your nights up accordingly. I'd also go to the doctor with two or three weeks of notes rather than a description, because the treatment study suggests a vague account is the one most likely to be underrated. Everything else on night heat is in the hot flashes at night section, and soaking sweats get their own page in night sweats.