New Delhi, Jul 8 (PTI) Early menopause which can occur before age 45 affects 1 in 14 women aged 30 to 49 living in low and middle-income countries, a study published in the British Medical Journal (BMJ) Global Health has estimated.
Researchers from the International Centre for Diarrhoeal Disease Research, Bangladesh, said health consequences of early and premature menopause will strain the health systems of the countries, particularly those in South Asia and East Asia and the Pacific, and sub-Saharan Africa.
Women usually go through the menopause between the ages of 45 and 55, but it is considered to be early if it occurs before the age of 45, and premature if it occurs before the age of 40.
Incidence was found to be consistently higher in rural areas than urban ones across the regions and countries studied, but education and delayed childbearing may strongly minimise the risk, the researchers said.
Pooled data was included from the Demographic and Health Survey (DHS) conducted since 2015 for 7,16,648 women between the ages of 30 and 49 in 44 low and middle-income countries, such as India, Indonesia, Gabon and Jordan, where women tend to experience menopause earlier than those in high income countries.
Data of nearly 3,65,000 women from India was included.
All regions of the world were studied other than North and South America for which no data were available.
Early and premature menopause can heighten risks of cardiovascular disease, osteoporosis, metabolic disorders, cognitive decline, depression, and early death and are major public health concerns. The conditions also seriously affect a woman’s quality of life.
South Asian women have a 34 per cent increased risk of a premature menopause, compared to European women, with half attaining menopause by age 47.4, according to a study published in The Lancet Obstetrics, Gynaecology, and Women’s Health journal in June.
The overall prevalence of premature or early menopause was over seven per cent (51,000 out of 716,648 women) — much higher than previous global estimates—with the highest prevalence among 40-44 year olds (14 per cent), the researchers found.
The highest prevalence was in Ethiopia, Indonesia, and Myanmar at 12 per cent, 11.5 per cent and over 10 per cent, respectively, and the lowest in Jordan at over two per cent, and nearly three per cent in both Gabon, and Armenia.
Most survey respondents lived in rural areas (62 per cent) and were found to be aged between 30 and 34 (29 per cent). Both women and their husbands were most often educated up to secondary school level (34 per cent and 17 per cent, respectively).
More than a third (38 per cent) of the women married before turning 18, and around 1 in 5 (21 per cent) gave birth to their first child before the age. Over half the women (58 per cent) had three or more children.
“With populations in (these countries) ageing rapidly and women expected to spend an increasing proportion of their lives in the postmenopausal state, the prevalence represents a substantial and growing burden on health systems already constrained by competing priorities and limited resources,” the authors wrote.
The findings reflect fundamental inequalities in healthcare access, nutritional status, educational opportunities and occupational exposures, the researchers said, adding that women in the regions were more likely to work as manual labourers and face workplace hazards.
They also underscored the urgent need to integrate menopause into reproductive health and non-communicable disease programmes.