A study published in the British Medical Journal (BMJ) Global Health estimates that early menopause, occurring before age 45, affects 1 in 14 women aged 30 to 49 living in low and middle-income countries. Researchers from the International Centre for Diarrhoeal Disease Research, Bangladesh, warn that the health consequences of early and premature menopause will strain health systems, particularly in South Asia, East Asia and the Pacific, and sub-Saharan Africa.
Study Scope and Methodology
Pooled data from the Demographic and Health Survey (DHS) conducted since 2015 included 716,648 women between ages 30 and 49 across 44 low and middle-income countries, including India, Indonesia, Gabon, and Jordan. Data from nearly 365,000 women came from India. All world regions except North and South America were studied due to data unavailability.
Key Findings
The overall prevalence of premature or early menopause was over 7% (51,000 out of 716,648 women), much higher than previous global estimates. The highest prevalence was among 40-44 year olds at 14%. By country, Ethiopia had the highest rate at 12%, followed by Indonesia at 11.5%, Myanmar at over 10%, while Jordan had the lowest at over 2%, and Gabon and Armenia at nearly 3%.
Incidence was consistently higher in rural areas than urban ones across regions. Most survey respondents lived in rural areas (62%) and were aged 30-34 (29%). Education and delayed childbearing may strongly minimize the risk. Both women and their husbands were most often educated up to secondary school level (34% and 17%, respectively). More than a third (38%) of women married before turning 18, and around 1 in 5 (21%) gave birth to their first child before age 18. Over half (58%) had three or more children.
Health and System Impacts
Early and premature menopause can heighten risks of cardiovascular disease, osteoporosis, metabolic disorders, cognitive decline, depression, and early death, seriously affecting a woman’s quality of life. The authors wrote: “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.”
Regional Disparities
South Asian women have a 34% increased risk of premature menopause compared to European women, with half attaining menopause by age 47.4, according to a June study in The Lancet Obstetrics, Gynaecology, and Women’s Health. The findings reflect fundamental inequalities in healthcare access, nutritional status, educational opportunities, and occupational exposures. Women in these regions are more likely to work as manual laborers and face workplace hazards.
Call to Action
The researchers underscored the urgent need to integrate menopause into reproductive health and non-communicable disease programmes to address this growing burden.
