Early menopause, cause for concern

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Bangalore, Feb 4 (UNI) Menopause is emerging as a major health scourge in India with an alarming 18 per cent of women in the 30 to 49 age group attaining the non-reproductive age prematurely.

Illiteracy among women, young age marriages and early child- bearing with poor nutritional levels have been cited as reasons for premature menopause, which might continue to be a burden in the future, according to a study conducted by the Institute for Social and Economic Change.

The study revealed that at least 11 per cent of Indian women of less than 40 years have attained menopause. The situation is grim in Andhra Pradesh (31.4 per cent), Bihar (21.7), Karnataka (20.2) and Gujarat (19.9). However, their counterparts in Kerala (11.6), West Bengal (12.8) and Rajasthan (13.1) go through the transition at a relatively old age.

With agricultural labourers (20.1 per cent) and domestic and manual workers (16.2) reporting high incidences of early menopause, it was clear that women from poor socio-economic background reached menopause earlier than their wealthy counterparts.

A study of 90,000 ever-married women aged 15-49 conducted under the National Family Health Survey (NFHS) in three phases since 1992-93, covering 99 per cent of the Indian population living in 26 states, proved that women indeed reached the non-reproductive stage at an early age of 30. The higher risk rate was reported in rural areas.

''The findings are alarming since the study showed that India has become the only country in the world where early menopause was reported. Natural menopause occurs between 45 and 55 years, with a mean age of incidence around 51 years worldwide. In India, the mean age of menopause is 44 years,'' Ms M Sivakami, Assitant Professor of the Institute of Social and Economic Changes here, told UNI.

Ms Sivakami said early menopause might be a risk factor for early mortality from disease related to decreased estrogen levels and might promote increased incidence of osteoporosis, heart disease, diabetes, hypertension and breast cancer. She said the data made available by the NFHS, based on which the analysis was made, revealed that the variations with respect to different socio-economic, demographic, nutritional and reproduction related variables implied that by and large women from the poor socio-economic sections reached menopause early compared to their rich counterparts. ''Besides, women who have started childbearing early and women with no children also reach menopause early.'' The study said India's ''overburdened and under-funded'' public healthcare system had no special programmes for older women and, therefore, important government bodies responsible for public healthcare must start a special programme to address this cause.

Besides, health education should be made an integral part of healthcare for women in midlife years.

Stressing the need for healthcare providers to be well-informed about this transitional phase of women and encourage women to communicate openly about the problems being faced during menopause, Ms Sivakami called for further research to enhance the knowledge regarding the problem in different socio-cultural settings in the country.