Author : Karan Babbar

Expert Speak Raisina Debates
Published on Jul 10, 2024

As India's population grows, investing in robust data systems that capture the realities of menopause is critical for equitable healthcare policy and resource allocation.

Why menopause data matters on World Population Day

This is part of the essay series: World Population Day 2024


Imagine a bustling office environment in India. Suddenly, a colleague reaches for a fan, her brow furrowed. While a summer heat wave might be one explanation, it’s also possible she’s experiencing a hot flash, a common symptom of menopause. This everyday occurrence highlights a demographic shift that requires greater attention: the growing number of women transitioning through menopause, particularly in rapidly developing nations like India. While projections from the Office of the Registrar General & Census Commissioner of India estimate a significant rise from 96 million in 2011 to a substantial 401 million by 2026, this demographic boom necessitates a more nuanced understanding of women's health needs throughout their lifespan. This article argues that investing in robust data systems that capture the realities of menopause is critical for equitable healthcare policy and resource allocation as India's population grows. 

In the average Indian woman’s lifespan, three decades would be a significant portion of their life. It is often marked by unique health challenges. Urbanisation, modern lifestyles, and the growing impact of climate change further complicate existing healthcare concerns for this ageing population. Yet, menopause remains largely absent from mainstream World Population Day conversations, and consequently, from policy priorities. This silence is particularly concerning because it overlooks the significant physical and emotional challenges women face during this transition. Symptoms such as hot flashes, night sweats, mood swings, and sleep disturbances can significantly impact their quality of life, often going undiagnosed and untreated due to a lack of awareness and accessible healthcare options.

In the average Indian woman’s lifespan, three decades would be a significant portion of their life. It is often marked by unique health challenges.

To effectively address the unique health and social needs of women transitioning through menopause, a strategic investment in robust data systems is important. Currently, there is a significant lack of comprehensive data on menopause and its intersection with various socio-economic factors. This data gap presents a significant obstacle to developing targeted interventions, allocating resources effectively, and advocating for the needs of this growing demographic. Such an investment can help us get a clear understanding of the challenges, disparities, and opportunities related to menopause in India, paving the way for more equitable and effective healthcare policies and programmes.

 

A graph of blue bars

Figure 1. Percentage of women in Menopause aged 45-49, NFHS-5 (2019-21).

This article examines the intersection of menopause and socio-demographic factors in India, aiming to highlight the need for data-driven policy interventions. Using data from the National Family Health Survey (NFHS-5, 2019-21), which includes a representative sample of 83,970 women aged 45-49, this analysis explores the prevalence of menopause and its potential link with other socio-demographic variables. The data shows that 38 percent of women in this age group have transitioned through menopause, a statistic that merits further investigation when considering the diverse socioeconomic landscape of India.

This article examines the intersection of menopause and socio-demographic factors in India, aiming to highlight the need for data-driven policy interventions.

Figure 1 illustrates that the percentage of women experiencing menopause increases with age, with nearly one in two women aged 49 having undergone the transition. However, a striking disparity emerges when education levels are considered. Among women aged 45-49, only 25 percent of those with high education levels reported experiencing menopause, compared to 42 percent of women with no formal education (Figure 2). This difference suggests that education plays a significant role in influencing the timing of menopause in India. 

Figure 2. Proportion of women in Menopause across Education Levels, NFHS-5 (2019-21).

Further analysis, disaggregating the data by education levels across various socio-demographic characteristics, reveals several interesting heterogenous patterns. 

Age

As Figure 3 illustrates, menopause rates increase with age for all women in India. However, a significant disparity emerges when education levels are considered. Women with higher education levels consistently report lower menopause rates across all age groups. Conversely, women with no education experience menopause at a higher rate throughout their lives. This finding suggests that education may be a key factor influencing the timing of menopause onset, potentially through its impact on lifestyle factors and overall health outcomes.

Figure 3. Percentage of women in menopause across education levels by age, NFHS-5 (2019-21).

Wealth 

Figure 4 shows that while wealthier women, across education levels, tend to experience menopause later, a surprising trend emerges—among wealthier women, those with no formal education show higher menopause rates compared to those with the no education. This finding suggests that education may have a more nuanced influence on lifestyle choices and health behaviours than wealth alone. Education likely empowers women to make informed decisions about diet, exercise, and other factors that could potentially impact the timing of menopause.

Figure 4. Percentage of women in menopause across education levels by wealth index, NFHS-5 (2019-21).

Area of residence 

Consistently, rural women, regardless of education level, experience menopause at a higher rate than their urban counterparts. However, even within these distinct regions, education remains a significant factor. Women with higher education levels consistently demonstrate lower menopause rates in both rural and urban areas. This suggests that education empowers women to make lifestyle choices that may influence menopause timing, irrespective of their environment and access to resources often associated with those living in urban areas.

Figure 5. Percentage of women in menopause across education level by area of residence, NFHS-5 (2019-21)

The analysis shows a surprising but clear link between lower levels of education and earlier onset of menopause in India. Women with lower education levels tend to experience menopause earlier than their more educated counterparts, suggesting that education may play a protective role, potentially by empowering women to make informed lifestyle choices that could delay menopause onset. Furthermore, the data hints at a possible link between socioeconomic disadvantage, particularly in terms of poverty and nutrition, and earlier menopause. Rural women, especially those with lower education and income levels, may face a compounded disadvantage. Limited awareness about menopause, coupled with challenges in accessing healthcare and potentially less nutritious diets, could contribute to the higher incidence of menopause observed in this demographic.

The analysis shows a surprising but clear link between lower levels of education and earlier onset of menopause in India. Women with lower education levels tend to experience menopause earlier than their more educated counterparts, suggesting that education may play a protective role, potentially by empowering women to make informed lifestyle choices that could delay menopause onset.

This data can inform the government and policymakers in multiple ways. First, it can help in targeting the public health initiatives by prioritising and raising girls' education levels and design menopause education programs specifically for women with lower literacy levels, particularly in rural areas. This includes awareness campaigns, accessible healthcare services, and community-based support systems. Second, understanding the regional disparities in menopause onset and the related healthcare needs can guide the efficient allocation of resources, ensuring that communities with lower socio-demographic receive adequate support. Lastly, investing in research that tracks women's health across their lifespans, with a particular focus on the menopausal transition, is crucial for understanding the long-term health outcomes and developing effective interventions.

As India's population dynamics shift, acknowledging and addressing the healthcare needs of its aging female population is essential for achieving equitable and sustainable development. Integrating menopause into broader conversations surrounding World Population Day is not merely about recognising a biological process, but about advocating for data equity and inclusive healthcare policies. By investing in comprehensive data systems that capture the complexities of menopause within the context of social determinants of health, India can move towards a future where all women, regardless of their background, can navigate this significant life transition with dignity, support, and access to quality healthcare.


Karan Babbar is an Assistant Professor at Centre for Development Studies, Jindal Global Business School, OP Jindal Global University and Board Member and Research Advisor with Menstrual Rights Global.

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Author

Karan Babbar

Karan Babbar

Karan Babbar is Assistant Professor at Jindal Global Business School OP JindalGlobal University. He works on issues at the intersection of education health andgender.

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