Pallikadavath, S; Ogollah, R; Singh, A; Dean, T; Dewey, A; Stones, W
(2016)
Natural menopause among women below 50 years in India: A population-based study.
Indian Journal of Medical Research, 144 (3).
pp. 366-377.
ISSN 0971-5916
https://doi.org/10.4103/0971-5916.198676
SGUL Authors: Stones, Robert William
Abstract
Background & objectives: The age at which menopause naturally occurs may reflect nutritional and
environmental circumstances as well as genetic factors. In this study we examined natural menopause as
a marker of women’s health at the population level in India and in some major States.
Methods: Data from the Indian District Level Household Survey (DLHS) carried out during 2007-2008
covering 643,944 ever-married women aged 15-49 yr were used; women of older ages were not included
in this survey. Since not all women in this age group had achieved natural menopause at the time of
survey, Cox proportional hazard regression models were employed to obtain the median age of women
reporting a natural menopause, excluding those who underwent hysterectomy. Hazard ratios (HRs) were
estimated for key socio-economic and reproductive variables that could potentially affect the age at
natural menopause <40 yr.
Results: Overall, menopause prior to age 40 was reported by approximately 1.5 per cent of women. In the
national data set, significant associations with age at natural menopause were identified with marriage
breakdown or widowhood, poverty, Muslim religious affiliation, ‘scheduled caste’ status, not having
received schooling, rural residence, having never used contraceptive pills, not been sterilized or had an
abortion, low parity and residence in the western region. Within data from five selected States examined
separately, the strength of these associations varied.
Interpretation & conclusions: Associations of natural menopause with sociocultural, family planning and
demographic variables were noted. Most importantly, there was an association with poverty that would
require further investigation as to causality. The proportion of women experiencing early menopause
may represent a useful overall indicator of women’s health. The data are reassuring with regard to
possible late effects of sterilization on ovarian function.
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