Prevalence and Determinants of Premature Menopause among Indian Women: Issues and Challenges Ahead

Jungari, Suresh; Chauhan, Bal Govind

doi:10.1093/hsw/hlx010

Cited by 25 publications

(27 citation statements)

References 25 publications

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“…Even though the prevalence of underweight among mid-age women was low (only 1.6%, N=398) in this study), and the prevalence of early menopause was less than 5%, the study had sufficient statistical power to detect an association based on the 24 cases of underweight women with early menopause (RRR: 2.15, 95%CI: 1.50-3.06). Being underweight may trigger early menopause as a result of malnutrition [34], concurrent or previous chronic illness (such as chronic obstructive pulmonary disease) [35], over-exercising [36], and weight-loss diet [18].…”

Section: Discussionmentioning

confidence: 99%

Body mass index and age at natural menopause: an international pooled analysis of 11 prospective studies

et al. 2018

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Current evidence on the association between body mass index (BMI) and age at menopause remains unclear. We investigated the relationship between BMI and age at menopause using data from 11 prospective studies. A total of 24,196 women who experienced menopause after recruitment was included. Baseline BMI was categorised according to the WHO criteria. Age at menopause, confirmed by natural cessation of menses for ≥ 12 months, was categorised as < 45 years (early menopause), 45-49, 50-51 (reference category), 52-53, 54-55, and ≥ 56 years (late age at menopause). We used multinomial logistic regression models to estimate multivariable relative risk ratios (RRRs) and 95% confidence intervals (CI) for the associations between BMI and age at menopause. The mean (standard deviation) age at menopause was 51.4 (3.3) years, with 2.5% of the women having early and 8.1% late menopause. Compared with those with normal BMI (18.5-24.9 kg/m), underweight women were at a higher risk of early menopause (RRR 2.15, 95% CI 1.50-3.06), while overweight (1.52, 1.31-1.77) and obese women (1.54, 1.18-2.01) were at increased risk of late menopause. Overweight and obesity were also significantly associated with around 20% increased risk of menopause at ages 52-53 and 54-55 years. We observed no association between underweight and late menopause. The risk of early menopause was higher among obese women albeit not significant (1.23, 0.89-1.71). Underweight women had over twice the risk of experiencing early menopause, while overweight and obese women had over 50% higher risk of experiencing late menopause.

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Section: Discussionmentioning

confidence: 99%

Body mass index and age at natural menopause: an international pooled analysis of 11 prospective studies

et al. 2018

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“…In contrast, being underweight may trigger early menopause as a result of malnutrition, over-exercising, weight-loss diet and having concurrent or a history of chronic illness (e.g. chronic obstructive pulmonary disease) [55][56][57]. In addition, less adipose tissue leads to lower leptin levels, which have been associated with early menopause (< 45 years) [58].…”

Section: Body Mass Indexmentioning

confidence: 99%

EMAS position statement: Predictors of premature and early natural menopause

et al. 2019

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Introduction: While the associations of genetic, reproductive and environmental factors with the timing of natural menopause have been extensively investigated, few epidemiological studies have specifically examined their association with premature (< 40 years) or early natural menopause (40-45 years). Aim: The aim of this position statement is to provide evidence on the predictors of premature and early natural menopause, as well as recommendations for the management of premature and early menopause and future research. Materials and methods: Literature review and consensus of expert opinion. Results and conclusions: Strong genetic predictors of premature and early menopause include a family history of premature or early menopause, being a child of a multiple pregnancy and some specific genetic variants. Women with early menarche and nulliparity or low parity are also at a higher risk of experiencing premature or early menopause. Cigarette smoking (with a strong dose-response effect) and being underweight have been consistently associated with premature and early menopause. Current guidelines for the management of premature and early menopause mainly focus on early initiation of hormone therapy (HT) and continued treatment until the woman reaches the average age at menopause (50-52 years). We suggest that clinicians and health professionals consider the age at menopause of the relevant region or ethnic group as part of the assessment for the timing of HT cessation. In addition, there should be early monitoring of women with a family history of early menopause, who are a child of a multiple pregnancy, or who have had early menarche (especially those who have had no children). As part of preventive health strategies, women should be encouraged to quit smoking (preferably before the age of 30 years) and maintain optimal weight in order to reduce their risk of premature or early menopause.

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“…Basic physical and psychosocial health are crucially tied to healthy childhood development, puberty, and the onset of menarche, as well as a predisposition to menstrual health-related morbidities and mortality throughout adulthood (UNICEF 2012; Biro and Deardorff 2013; Boutot 2018). Nutritional deficiencies affect the onset of menarche and menopause, intensity of PMS symptoms, and the duration, heaviness, and frequency of one's flow (Jeejebhoy 2000;Gokhale 1996;Patle et al 2015;Jahangir 2018;Jungari and Chauhan 2017). Girl-children encounter unequal access to the nutritional, medical, and emotional support systems essential to basic health (Guilmoto et al 2018;Inamdar, Inamdar, and Sachdeva 2011).…”

Section: Basic Healthmentioning

confidence: 99%

Menstrual Justice: A Missing Element in India’s Health Policies

Manorama¹,

Desai²

2020

The Palgrave Handbook of Critical Menstruation Studies

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Proposing a novel framework of menstrual justice, the chapter argues that women’s health needs must be understood as the result of the complex interplay of their everyday gendered experiences of living, their biology, and their medical condition. The Indian state’s health policies fail women because they do not recognize that the marking of women as impure menstruating bodies is a cause of women’s health inequity from birth to death. This very denial by the state policy of women’s gendered experience of health is menstrual injustice. The chapter elaborates on this idea by establishing the links between women’s stigmatization as menstruating bodies, lack of control over their bodies, and ill-health, pointing to the high incidence of a variety of menstrual health problems in pre-menarche, during menstruation, perimenopause and postmenopause. The chapter then identifies the gender-specific biases, blind spots, gaps, and barriers in state policies that impede the security of women’s health across their life-cycles.

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Prevalence and Determinants of Premature Menopause among Indian Women: Issues and Challenges Ahead

Cited by 25 publications

References 25 publications

Body mass index and age at natural menopause: an international pooled analysis of 11 prospective studies

Body mass index and age at natural menopause: an international pooled analysis of 11 prospective studies

EMAS position statement: Predictors of premature and early natural menopause

Menstrual Justice: A Missing Element in India’s Health Policies

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