A Growing Global Health Issue Affecting Half the World’s Population
For 38-year-old Rosy Devi from Bihar, India, daily life has become a struggle. Since undergoing a hysterectomy in 2019 – a surgery that pushed her into premature menopause – her health has been declining. Aches, breathlessness, chest pain, and sudden waves of heat have become part of her everyday routine.
“I’m walking and suddenly feel intense heat… I start sweating and get chest pain,” she explains. “Now I feel old. My body, my face – everything has changed.”
Devi expected menopause much later in life, not as an abrupt consequence of surgery. Her experience reflects a worrying trend: millions of women around the world are unaware of what menopause really involves, despite it being a natural stage for half the global population.
This lack of understanding, experts warn, is not just inconvenient – it can be dangerous.
What Is Menopause – And Why Do So Many Know So Little?
Menopause marks the permanent end of menstruation for at least 12 months. It naturally occurs for most women between 45 and 55, according to the World Health Organization (WHO).
However, research shows:
Up to 9.4% of women experience menopause early (ages 40–44).
Up to 8.6% enter menopause before 40 (premature menopause).
In rare cases, menopause can begin in a woman’s 20s.
Surgeries like hysterectomies or medical treatments like chemotherapy can trigger menopause at any age.
The First Stage: Perimenopause
Before full menopause, many experience perimenopause, which can:
Start as early as the mid-30s
Last four to eight years
Cause irregular periods, hot flushes, sleep issues, and mood swings
Yet many women cannot pinpoint when these changes began, because – as one expert puts it – “menopause has not even been on the radar.”
Widespread Lack of Education
A UK-based study of over 800 postmenopausal women found:
90% were never taught about menopause in school.
Nearly half felt “completely uninformed”.
Many reported their doctors lacked proper training and dismissed their concerns.
Professor Joyce Harper from UCL says the findings show a “profound lack of education” among both the public and healthcare professionals.
Menopause Happens in Different Ways – And at Different Times
Types of Menopause
Natural Menopause: Occurs gradually with age.
Early Menopause: Before 45.
Premature Menopause: Before 40.
Surgical Menopause: Due to removal of ovaries or uterus.
Medical Menopause: Triggered by treatments like chemotherapy or radiation.
A Concerning Trend
Research shows:
Rates of early and premature menopause are increasing in low- and middle-income countries.
Average menopause age is falling.
In rural India, for instance, limited healthcare access and low awareness contribute to rising cases of premature menopause.
Women often undergo unnecessary hysterectomies, sometimes without fully understanding the procedure or under family or medical pressure.
Menopause Symptoms Are Vast – And Often Misunderstood
While hot flushes and mood changes are widely recognised, experts warn that symptoms vary enormously.
Common Symptoms (affecting up to 80%)
Hot flushes
Night sweats
Vaginal dryness
Urinary urgency
Insomnia
Mood swings, irritability, or depression
Other Frequently Reported Symptoms
Headaches and migraines
Heart palpitations
Joint and muscle pain
Weight gain
Hair loss
Reduced concentration (“brain fog”)
Changes in libido
Less Common but Significant Symptoms
Dry eyes or blurred vision
Itchy skin or scalp
Acne flare-ups
Increased bruising
Researchers say menopause is a highly individual journey, which makes diagnosis even more challenging.
Why a Lack of Menopause Awareness Is Dangerous
Menopause symptoms last on average seven years, but the long-term health implications are even more critical.
1. Increased Risk of Heart Disease
After menopause, falling oestrogen levels affect cholesterol and fat regulation, raising the risk of:
Heart attacks
Strokes
Coronary heart disease
Heart disease is the leading cause of death among women globally.
2. Higher Likelihood of Respiratory Conditions
Studies link premature and early menopause to:
Chronic obstructive pulmonary disease (COPD)
Other respiratory disorders
3. Mental Health Risks
Alongside mood swings and insomnia, women may face:
Higher rates of depression
Increased anxiety
Emotional distress due to stigma or lack of support
Experts stress that recognising menopause early helps women manage health risks effectively.
How Women Can Manage Menopause – Treatment Options Around the World
Hormone Therapy (HRT)
The most common global treatment, HRT:
Replaces missing hormones
Reduces symptoms
Lowers long-term health risks
Usually lasts 2–5 years
However, access is limited in low-income countries due to cost and healthcare availability.
Side Effects and Risks
HRT may increase the risk of:
Blood clots
Gall bladder disease
Breast, ovarian, or womb cancer (risk remains small and depends on individual health factors)
Experts emphasise informed decision-making, not fear.
Other Management Options
Antidepressants (for hot flushes or mood symptoms)
Vitamin supplements
Herbal remedies (not generally recommended due to limited evidence)
Lifestyle adjustments, including:
Quitting smoking
Reducing alcohol intake
Increasing exercise
Weight management
Reducing stress
An analysis from the US and Europe shows most women rely on lifestyle changes alongside medical support.
In the US, the removal of “black box warnings” on HRT may encourage more women to consider treatment.
Why Policymakers – and Society – Must Pay Attention Now
With longer life expectancy worldwide, the number of women aged 40 and above is rising rapidly.
Health systems in many countries, especially low-income nations, still focus primarily on reproductive health, neglecting post-reproductive issues such as:
Cardiovascular disease
Osteoporosis
Mental health challenges
Chronic conditions triggered or worsened by menopause
Researchers say countries like India urgently need post-reproductive health policies, not just maternal health programmes.
Breaking the Stigma
Experts stress the need for:
Public awareness campaigns
Updated medical training
School education on menopause
“As girls grow up, they should understand that menopause is not the end – it’s just another chapter,” says researcher Gayathri Delanerolle.
Conclusion
Menopause is a natural part of life, but the world still treats it as a taboo. This lack of awareness leaves millions of women misinformed, undiagnosed, and unsupported.
Better education, accessible healthcare, and open conversations are crucial to ensuring that every woman can navigate menopause with dignity, knowledge, and confidence.
Sources
World Health Organization (WHO)
Cleveland Clinic
British Heart Foundation
The Menopause Society (US)
Mayo Clinic
University College London (UCL)
Interviews and research cited by CNN
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