Early Menopause Risk Higher in Rural Women: New Study

Key Points

• • Early menopause affects more than 7% (1 in 14) of women aged 30–49 in low- and middle-income countries (LMICs).
  • Rural women consistently experience higher rates of early menopause than urban women.
  • Early marriage, adolescent childbirth, lower education, poverty, and higher parity are associated with increased risk.
  • Higher education and employment significantly reduce the likelihood of early or premature menopause.
  • Researchers analyzed data from 716,648 women across 44 LMICs, making this one of the largest studies on the topic.
  • Findings highlight the need to integrate menopause care into reproductive health and chronic disease prevention programs.
  • For More Updates in Woman’s Health, register for HerHealth2026

Early Menopause Common Among Women in Low- and Middle-Income Countries

Early menopause affects one in 14 women across 44 LMICs

Early menopause risk remains a significant but often overlooked public health concern in low- and middle-income countries (LMICs), according to a large pooled analysis published in BMJ Global Health. Researchers found that more than one in 14 women aged 30 to 49 years experience early or premature menopause, a prevalence considerably higher than previous global estimates.

The analysis included 716,648 women from 44 LMICs, providing one of the most comprehensive assessments of menopause patterns in resource-limited settings. The findings are particularly relevant for healthcare professionals because early menopause increases long-term risks of cardiovascular disease, osteoporosis, metabolic disorders, depression, cognitive decline, and premature mortality.

Women typically reach menopause between 45 and 55 years of age. Menopause before age 45 is classified as early menopause, while menopause before age 40 is considered premature menopause. As populations continue to age across LMICs, researchers emphasize that menopause-related healthcare demands are likely to increase substantially.

What factors increase the early menopause risk?

The study examined demographic, reproductive, socioeconomic, and community-level factors associated with menopause timing. Researchers found that women living in rural communities consistently had higher rates of early menopause than those in urban settings across every region included in the analysis.

Several social and reproductive factors were linked with increased prevalence, including:

• Childbirth before age 18
• Marriage before age 18
• No formal education
• Lower household wealth
• Limited media exposure
• Having three or more children
• Rural residence

Among participating countries, Ethiopia (12%), Indonesia (11.5%), and Myanmar (just over 10%) reported the highest prevalence. In contrast, Jordan, Gabon, and Armenia reported the lowest rates, ranging from approximately 2% to 3%.

Researchers suggest that rural disparities likely reflect unequal access to healthcare, nutrition, education, and occupational safety. Women in rural areas are also more likely to perform physically demanding work and encounter environmental exposures, including agricultural chemicals, that may influence reproductive health.

Education may help reduce early menopause risk

One of the strongest protective factors identified in the analysis was education. Compared with women who had no formal education, those with a college education were 58% less likely to experience early or premature menopause. Employment also appeared beneficial, with working women showing a 14% lower likelihood of early menopause than women who were unemployed.

The researchers caution that the study was observational and cannot establish cause-and-effect relationships. In addition, menopause status was self-reported, and the analysis could not distinguish natural menopause from surgically induced menopause. Important lifestyle variables, including smoking, alcohol consumption, diet, physical activity, hormonal contraceptive use, breastfeeding duration, and environmental exposures, were also unavailable in the survey data.

For More Updates in Woman’s Health, register for HerHealth2026 or other CME conferences in Obstetrics and Gynecology 

Despite these limitations, the findings reinforce the need for healthcare systems in LMICs to recognize menopause as an essential component of women’s health. Integrating menopause care into reproductive health services and non-communicable disease prevention programs, while promoting girls’ education, delaying early marriage, and improving access to healthcare in rural communities, may help reduce the growing burden associated with early menopause.

Source:

BMJ Group