Being menopausal in India is not only difficult for women; it is almost officially unheard of in public circles. But women in India go through menopause just as women do elsewhere in the world. India has traditionally ignored women’s health issues including menopause but now exciting changes are taking place. Indian women face many social and cultural challenges in their lives but when it comes to menopause these women share many of the same experiences with women just like us.

Menopause attitudes in India
Women in India are no different in terms of attitudes towards menopause; some women dread and fear menopause while other women embrace or at least accept menopause. The fear and dread of menopause stem from being seen as no longer useful or productive in society. For the most part, life for Indian women centers on home and family while accepting secondary citizen status in this male dominated culture. Women’s issues including health and menopause are almost never discussed.

The flip side notes the relief women feel about the end of having menstrual periods. Although women always remain subservient to men, older women in India do enjoy a measure of respect as the senior member of the family. Unfortunately this enhanced status does not make it easier for women to talk about or seek help for menopause.

Indian women and menopausal symptoms
Menopause symptoms vary from woman to woman in India as is the case for women elsewhere. The Indian Menopause Society’s (IMS) 2008 Consensus Statement contains important statistics about menopausal symptoms and recommendations to improve healthcare for Indian women. Some of the IMS research findings show:

*The average age of menopause in India is 47.5 years, just slightly lower than the average age of 51 for North American and European women. Premature menopause is on the rise in India due to a combination of environmental and genetic reasons.

*Indian women living in rural areas (72% of the population) and urban areas both cite having urogenital symptoms and general body aches and pains. Interestingly, women in urban areas complain more about having hot flashes, mood swings, psychological problems, and intercourse challenges. Like their Western counterparts, urban-based Indian women are subjected to more demanding and fast-paced lifestyles which may explain the differences in symptom reporting.

*Osteoporosis is a serious risk for Indian women. Osteopenia, or low bone mineral density (BMD) usually means a greater chance of developing osteoporosis. Approximately 35-40% of Indian women aged 40-65 suffer from osteopenia. Indian women tend to have low bone density due to a lack of both sufficient calcium intake and adequate exercise.

*Cardiovascular disease is quickly becoming one of the leading causes of death in women and Indian women are no exception. Higher HDL/LDL cholesterol and triglyceride levels, increased high blood pressure occurrences, and obesity rates among menopausal Indian women (and women of all ages) translate into increased risks for heart attacks and strokes. Diabetes rates are also on the rise for women in India.

*Cancer rates for Indian women between the ages of 35 – 64 are steadily growing. Breast, cervical, ovarian, and endometrial cancers account for between 29.4 and 72.5% of all cancers in women. Cancer rates vary between India’s geographic regions; healthcare access, education, and lifestyle are different throughout the country.

Surgical menopause (hysterectomy) is performed widely in India and both doctors and patients view a hysterectomy as a preferred option in menopause treatment. Compare this to North America and Europe where hysterectomies are no longer considered the best option for women. But with limited menopause treatment options, the fear of developing hormonal related cancers pushes many women to request a hysterectomy and doctors are all too willing to perform this controversial procedure.

The future for Indian women and menopause
The IMS is working to help improve awareness about women’s health issues and educating doctors and patients about menopause. This is an enormous project in India where the huge population and wide range of literacy and education levels make it difficult to effect positive change for women in society. The IMS seeks to improve living, dietary, and physical conditions of women.

Changes in India are slowly happening and though it may take several decades, talking about and seeking help for menopause will help to improve the lives of women in India.

Please visit www.indianmenopausesociety.org for the full 2008 Consensus Statement and to learn more about how women around the world live with menopause.

Menopause, Your Doctor, and You