Large variation of early and premature menopause in low- and middle-income regions
A new study from Stockholm University’s Department of Public Health Sciences highlights large regional differences in the prevalence of early and premature menopause in low- and middle-income regions. It also highlights that prevalence in these regions is higher than what has been reported in the literature for high-income countries.
These findings have far-reaching health implications. Early loss of estrogen increases the risk of diseases such as cardiovascular disease, osteoporosis, and depression. As life expectancy rises globally, more women are spending a greater portion of their lives post-menopause – often without access to menopausal hormone therapy or appropriate health counselling.
“Therefore, it is essential to consider the age at which menopause occurs in order to ensure that people are not just living longer, but also living in good health,” says Sydney Ross,
researcher at the Department of Public Health Sciences at Stockholm University.
Highest prevalence in Africa, South-East Asia and the Americas
In the study, the researchers found that for early menopause – defined as occurring before age 45 – the highest prevalence was found in the African, South-East Asian and the Americas regions. In the Americas alone, over 15% of women go through menopause before the age of 45. Premature menopause was found to be the most prevalent in the Southern Africa region, with nearly 7% of the women reaching menopause before the age of 40.
Our study shows that a larger proportion of women in low- and middle-income countries experience menopause at early ages, where the benefits of hormone therapy may outweigh its risks.
The researchers analysed data from over 369,000 women aged 30–44 across 55 low- and middle-income countries. However, the results are also relevant to high income countries, where there is a large and growing number of resident women born in low- and middle-income countries.
“Our findings suggest that these migrant women may face unmet healthcare needs, as professionals may not be used to women experiencing menopause at earlier ages, and their symptoms may therefore be misinterpreted,” Ross says.
A call for a global health perspective on menopause is needed
According to the researchers, the results of this study are relevant for informing treatment discussions. They call for a global health perspective on menopause to prevent potential health inequalities both between and within countries.
“Recent studies based on research from high-income countries have advocated for empowering women through the promotion of lifestyle changes, both to manage symptoms and to prevent potential health consequences related to hormonal changes. While we support this approach, our findings also highlight the need for better access to menopausal hormone therapy and personalized risk assessments,” says Sol Juárez, Senior Lecturer at the Department of Public Health Sciences at Stockholm University. ”Our study shows that a larger proportion of women in low- and middle-income countries experience menopause at early ages, where the benefits of hormone therapy may outweigh its risks.”
Håkan Soold
Facts
Menopause is part of a woman’s natural biological aging process; it is defined as the cessation of menstruation for 12 consecutive months (the term woman is used throughout this article for brevity but the authors acknowledge that not all individuals who experience menopause identify as women). The average age for menopause is between 45 and 55 years but it can also occur at younger ages for natural or medical reasons. Menopause occurring before age 40 years is referred to as premature menopause, while early menopause occurs before age 45 years.
The study Variations in the prevalence of premature and early menopause in low and middle-income regions: a cross-sectional study was published recently in the scientific journal Climacteric.
First author of the study is Sydney Ross, researcher at the Department of Public Health Sciences at Stockholm University. Contributing author is Sol Juárez, senior lecturer at the Department of Public Health Sciences at Stockholm University.
Last updated: June 25, 2025
Source: Department of Public Health Sciences