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Secular trends in premature and early menopause in low-income and middle-income countries

Leone, Tiziana; Brown, Laura; Gemmill, Alison; (2023) Secular trends in premature and early menopause in low-income and middle-income countries. BMJ Glob Health , 8 (6) , Article e012312. 10.1136/bmjgh-2023-012312. Green open access

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Abstract

BACKGROUND: While secular trends in high-income countries show an increase in the mean age at menopause, it is unclear if there is a similar pattern in low-income and middle-income countries (LMICs), where women's exposure to biological, environmental and lifestyle determinants of menopause may differ. Premature (before age 40 years) and early (ages 40-44 years) menopause could have negative repercussions on later life health outcomes which in ageing societies could mean further stress on low-resource health systems. An evaluation of such trends in LMICs has been hampered by the suitability, quality and comparability of data from these countries. METHODS: Using 302 standardised household surveys from 1986 to 2019, we estimate trends and CIs using bootstrapping in the prevalence of premature and early menopause in 76 LMICs. We also developed a summary measure of age at menopause for women who experience menopause before the age of 50 years based on demographic estimation methods that can be used to measure menopausal status in surveys with truncated data. RESULTS: Trends indicate an increasing prevalence of early and premature menopause in LMICs, in particular in sub-Saharan Africa and South/Southeast Asia. These regions also see a suggested decline of the mean age at menopause with greater variation across continents. CONCLUSIONS: This study enables the analysis of menopause timing by exploiting data generally used for the study of fertility by methodologically allowing the use of truncated data. Findings show a clear increase in prevalence of premature and early menopause in the regions with the highest fertility with possible consequences for later life health. They also show a different trend compared with high-income regions, confirming a lack of generalisability and the importance of accounting for nutritional and health transitions at the local level. This study calls for further data and research on menopause on a global scale.

Type: Article
Title: Secular trends in premature and early menopause in low-income and middle-income countries
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1136/bmjgh-2023-012312
Publisher version: http://dx.doi.org/10.1136/bmjgh-2023-012312
Language: English
Additional information: © 2022 BMJ Publishing Group Ltd. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license (http://creativecommons.org/licenses/by-nc/4.0/).
Keywords: cross-sectional survey, descriptive study, medical demography, Female, Humans, Adult, Middle Aged, Menopause, Premature, Developing Countries, Menopause, Asia, Southern, Income
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health > Infection and Population Health
URI: https://discovery.ucl.ac.uk/id/eprint/10172209
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