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Indian women struggle to find resources to help them cope with the end of their periods
Indian women reach menopause on average a few years earlier than their Western counterparts, studies show. A recent article found that the number of women experiencing premature menopause, particularly in the 30 to 39 age group, is also increasing. Yet there are few resources to help them cope.
“In some studies, the average age of menopause in India is 47 years – meaning some women may reach it between 44 and 45, while others around 50, which is considered normal “, says Dr Ruma Satwik, gynecologist and obstetrician at Sir Gangaram Hospital in Delhi. .
That's several years earlier than in the United States, for example, where the average age is 51.
Doctors say early menopause is the result of nutritional and environmental circumstances as well as genetic factors.
But in a country where discussions about menstruation are still fraught with stigma and taboo, awareness about menopause is lagging.
Sangeeta, who goes by one name, is overwhelmed every day as she juggles work, household chores and childcare while enduring severe hot flashes, fatigue, insomnia, headaches, back and abdominal pain.
“What’s the point of living like this?” asks the 43-year-old. “Sometimes I feel like my pain will end when I die. »
A caretaker at Dr Ram Manohar Lohia Hospital, a government-run facility in the capital Delhi, Ms Sangeeta entered menopause a year ago, but she did not know until recently that the hospital had a dedicated clinic to address the problems of health that she raised.
Hundreds of miles away, in the financial capital, Mumbai, Mini Mathur says she felt like she was experiencing “every symptom possible” after turning 50.
The TV host says she has never had any medical problems and has followed a healthy lifestyle. The onslaught of symptoms reminded him of advice a friend had given him years ago.
“It happens to everyone. Please go for it.”
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TV host Mini Mathur says it was difficult to find a doctor in India who would take her symptoms seriously
Indian census data from 2011 showed that the country had 96 million women over the age of 45. By 2026, this number is expected to reach 400 million, says Dr Anju Soni, president of the Indian Menopause Society.
“Indian women live a third of their lives after menopause,” she says.
Women are considered menopausal when they have not had their period for a year. But this is preceded by perimenopause, a phase of gradual decline in reproductive hormones that can last between two and ten years.
The symptoms are very varied: from alterations in mood, memory, concentration, libido to effects on bones, brain, muscles, skin and hair. Depending on its severity, women may experience a reduction in their quality of life.
Most symptoms can be managed with supplements, diet changes, exercise and, if necessary, hormone replacement therapy, doctors say. But there are no tests to determine the disease and they usually rely on ruling out other causes of the symptoms.
Doctors say menopause and perimenopause are poorly researched worldwide and very little is learned about them in medical schools.
This can make the process of getting a diagnosis quite frustrating for women, says Dr. Satwik.
Ms Mathur says she had to travel to several health centers across the country and abroad over the past two years before she received the care she needed.
She was amazed to find that many of her symptoms – including brain fog, low mood, joint pain and anxiety – “significantly improved” when she started using a topical progesterone cream.
“I had to go to Austria to find a doctor who wouldn't deny my symptoms and feelings and say 'sabko hota hai (it happens to everyone)'.”
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India is expected to have 400 million women aged over 45 by 2026.
The refrain is all too familiar to activist Atul Sharma, 60, who was so worried about the changes menopause was bringing to her mood and libido that she hid her illness from her husband for nearly six years.
Ms Sharma, who works with rural women on health and economic empowerment in northern Uttar Pradesh state, found that there were virtually no offers for postmenopausal women in the rural government clinics. The primary health workers who wanted to help had no specialized training.
“Even the nurse who comes here says, 'Ab iske liye bhi davai mangogi (now you will also get medicine for this)? Bear with it. It happens to all women. »
In 2022-2024, Dr. Satwik surveyed more than 370 women aged 40 to 60 about their symptoms and severity.
“About 20% experienced nothing at all. The remainder experienced one or more mild symptoms, while 15 to 20% had a severe degree.
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In the United States, Hollywood actresses like Halle Berry are speaking publicly about their experiences with menopause.
Although information in India remains scarce, many women say they turn to social media and that online resources are often more enlightening than conversations with their doctors.
Many follow American specialists like Dr. Mary Claire Haver who shares her latest research on social media and celebrities like Hollywood actresses Naomi Watts and Halle Berry who promoted the documentary The M Factor: Shredding the Silence on Menopause. Watts is writing a book on menopause herself while Berry is pushing for new legislation to promote research, training and education.
Ms Mathur says she feels privileged to have received treatment. “How do women who raise their families, their children, go to work, travel in crowded local trains, cope with this problem?
“We don’t know about the West,” she says. “We don’t have enough brands of estrogen patches and progesterone creams that we need in India.”
She is currently taking a course in the United States certified by the National Board of Health and Wellness Coaches, hoping to bridge the gap between information, resources and access to specialists for women from all backgrounds in India .
“The cost of this treatment is out of reach for many poor women in India,” says Sharma. Ms Sangeeta says she is resigned to living with the pain.
Increased awareness needs to come from the medical fraternity, says Dr Satwik, adding that there needs to be as much discussion about menopause or perimenopause as there is about fertility and adolescent health.
Dr Soni says the government already has a network of health professionals in rural and remote areas.
“They already give supplements and provide health care services to pregnant women. Now extend this to postmenopausal women.
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