BANGALORE: Menopause among women (end of reproductive capacity) occurs at a relatively early age in Andhra Pradesh, Karnataka and Bihar on account of poor nutrition level, early marriage, early child bearing and illiteracy.

Premature menopause among women in the age group of 35 to 39 is high in States such as Gujarat (10.7 per cent) and Karnataka (10.6 per cent). It indicates that the ageing process begins early among these women. The premature change of life can trigger marital disharmony and domestic violence because of the decrease in sexual desire among women and mood swings owing to hormone depletion.

In India, 17.8 per cent of women in the age group of 30 to 49 are in menopause stage and the proportion is higher in rural areas (18.3 per cent) compared with urban centres (16.1 per cent). As many as 3.1 per cent of the women experience menopause by the age of 30 to 34. The average is 8 per cent for women in the age group of 35 to 39. The incidence is rapid after the age of 40 or 41.

By the age of 48 two-thirds of women would have reported the change, according to a report "Menopause: An Emerging Issue in India" (2005) prepared by T.S. Shyamala and M. Shivakami of the Institute for Social and Economic Change, Bangalore. As the primary focus of existing public health care is on maternal and child health, the use of scarce resources for the treatment of non-life threatening conditions such as menopause receives low priority.

A multiplicity of symptoms has been attributed to menopause and they include sleep disturbances, extreme sweating, irritability, increased risk of osteoporosis and heart diseases, according to the report.

A sizable proportion of women in the country reach menopause prematurely (ovarian failure). Illiterate women have reported the highest incidence of the change.

It is observed that the onset of menopause is late among women enjoying high standards of living (15.7 per cent) as against women with medium incomes and standard of life (18.1 per cent) and low incomes (19.2 per cent).

Occupation-wise, the onset of the change is early among agricultural labourers (20.1 per cent) as compared with manual and domestic workers (16.2 per cent) and other professionals (14.3 per cent). The proportion of women who have undergone change of life is 34.9 per cent among women who gave birth to their first child when they were aged between 18 and 20 years, 30.8 per cent (21 to 23 years) and 25.8 per cent (24 years and more). The incidence is significantly higher among women who never used contraception (23.8 per cent).

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