New Delhi

Women living in low- and middle-income countries are more likely to experience premature menopause, with South Asian women facing a particularly elevated risk compared to other ethnic groups, according to a major international study published in The Lancet Obstetrics, Gynaecology & Women's Health.

The analysis, which examined data from 26 countries, found that women in low- and middle-income nations were 53 per cent more likely to undergo premature menopause than those in wealthier countries. On average, half of these women reached menopause by the age of 47.5 years, compared with 50.6 years among women in high-income nations.

Researchers also observed that South Asian women had a significantly greater likelihood of entering menopause earlier than their European counterparts. Compared with European women, South Asians faced a 34 per cent higher risk of premature menopause, with the median age of menopause being 47.4 years versus 50.7 years.

The study was conducted by an international team of scientists from institutions including The University of Sydney in Australia, along with researchers from Europe, Asia and Latin America.

Premature menopause refers to menopause occurring before the age of 40, while early menopause is defined as occurring between the ages of 40 and 44.

The findings highlighted that women who experience menopause at a younger age face a greater risk of serious cardiovascular complications. Early menopause was associated with a 14 per cent increase in the likelihood of major cardiovascular events, such as heart attacks and strokes, while premature menopause raised that risk by 27 per cent.

Importantly, the association between early menopause and cardiovascular disease remained consistent regardless of geographic location or ethnicity, according to data from the Prospective Urban Rural Epidemiologic (PURE) study.

Researchers suggested that premature and early menopause should be recognised as independent indicators of heightened cardiovascular risk among women.

"The findings underscore the importance of monitoring and managing cardiovascular health among women who experience premature or early menopause worldwide," the authors noted.

The study analysed information from 1,11,619 women across 26 countries. Of these, an estimated 9.5 per cent had undergone premature menopause, while 15.3 per cent had experienced early menopause.

The researchers pointed out that women in low- and middle-income countries often recorded higher rates of cardiovascular events despite showing lower prevalence of traditional risk factors such as obesity, diabetes and hypertension.

Other contributing factors to cardiovascular disease include air pollution, unhealthy diets, lower educational attainment and reduced physical strength. However, the authors said that early or premature menopause represents an additional, women-specific risk factor that warrants greater attention, particularly in lower-income settings.

They described the study as the largest of its kind to consistently investigate menopausal patterns across diverse populations using two standardised questions regarding menstrual history.

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"This study confirms that premature menopause is linked to an increased risk of major cardiovascular events, and this relationship remains consistent across different income groups and ethnic populations," the researchers concluded.