Women are ageing into silence. India can't afford to ignore menopause

Time of India

2 days ago

Every woman who lives long enough will experience menopause — the end of her ovarian function. Yet in India, this transition remains shrouded in taboo, misinformation, and medical neglect.
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While global awareness of women's midlife health gains momentum, India lags dangerously behind. Most Indian women begin menopause in their mid-40s — years earlier than women in developed nations — and often navigate this transition without medical guidance, reliable information, or therapeutic support. If India is to secure a healthier and more economically stable future, we must bring menopause out of the shadows and integrate it into national health policy.
A Silent Health Crisis
Menopause affects half the population, yet receives a fraction of the attention devoted to other life stages. In India, the absence of public dialogue, policy recognition, and accessible clinical care has created widespread suffering behind closed doors. This silence isn't merely social — it's systemic, embedded in India's healthcare infrastructure and medical education.
Consider this: while pregnancy and childbirth receive substantial medical attention and government support, the phase that follows — when women spend potentially 30-40 years of their lives post-menopause — remains largely ignored.
This medical blind spot has serious consequences for women's health, economic productivity, and quality of life.
South Asian Disadvantage
Indian women face a unique challenge. Research shows that South Asian women typically reach menopause between ages 45-47, compared to the global average of 50-52. This earlier onset stems from multiple factors: nutritional deficiencies, early pregnancies, lower body mass index, and limited access to preventive healthcare throughout their reproductive years.
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The implications are profound. Indian women spend more years in the post-menopausal phase, facing elevated risks for cardiovascular disease, osteoporosis, diabetes, and cognitive decline. A recent FP Analytics report reveals that Central and Southern Asia will see the greatest increase globally in women entering menopause by 2050. By 2030, nearly half a billion women worldwide aged 45-55 will be in this transition, with India contributing significantly to these numbers.
Without adequate medical infrastructure and education, this demographic shift threatens to overwhelm India's healthcare system.
Medical Gaps and Missed Opportunities
Cultural discomfort around menopause compounds clinical shortcomings. Many Indian doctors remain hesitant to prescribe hormone replacement therapy (HRT), despite it being first-line treatment internationally. Women frequently report being dismissed when presenting symptoms like brain fog, insomnia, anxiety, or joint pain — symptoms often attributed to 'normal aging' rather than treatable menopausal changes.
Dr.
, a gynecologist at AIIMS Delhi, notes: 'We see women suffering in silence because they don't know these symptoms are connected to menopause. And when they do seek help, many practitioners lack the training to provide appropriate care.'
The medical curriculum in India dedicates minimal time to menopause management, leaving healthcare providers ill-equipped to address this critical life stage. This knowledge gap perpetuates a cycle of inadequate care and continued suffering.
The Hidden Economic Cost
While India lacks comprehensive data on menopause-related economic losses, international studies paint a concerning picture. In the UK, menopause-related productivity losses cost the economy billions annually through absenteeism, reduced performance, and early retirement. Given India's massive female workforce and rising life expectancy, similar economic impacts are inevitable without intervention.
Consider the ripple effects: when women struggle with untreated menopausal symptoms, it affects not just their careers but their families' economic stability. As more women enter the workforce, ignoring their midlife health needs becomes economically unsustainable.
From Exception to Epidemic: The Great Transition
For most of human history, menopause was a biological rarity. A century ago, when Indian women lived an average of 25-35 years, most died before their ovaries ceased functioning.
Today, with life expectancy reaching 71 years for women, India has crossed a critical threshold: menopause has transformed from the exception to the norm.
Consider the mathematics of this shift. With menopause typically occurring in the late 40s for Indian women, and life expectancy now extending into the 70s, the majority of Indian women will spend 25-30 years of their lives in a post-menopausal state. What was once experienced by a small fraction of the population now affects hundreds of millions of women.
We have successfully extended human lifespan, but we have not extended ovarian function to match.
This demographic reality demands a fundamental rethinking of women's health. Every other vital organ system receives extensive medical attention when it begins to fail. We develop treatments for heart disease, interventions for kidney dysfunction, and therapies for liver disorders. Yet when it comes to ovarian failure — which affects metabolism, immune function, cardiovascular health, bone density, and cognitive performance — we simply accept it as inevitable.
Beyond Acceptance: Reimagining Ovarian Health
But what if menopause didn't have to be inevitable? What if, just like we've learned to support other aging organs, we could extend ovarian function throughout a woman's lifespan?
When most people think about the ovary, they think about babies. When they think about menopause, they think 'hot flashes.' However, groundbreaking research in the field of Ovarian Health has demonstrated that the ovary is much more than simply a 'reproductive organ.'
The consequences of ovarian dysfunction — whether in early life through conditions like PCOS (affecting 15% of women globally) or in midlife through menopause — help explain why women are sick for 25% more of their lives than men.
The ovary serves as the 'central command' of a woman's health and vitality, critical to every major system and function of her body. This makes menopause the single biggest accelerant of unhealthy aging for women, including the onset of heart disease, stroke, obesity, diabetes, autoimmune disorders, osteoporosis, and cognitive decline.
My research team at Celmatix Therapeutics, supported by a prestigious ARPA-H SPARK award from the U.S. government in 2024, has been pioneering breakthrough therapeutics designed to extend ovarian function throughout the modern lifespan.
This isn't about indefinitely extending fertility. Eggs age on their own biological timeline regardless of ovarian health. Instead, our work focuses on therapeutically regulating ovarian folliculogenesis through drugs that target Anti-Mullerian Hormone (AMH).
Women are born with a finite number of ovarian follicles, and AMH acts as molecular brakes, keeping this reserve from depleting too quickly. By strategically modulating these brakes during the years when women aren't trying to conceive, we can extend ovarian function throughout the lifespan.
The implications are profound. Rather than accepting that the timing of menopause is fixed, we're working toward a future where it becomes a choice — where women can anticipate living healthy, active lives with fully functioning ovaries well into their nineties.
They won't just survive past middle age; they will thrive.
A Blueprint for Change
Addressing India's menopause crisis requires coordinated action across multiple sectors:
Healthcare System Reform:
Integrate menopause care into existing programs like Ayushman Bharat and the National Health Mission. Establish specialized menopause clinics in urban centers and train primary healthcare workers to recognize and manage menopausal symptoms.
Medical Education Overhaul:
Mandate comprehensive menopause training in medical curricula. Develop continuing education programs for practicing physicians, particularly in gynecology and family medicine.
Public Awareness Campaigns:
Launch national initiatives to normalize menopause discussions. Use regional languages and culturally appropriate messaging to reach diverse populations. Leverage popular media and community health workers to spread awareness.
Workplace Adaptation:
Encourage employers to implement menopause-friendly policies, including flexible work arrangements, adequate healthcare coverage, and awareness programs for managers and colleagues.
Research Investment:
Fund studies specific to Indian women's menopause experiences, considering regional variations in diet, lifestyle, and genetics. This research should inform evidence-based treatment protocols.
A global imperative
India's opportunity to lead in this space is significant. While recent years have seen increased awareness and media coverage of menopause, there's a risk of falling into what I call the 'empowerment' narrative trap — suggesting women should feel proud of being menopausal rather than addressing the catastrophic health impacts. We don't celebrate osteoarthritis, tooth decay, cognitive decline, or heart failure, and we shouldn't celebrate ovarian failure either.
The economic implications are staggering. Women comprise 80% of home and professional healthcare providers globally and play an increasingly vital role in the workforce. With more menopausal women in the workforce than ever before, the consequences of untreated ovarian dysfunction ripple through entire economies. When women thrive through better ovarian health, societies benefit immeasurably.
For India specifically, this represents both a challenge and an unprecedented opportunity.
As the country with one of the world's largest populations of women entering menopause, India could pioneer new models of ovarian health that benefit not just its own citizens, but women globally. The question isn't whether the country can afford to invest in this research — it's whether India can afford not to.
The path forward
As India's population ages and women's life expectancy increases, menopause will affect an unprecedented number of women.
We can either address this proactively or face the consequences of continued neglect. The choice reflects our commitment to women's health and economic participation.
Other countries offer valuable lessons. Australia's National Menopause Guidelines and the UK's workplace menopause policies demonstrate what's possible with political will and systematic change. India has the opportunity to leapfrog traditional approaches and create innovative solutions suited to our unique context.
The second half of women's lives matters. By investing in menopause care today, India can unlock healthier, more productive futures for millions of women — and strengthen our society as a whole. The time for silence has passed; the time for action is now.