On May 28, as the world marks the International Day of Action for Women's Health, we need to talk about something Indian public health almost never addresses. Menopause.
Despite being a virtually universal experience for women, menopause remains invisible in policy, planning, and even workplace or family discussions. Women can experience extreme symptoms over several long years of perimenopause and menopause, including hot flashes, disrupted sleep, depression, joint pain, and cognitive changes that are often physically debilitating, mentally draining, and economically disruptive. A large majority of Indian women navigate menopause in silence, without clinical guidance or institutional support, and often without even knowing what they are going through.
The scale of this neglect is hard to overstate. This year alone, approximately 140 million women in India will experience menopause. As life expectancy rises to 73.6 years, women will spend nearly three decades of their lives in a post-menopausal stage. Managing menopause health is crucial to leveraging what demographers call the "silver dividend", the economic and social opportunities that arise from a growing older population.
Evidence from the Longitudinal Ageing Study in India (LASI, 2017-19), which analyzed data from 25,256 women nationwide, reveals a striking burden of untimely menopause. As many as 7.4% of women experienced premature menopause (before age 40) and 17.5% had early menopause (between ages 40 and 44), while the average menopausal age in India is approximately 46 years, well below the global norm. Early and premature menopause significantly elevate risks for cardiovascular disease, osteoporosis, depression, and cognitive decline. These are serious, long-term health consequences with no treatment pathway for most women in India.
The mental health dimension alone should compel action. Among women aged 50 and above, the weighted prevalence of depression is 21.76%, significantly higher than among younger women. Over 22% of postmenopausal women report persistent sleep disturbance. And fewer than one in ten women with symptoms ever seek medical care for them.
This is not because the symptoms are mild. It is because most women do not know that help exists, or have been conditioned to believe that suffering through it is simply what women do.
The LASI data also makes clear that this burden falls hardest on those with the fewest resources. Women with lower education, no assets in their name, and limited household decision-making power experience higher rates of both physical and psychological symptoms. Rural women face menopause with nutritional deficits, limited access to care, and almost no community acknowledgment that what they are experiencing is a health issue.
And yet India's national health infrastructure offers almost no formal response. A handful of menopause clinics exist at AIIMS Delhi and select teaching hospitals in a few states. They are doing important work but they are also completely out of reach for the majority of women who need them. There are no standard protocols for the management of peri-, menopausal, and post-menopausal care.
What is needed is not complicated. Menopause must be integrated into primary healthcare, not left to urban specialists. Community health workers need training and protocols. The National Family Health Survey and LASI need standardised menopause symptom modules.
Above all, the silence has to break.
Seventy-five percent of Indian women experience menopausal symptoms. Less than 10% seek care. That gap is not a medical mystery. It is the result of a culture that treats women's health as private suffering, that stops paying attention to women's bodies once their reproductive years are deemed over, and that has never once made menopause a subject fit for public conversation.
As India moves through a demographic transition where the population of older women is growing rapidly, this neglect will become increasingly costly in healthcare burden, lost productivity, and preventable disease.
Global actors are finally paying attention. On October 20, 2025 — World Menopause Day — global leaders launched a declaration warning that by 2030, 1.2 billion women will be menopausal or post-menopausal, with a sizable proportion experiencing symptoms that can disrupt their health, relationships, and careers. The declaration called on the WHO and national governments to develop first-ever policies and guidance to support menopausal women. India cannot afford to stay silent. The most important action India can take begins with the simplest step: start talking about menopause. And make sure the rest follows.
(Poonam Muttreja is executive director, of Population Foundation of India; Dr Priya Nanda is a member of WHO Human Reproduction Programme’s Scientific and Technical Advisory Group)
