South Asia Women Age Faster Than European and U.S. Peers

The Hidden Crisis: Early Menopause and the Health Challenges Faced by South Asian Women

In many parts of South Asia, a woman’s value is often tied to her ability to bear children. This cultural norm creates a stigma around aging, especially for women who experience menopause earlier than expected. For many, this early onset of menopause is not just a personal health issue but also a reflection of deeper societal and medical challenges.

Sumrin Kalia, a Pakistani woman living abroad, was married at 18 and had four children by the time she was 25. She experienced no obvious signs of menopause until she suddenly and unexpectedly went through it at the age of 37. “I began experiencing excessive bleeding. I went to a doctor, who told me I might be perimenopausal,” Kalia shared. At the time, she had been using an intrauterine device (IUD) for birth control, which she had removed, and her periods stopped altogether without any explanation. Her experience is not unique; many South Asian women have similar stories of facing perimenopause symptoms earlier than their global counterparts.

A Faster Clock: Menopause in South Asia

A U.S.-based study found that South Asian American women reported an average menopause age of 48 or 49 years, compared to 52 years for the general U.S. population. In South Asia itself, the average age is even lower. In countries like India and Pakistan, women typically enter menopause between 46 and 47 years old, with perimenopausal symptoms appearing before that. This trend suggests that South Asian women are experiencing menopause on a faster clock, raising concerns about the factors contributing to this phenomenon.

The decline in fertility rates in South Asia reflects shifting patterns in reproductive behavior. For instance, Pakistan’s average number of children per woman dropped from 3.61 in 2023 to 3.19 in 2024, while India saw a more modest decrease from 2.14 to 2.12. While the connection between these trends and early menopause remains unclear, there are indications that multiple factors—ranging from genetics to environmental influences—are playing a role in the accelerated aging process among South Asian women.

Genetic and Biological Factors

Hormonal health expert Palwasha Khan, a consultant physician based in Pakistan, explained that menopause timing is partly genetic. “There’s no exact rule, but studies show women tend to start and end their periods around the same age as their mothers,” Khan said. Additionally, she highlighted the impact of vitamin D deficiency, which is prevalent among South Asian women and can worsen chronic health issues linked to aging. Many women also experience ovarian failure in their late 30s or 40s, often compounded by undiagnosed medical conditions and limited access to quality healthcare.

Cultural Pressures and Neglected Health Concerns

In South Asia, particularly in Pakistan, societal expectations place immense pressure on women to have children soon after marriage. This focus on fertility often overshadows broader health concerns, including hormonal health. According to Khan, awareness around hormonal health is minimal, and treatments such as hormone replacement therapy (HRT) are rare. “You’d have to pick 10,000 women to find two who’ve gone on [HRT],” she noted.

This intense emphasis on reproduction sidelines discussions about menopause and long-term well-being. As a result, many women face significant physical and emotional challenges without adequate support or understanding.

Emotional and Cognitive Struggles

Sabina Qazi, a Pakistani woman in her mid-40s based in Karachi, shared her experience of dealing with the emotional and cognitive effects of menopause. After undergoing a radical hysterectomy due to cancer risk, she faced severe menopause symptoms, including brain fog and difficulty concentrating. “My husband and children would talk to me, but the words would just fall off in between… I had the constant need to prove that I wasn’t stupid,” she described.

Qazi’s experience highlights the lack of attention given to the long-term consequences of medical procedures that lead to surgical menopause. Although the surgery was preventive, the emotional weight of the decision was never fully acknowledged. The procedure was framed as inevitable, with little consideration for its impact on her mental and emotional health.

The Broader Implications

Medical consultant Palwasha Khan has observed a pattern of ovarian failure occurring in the late 30s or 40s among South Asian women, often accompanied by a range of chronic health conditions. This trend underscores the complex interplay between biological, social, and cultural factors affecting women’s health.

Khan emphasized that various factors—including chronic illnesses, stress, and social pressures—are accelerating aging in South Asian women. “Brown women are too burned out,” she said. “The weight of society. The weight of mothers-in-law. Brown women end up taking on too much stress, and this makes them age faster.”

Many women face relentless social expectations and little support, intensifying both physical and emotional health challenges. One woman of South Asian descent living in Saudi Arabia described feeling “angry all the time,” highlighting the deep-seated frustration and exhaustion many women experience.

These stories reveal a pressing need for greater awareness, support, and medical attention for South Asian women facing early menopause and related health issues. Addressing these challenges requires a shift in societal attitudes and a commitment to improving access to healthcare and education.