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The onset of menopause often signals an unwelcome transition in the lives of many women. According to Palacios et al (1), although the timing of natural or spontaneous menopause may vary genetically, ethnically, and geographically, the latter variations are found in the natural menopausal age of major regions in the world including Europe (50.1-52.8 years), North America (50.551.4), Latin America (43.8-53), and Asia (42.1-49.5). The age of the onset of menopause is suggested to significantly affect women’s health. This is corroborated by the UK Biobank data which represented that earlier menopausal age (<47 years) is independently correlated with the higher incidence of cardiovascular diseases (CVDs) in later life (2). Additionally, a significant association exists between lower menopausal age, longer duration of postmenopausal period, and a shorter period between menarche and menopause, with the risk of CVD or CVD-related mortality (3-5). Early menopause may occur due to medical interventions or genetic diseases although some social determinants are significantly related to the onset of natural menopause. These social determinants include education (6-8), oral contraceptive use (6-8), employment (6), smoking (6-8), body weight (6-8), alcohol consumption (6,8), self-rated health (6), physical activity (6-8), younger generation (7), early menarche (7,8), age at first birth (7), parity (7,8), an experience of severe food shortage (7), socioeconomic status (8), and diet (7,8). What is missing from the list is the residential factor, especially the rural-urban factor, even though numerous direct and indirect studies have focused on the rural-urban difference in the onset of natural menopause. Given the undesirable relation of menopause with women’s health, this review aimed to establish a correlation between the rural-urban factor and natural menopausal age. Such findings will be useful in the formation and implementation of health policies that respond to the needs of rural and urban women.

Rural-Urban Difference in Natural Menopausal Age and the Correlating Factors