Early menopause affects one in 14 women aged 30 to 49 living in low- and middle-income countries.

The numbers were consistently higher in rural areas than in urban areas across the 44 nations included in the analysis published in the journal BMJ Global Health on July 7 (2026).

This “reflects fundamental inequalities in healthcare access, nutritional status, educational opportunities and occupational exposures”, highlight the researchers.

But education and delayed childbearing strongly minimise the risk.

Compared with women with no formal education, those with a college education were 58% less likely to experience an early or premature menopause.

Women usually go through menopause between the ages of 45 and 55, so it is considered early if menopause occurs before the age of 45, and premature if it occurs before the age of 40, note the researchers.

Early and premature menopause are major public health concerns as they heighten the risks of cardiovascular (heart) disease, osteoporosis, metabolic disorders, cognitive decline, depression and early death, as well as seriously affecting the quality of life, they add.

The team from Bangladesh’s International Centre for Diarrhoeal Disease Research analysed data for 716,648 women from the global Demographic and Health Survey.

All regions of the world were included, other than North and South America, for which no data were available.

The overall frequency of premature or early menopause was just over 7%, which is much higher than previous global estimates, say the researchers.

The highest frequency was among 40- to 44-year-olds (14%).

Women in Ethiopia (12%), Indonesia (11.5%) and Myanmar (just over 10%) were the most affected, while those in Jordan (just over 2%), Gabon (nearly 3%) and Armenia (nearly 3%) were the least affected.

The factors associated with a high frequency of early menopause were:

• Giving birth before the age of 18 (11%)
• Marriage before the age of 18 (just over 10%)
• No formal education (just over 9%)
• Material disadvantage (just over 8%)
• No exposure to media (just over 8%)
• Residence in rural areas (8%), and
• Having three or more children (7.5%).

The findings “underscore the urgent need to integrate menopause into reproductive health and non-communicable disease programmes, particularly targeting rural areas and addressing social determinants, including girls’ education and delayed marriage”, conclude the researchers.