Menopause Across Asia: A Comprehensive Meta-analysis of Age and Influencing Factors.

Abstract

The irreversible cessation of menstruation, menopause, is a significant event in a woman's life. Its timing varies widely across populations and is influenced by genetic, environmental, and lifestyle factors. Data from various Asian countries such as India, Pakistan, China, Sri Lanka, Malaysia, Indonesia, Japan, South Korea, Thailand was synthesised to examine the average age of menopause and identify regional variations, and explore associated determinants. Systematic review and metaanalysis were conducted following PRISMA guidelines. Datawere gathered from electronic databases including PubMed, Scopus, Web of Science, and Google Scholar. The analysis included population based and cohort studies reporting mean age at natural menopause, whereas those focusing on premature ovarian insufficiency or surgical menopause were excluded. Random-effects models were applied for pooled estimates, and subgroup analyses were performed based on socioeconomic status, residence, body mass index, smoking, and education. The results revealed pooled mean age of menopause ranged from 46.36 years in Pakistan to 52.0 years in Indonesia. Urban women experienced later menopause than rural women (49 vs. 46.5 years). Higher BMI, socioeconomic status, parity, and education were associated with delayedmenopause, whereas smoking, alcohol use, stressful and physically demanding workload, and early menarche were linked with earlier onset. These findings highlight that the age at menopause varies significantly.