People worldwide don’t know enough about menopause. Here’s why that’s dangerous

The Global Health Crisis Hiding in Plain Sight: Why Menopause Ignorance Is Literally Killing Women When Rosy Devi started experiencing chest pain, shortness of breath, and constant body aches at age 38, she never connected these alarming symptoms to her hysterectomy two years earlier. The Indian mother of four didn't realize that her surgery had triggered premature menopause, launching her into a health crisis that millions of women worldwide face in dangerous silence. Devi's body aches most of the time, short walks have become difficult, she loses her breath easily, has chest pain and feels her health is generally getting worse. It has been a gradual decline since her hysterectomy in 2019 which led to her prematurely going through menopause. Her experience illuminates a stark global reality: menopause has a wide range of symptoms and brings several health risks, yet people worldwide know little about it and awareness and care services remain inadequate. The stakes couldn't be higher. Heart disease is the leading cause of death in women worldwide. What many don't realize is that menopause dramatically increases this risk. Menopause causes a significant drop in estrogen – which works in regulating cholesterol and fat – increasing the risk of developing coronary heart disease or suffering a heart attack or stroke. Multiple studies also show a greater risk of respiratory conditions such as chronic obstructive pulmonary disease (COPD) following menopause, particularly premature menopause. The numbers are sobering. Women with premature menopause (aged under 40) had a 55% increased risk of a non-fatal cardiovascular disease event, and women with early menopause (aged 40-44) had a 30% increased risk. For those experiencing early menopause, women are at an 83% increased risk of osteoporosis, 68% increased risk of fracture, and 59% higher mortality compared with women who had menopause after 47 years. Yet the knowledge gap persists globally. Menopause is often not discussed within families, communities, workplaces, or health-care settings. Women may not know that symptoms they experience are related to menopause, or that there are counselling and treatment options that can help alleviate discomfort. This ignorance extends beyond hot flashes and mood swings. Mental health is "not discussed at all," with a heightened risk of depression and anxiety during menopause. The timing makes this crisis even more urgent. Most women experience menopause between ages 45 and 55, but up to 9.4% experience it between 40 and 44, while up to 8.6% experience it before age 40. Menopause and its symptoms last for around seven years on average. With women comprising half the global population, this represents a massive public health challenge affecting hundreds of millions. The solutions exist but remain unevenly distributed. Hormone therapy is the most prescribed care option worldwide, thought to help mitigate symptoms and risks, but these therapies are more available in high-income countries due to cost, access to health care services, and knowledge among practitioners. Even within wealthy nations, access depends heavily on economic status. Simple lifestyle interventions can make a significant difference. Lifestyle changes like quitting smoking, reducing alcohol consumption, increasing exercise, reducing stress levels and losing weight can help with symptoms and combat the heightened risk of conditions such as osteoporosis and heart disease. The path forward requires systemic change. What's needed is comprehensive research, public awareness campaigns, including in schools, and evidence-based training for health care professionals. Greater awareness will help women get the correct support, and make the changes required in their lifestyle, to mitigate the health risks menopause brings. As global populations age and women live longer post-menopause, this health crisis will only intensify. The question isn't whether we can afford to address menopause awareness – it's whether we can afford not to. Every woman deserves to understand what's happening to her body and access the care that could save her life.