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

Abstract

Objectives: Early menopause is shown to correlate with an increased rate of cardiovascular diseases with age advancement. Smoking, physical activity, body mass index (BMI), and the socio-economic level are consistently linked with the onset of menopause though there is no consensus on the residential factor. Considering the undesirable relation of menopause with women’s health, the present review sought to identify the correlation between the rural-urban factor and natural menopausal age. Methods: A comprehensive literature search, covering publications from 1984 to 2017, was done using several databases such as MEDLINE, PubMed, and Google scholar. Evidence from 13 research articles was analyzed for a rural-urban difference in natural menopausal age. The search was later expanded to explore correctable confounding factors such as smoking habits, physical activities, and BMI. Results: Rural women in the Asian region appeared to reach their natural menopausal age earlier than their urban counterparts. This was in contrast with the majority of findings in the non-Asian regions, suggesting a regional variation in the rural-urban difference in natural menopausal age. Based on the findings, earlier menopausal age was related to smoking prevalence and this relationship was consistent in both Asian and non-Asian regions. Similarly, higher physical activity was linked to the early age of natural menopause in both Asian and non-Asian regions. Finally, the results revealed the association between higher BMI and higher menopausal age in the Asian region although this association was not observed in the non-Asian regions. Conclusions: The rural-urban difference in menopausal age has regional variations with rural Asian women reaching menopause earlier than their urban counterparts, but this association was not replicated in the non-Asian regions. Eventually, this difference was affected by factors such as tobacco smoking, high physical activity, and BMI.