Menstruation and menopause are significant milestones in women's reproductive health.
The care provided during these transitions is representative of both socio-cultural norms and women's social status.
Menopause care requires effective interventions for maintaining better mental health, managing conditions such as hot flushes and sometimes, hormone therapy.
The care required during menstruation emphasizes the use of menstrual products, maintenance of hygiene and use of medication and pain relief accompanied by yoga and comfortable clothing.
Although menopause care and menstrual care are different, in India they converge on the common platform of women's social identity, reproductive health consciousness, healthcare attitudes and counseling by health professionals.
The average age of menopause in India is lower than most other countries by around five years, with women experiencing menopause when they're 46. Early onset of menopause is associated with dietary deficiencies, educational status and poverty.
This not only points to the need for increased awareness and timely care but also indicates better care and well-being throughout a woman's reproductive cycle.
Menopause care as menstrual care
In a family setup, menopause and menstruation not only mark the reproductive spectrum but also signal the adoption and transfer of care protocols between older and younger women.
Menopause care is mostly driven by community-led practices such as hatha yoga and meditation and forms of self-care.
Menstrual care among young girls relies on reproductive health care perceptions of older women in the family and community.
When there is open communication about menopause among women in a community they are more likely to pass on that knowledge and care during menstruation on to their daughters.
How open these lines of communication are depend on the culture of the communities the women grew up in.
A gynaecologist from the Post Graduate Institute of Medical Education and Research (PGIMER) in Chandigarh told this researcher that women talk to their daughters regarding healthy habits and hygiene if they take care of their own hygiene.
"Most of the cases of maternal health complications are due to poor menstrual hygiene (along with other factors) which they were never told by their mothers. Menstruation and menopause are taboo in socially backwards parts of India," she said.
Further, women's attitudes towards menopause care are dependent upon factors such as self-awareness, reproductive health consciousness, positive birth experiences, family economic status and community affinity for women's care and reproductive health rights.
Menstruation care has been statistically documented to some extent by the Indian government but critical data for menopause care practices among women is missing.
In the five years of national family health survey (NFHS-4 to NFHS-5), the use of menstrual care protection and hygienic methods by women aged 15–24 years has increased 20 percentage points from 58 percent to 78 percent.
The lack of education around menopause is so high that more than 94 percent of women were never taught about menopause in school and around 60 percent of women start looking for information regarding menopause as their symptoms start.
Almost 10 percent of postmenopausal women have lifelong hot flushes. Hot flushes have posed a financial burden with decreased work performance of women by around 10 to 12 percent.
The silence and stigma surrounding menopause care also transfers to menstruation care of young girls in the form of neglect, emotional suppression, assertiveness challenges, perpetuation of myths and negative attitudes towards reproductive health.
Menstrual discomfort has resulted in school dropouts of 6 to 11 percent.
Integrated care model
There is no data that talks about integrated care models for menopause and menstrual care for young women.
If the government can provide accurate and detailed information about menopause symptoms and available treatments, women can make informed decisions about their health and subsequently pass on a better menstrual care model for their daughters.
Ministry of Culture initiatives such as menopause awareness fests, art exhibitions, street plays and music and dance performances can bring behavioral change among women by creating awareness and community cohesion on the need for menopause and menstrual care.
It can go a long way in building and adopting better care protocols by the women for their menopause symptoms and thereby, menstrual care for their daughters.
Community support, governmental interventions, and treatment access and remedies can help women alleviate feelings of isolation and empower them to embrace the transformative journey of later womanhood with wisdom and dignity to nurture the younger women in their families.
(The author is Associate Professor of Public Policy at Manav Rachna International Institute of Research and Studies. This article was originally published under Creative Commons)
