Environmental Quality and Its Linkages with Age at Menarche and Menopause: New Evidence from India

Aparajita Chattopadhyay, International Institute for Population Sciences, India
Sourav Biswas, International Institute for Population Sciences (IIPS)
Kathrin Schilling, Columbia University Mailman School of Public Health

Air and water quality can affect age at onset and cessation of menstruation. Most research in India has focused on socio-demographic and biological aspects of menarche and menopause, but exploring it in the context of environmental quality remains largely ignored. This study examines associations between exposure to particulate matter and groundwater parameters and the onset of menarche (n= 179,972 for girls aged 15-24 years) and menopause (n= 268,699 for women aged 30-49 years) between 2019-2021 in India, using NFHS 5 and triangulating it with satellite-based PM2.5 data and groundwater data. We applied spatial analysis and multivariable regressions at the cluster, district, and individual levels on age at menarche and menopause. After controlling available confounding factors, the study reveals that pollution exposure enhances the risk of late menarche and early menopause. Elevated PM2.5 leads to late menarche (AOR: 1.24) and early menopause (HR: 1.18), especially in the northern plains. For the physicochemical water parameter, water pH above 8.5 (AOR: 1.48) and electrical conductivity above 300 µS/cm (AOR: 1.15) were linked to late menarche, while early menopause was associated with higher electrical conductivity (HR:1.25). These findings call for action to improve air and groundwater quality to ensure safer reproductive outcomes for women.

Keywords: Population, Environment, and Climate Change, Sexual and Reproductive Health and Rights, Spatial Demography, Gender Dynamics

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