The Dual Burden: Determinants and Spatial Clustering of Reproductive Health Morbidity among Older Women in India - Insights from LASI
1
Population Studies, International Institute for Population Sciences, Mumbai, India
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
INTRODUCTION:
Reproductive health morbidities (RHMs) are predominantly examined during women’s reproductive years, despite often persisting into later life and substantially affecting well-being. Among older women, physiological transitions related to menopause and surgical interventions such as hysterectomy—highly prevalent in India—reshape gynecological health risks, yet remain understudied. With India undergoing rapid population ageing, evidence on RHMs among older women is critical for informed geriatric and reproductive health policy. Adopting a life-course perspective, this study examines reproductive health morbidity among Indian women aged 40 years and above, specifically, to estimate the prevalence, type, severity, and spatial distribution of self-reported RHMs across states, and identify key determinants of RHM, with particular emphasis on hysterectomy status and menopausal indicators, adjusting for socioeconomic and demographic factors.
METHODS:
Data were drawn from Wave 1 of the nationally representative Longitudinal Ageing Study in India (LASI). Descriptive and bivariate analyses assessed prevalence and patterns of RHMs. Multivariate logistic regression estimated adjusted odds of reporting any RHM, controlling for age, education, wealth, residence, hysterectomy status, menopausal status, age at menopause, and duration since menopause. State-level variation was examined using choropleth maps, and spatial autocorrelation was assessed using Moran’s I statistic.
RESULTS:
Overall, 16.2% of women (N=25,530) reported at least one RHM. Mood swings were the most frequently reported condition (36.3%), and 37% of cases were of moderate or severe intensity. Hysterectomy emerged as the strongest predictor of RHM (AOR=3.03; 95% CI: 2.72–3.37). Higher wealth status was associated with increased reporting, while longer duration since menopause showed a protective effect. Substantial geographic heterogeneity was observed, with evidence of spatial dispersion rather than clustering.
CONCLUSIONS:
Reproductive health morbidity remains a significant concern among older Indian women, shaped by both socioeconomic factors and reproductive life-course transitions. The findings highlight the need for region-specific, menopause-sensitive reproductive health strategies within ageing and women’s health programs.
Reproductive health morbidities (RHMs) are predominantly examined during women’s reproductive years, despite often persisting into later life and substantially affecting well-being. Among older women, physiological transitions related to menopause and surgical interventions such as hysterectomy—highly prevalent in India—reshape gynecological health risks, yet remain understudied. With India undergoing rapid population ageing, evidence on RHMs among older women is critical for informed geriatric and reproductive health policy. Adopting a life-course perspective, this study examines reproductive health morbidity among Indian women aged 40 years and above, specifically, to estimate the prevalence, type, severity, and spatial distribution of self-reported RHMs across states, and identify key determinants of RHM, with particular emphasis on hysterectomy status and menopausal indicators, adjusting for socioeconomic and demographic factors.
METHODS:
Data were drawn from Wave 1 of the nationally representative Longitudinal Ageing Study in India (LASI). Descriptive and bivariate analyses assessed prevalence and patterns of RHMs. Multivariate logistic regression estimated adjusted odds of reporting any RHM, controlling for age, education, wealth, residence, hysterectomy status, menopausal status, age at menopause, and duration since menopause. State-level variation was examined using choropleth maps, and spatial autocorrelation was assessed using Moran’s I statistic.
RESULTS:
Overall, 16.2% of women (N=25,530) reported at least one RHM. Mood swings were the most frequently reported condition (36.3%), and 37% of cases were of moderate or severe intensity. Hysterectomy emerged as the strongest predictor of RHM (AOR=3.03; 95% CI: 2.72–3.37). Higher wealth status was associated with increased reporting, while longer duration since menopause showed a protective effect. Substantial geographic heterogeneity was observed, with evidence of spatial dispersion rather than clustering.
CONCLUSIONS:
Reproductive health morbidity remains a significant concern among older Indian women, shaped by both socioeconomic factors and reproductive life-course transitions. The findings highlight the need for region-specific, menopause-sensitive reproductive health strategies within ageing and women’s health programs.
| eISSN: | 2654-1459 |
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