Characteristics of menopause in three socioeconomic urban groups in Karachi, Pakistan

To determine age, symptoms and treatment choices in Pakistani women with spontaneous menopause, three groups in Karachi were interviewed using a structured questionnaire. The groups consisted of 250 poor slum dwellers, 250 middle class clinic attenders and 150 wives of retired military officers. Interviews were carried out in 1989 and 1990 by members of a team from the Aga Khan University consisting of a gynaecologist, a community health physician and two senior medical students. All interviewees had natural menopause at least 12 months previously. The results showed a mean age of 47 years for menopause in all groups. One in five women were symptomatic in the poorest group but one in two were in the other groups. Treatment was sought by 6% in the poor group, 26% of the middle class group and 38% of the most privileged group. Age at menopause was 4 years earlier than in most reports and fewer women had menopausal symptoms. These urban women may not represent the situation across the country but, as life expectancy in Pakistan is rising (now 56.4 years for women), menopausal problems may increase.