Her younger sister is now HIV positive, the result of her husband's playing around. Her older sister died in childbirth during her seventh pregnancy. The worldwide population of post-menopausal women is expected to increase by the year 2030 to a total of 1.2 billion. Of these, about 75 per cent will live in developing countries. The health and circumstances of women in their older years are to a great extent the cumulative outcome of reproductive and sexual health during the earlier years.
Women live longer than men and average more years of ill health late in life.
Their older-age health concerns focus on issues such as hormone replacement and degenerative conditions such as arthritis and osteoporosis. In developing countries, many older women suffer from chronic health problems caused by years of neglect, discrimination and hardship. Lifelong exposure to smoky kitchens, polluted water, and pesticides may also have harmed their health. Reproductive health problems after menopause are significantly influenced by the quality of care women receive when younger. Uterine prolapse, urine incontinence, and the debilitating outcome of living with vesicovaginal fistula are examples of post-menopausal health problems that have their origin in poor or no obstetrical care at an earlier age.