Inside Maharashtra’s new menopause clinics: A quiet healthcare shift for midlife women as 22,000 show up for consults

Her tone is gentle, almost conversational. “These are leading questions. Women rarely volunteer menopause-related problems. We have to draw them out, talk to them in a way that allows them to trust us with their intimate details,” she says.

Hundreds of such clinics now operate in district hospitals, urban health centres and municipal facilities.

The room — Antenatal Care and Gynaecology OPD–23 — is small and functional, with pale walls, metal furniture and a desk crowded with files. For most of the week, it serves as a routine outpatient department. But on Wednesdays, it becomes something unusual in India’s public healthcare system: a menopause clinic, which the Maharashtra government has introduced as part of its women’s health initiative. The clinics will operate every Wednesday at district hospitals, sub-district hospitals, municipal hospitals and some rural facilities to help women negotiate the trickiest phase of their lives.

Understanding symptoms through conversations

Shanti listens quietly at first. Dr Bhagat then asks her about general health concerns. After a moment, she says that she wakes up once or twice each night to use the bathroom. Then, as if anxious not to lose focus, she adds softly, “Please address this problem first.” Frequent urination is another symptom of menopause.

For many women who arrive here, menopause is not an urgent concern but an indistinct background condition — overshadowed by more immediate discomfort, financial constraints, domestic responsibilities and stigma.

Another patient arrives whose concerns take a different shape. Renuka Kadam, a 54-year-old police inspector, wants a routine health check required for a fitness assessment. She chose the District Hospital largely because it is close to her office. During consultation, however, she begins to describe a persistent anxiety that has troubled her in recent months. “My periods stopped some time ago,” she tells Dr Bhagat and Dr Ruta Mulay, a consulting gynaecologist. “With responsibilities at home and at work, I never had time to check whether this was normal. I get irritated frequently. I wasn’t like this before.”

Kadam, a mother of two daughters, says her understanding of menopause has come mostly through conversations with friends. One such discussion unsettled her: a friend in her mid-fifties had reported a sudden drop in haemoglobin levels, a condition doctors say may sometimes be associated with post-menopausal bleeding.

Dr Mulay responds with a measured reassurance. She speaks of balanced diets, fibre intake, reduced refined sugar, regular sleep and techniques to manage stress — small adjustments intended to smooth what she describes as a biological transition rather than an illness.

As Kadam leaves the clinic, she recalls advice from her daughter, a psychologist working with an NGO: “She tells me menopause is part of the journey. She says I should stay happy.” Her experience reflects a different relationship to midlife health — one shaped by access to information and an enabling environment.

What’s the response so far?

The menopause clinics are part of the state government’s effort to extend institutional care to women beyond their reproductive years and address the physical and psychological changes associated with ageing.

According to state health department data, between January 14 and February 4, 22,938 women visited 681 menopause clinics across Maharashtra for consultation, evaluation and treatment. Hundreds of such clinics now operate in district hospitals, urban health centres and municipal facilities. Patients who present during the week with related symptoms may be referred for specialised consultation.

The initiative, guided by the Minister of State for Public Health Meghna Bordikar, promises medical evaluation, mental-health counselling, hormonal and cardiovascular assessments, and lifestyle guidance. Yet statistics convey only part of the story. The more complicated task lies in persuading women that menopause warrants medical attention at all.

The need for greater awareness

Outside the consultation room, the hospital’s outpatient department hums with routine activity. Each day, between 80 and 100 women arrive with a range of gynaecological complaints. Few identify menopause as their primary concern.

Three posters, explaining menopausal symptoms and management strategies, have been put up on a display wall, beside a larger board detailing injectable contraceptives. The juxtaposition is revealing. For decades, public health programmes in India have focused overwhelmingly on fertility, childbirth and family planning; the needs of women after their reproductive years have received far less attention.

“It has only been a few weeks since we started,” Dr Mulay says. “So we ask every woman above 45 about symptoms — sudden heat in the body, sweating, sleep disturbances. Many think such things are simply to be endured.”

To expand awareness, the hospital has begun working with Accredited Social Health Activists, or ASHAs, who conduct home visits and community outreach. District Civil Surgeon Dr Nagnath Yempalle describes these efforts as part of a broader information campaign designed to familiarise women with services that are, for many, conceptually new.

Around noon, Dr Bhagat reviews a list of patients seen earlier in the year. One case lingers in her mind — a woman in her early 50s who initially reported mild symptoms such as vaginal dryness and itching. Nearly a year after her last menstrual period, she began experiencing sudden mood fluctuations. “She told us she would feel happy for some time and then suddenly the opposite,” Bhagat recalls.

The doctors counselled her about exercise, strength training and diet — recommending foods rich in phytoestrogens such as soybeans, drumsticks and green leafy vegetables. A follow-up appointment was scheduled. She did not return.

Such absences are common. Menopause care, unlike acute treatment, requires continuity — something difficult to sustain amid economic pressures, household responsibilities and lingering social discomfort around discussing ageing bodies.

A few seats away from the consultation room, another patient waits quietly. Lakshmi, a 30-year-old jewellery store employee, has come seeking a medical termination of pregnancy. “I have a son,” she says. “This pregnancy was not planned. We are a working couple and have many challenges.” Her presence is a reminder of competing priorities within women’s healthcare. For younger patients, the immediate demands of reproduction remain pressing; for older women, the changes of midlife often recede into the background.

Shortly after noon, the calm of the outpatient department is briefly disrupted by the arrival of Shankar Jagtap, a Member of the Maharashtra Legislative Assembly representing the Chinchwad constituency. Accompanied by aides, he walks through the corridors, enquiring about medicine availability before stopping at OPD–23 to inspect the menopause clinic. Doctors mention the possibility of organising an awareness camp for International Women’s Day. Jagtap listens and responds with pragmatic brevity: “Try for better footfall. Step out and reach out to them.” His remark captures the challenge of normalising menopause as a significant women’s health issue. The infrastructure is there but participation depends on reshaping long-held assumptions about women’s health, ageing and care.