Women's health policy in India has traditionally been reproduction-centric. Discuss the significance of State-led perimenopause/menopause health policies in addressing this gap.

The WHO notes that most women reach menopause between 45 and 55, and that the preceding perimenopausal transition can last years, affecting physical, emotional, mental and social well-being [1]. India's health system, organised around fertility and motherhood, has largely bypassed this phase — a gap the recent State policies seek to correct.

The reproduction-centric legacy

• Programme design has evolved from family planning to Reproductive and Child Health, measuring women's health mainly through fertility, contraception and maternal outcomes — the dominant domains of the NFHS itself [2].
• Ayushman Bharat–Health and Wellness Centres widened primary care beyond RCH to non-communicable diseases, mental health and geriatric care [4], yet offered no life-stage package for mid-life women.
• The NPHCE begins at old age [5], leaving the mid-life decade institutionally unattended.

Significance of the State-led initiatives

• Karnataka's 'Ruthu Thare', launched by its Health Department, is projected as India's first dedicated women's health policy with a menopause focus — awareness, early diagnosis, treatment access and training of health professionals and ASHAs [3].
• Tamil Nadu's announced perimenopausal care policy routes screening, counselling and treatment for both physical and mental health needs through PHCs and higher centres — using existing infrastructure rather than a parallel vertical.
• Both normalise a stigmatised transition, treating it as routine care, and embed mental health in a specific life-stage cohort.
• Since public health is a State subject under the Seventh Schedule [6], these are legitimate laboratories of policy; near-simultaneous action by two States signals horizontal policy diffusion in Indian federalism.

Caveats

• Delivery rests on already-stretched PHC staff without dedicated cadres; menopause-specific morbidity data and assured financing through gender budgeting remain thin.

These policies mark a shift from viewing women as reproductive agents to recognising a full life-cycle of health needs. Their real test lies in scaling through the NHM and HWC network, backed by trained personnel and reliable data, so that a national framework can follow — advancing both SDG-3 on well-being and SDG-5 on gender equality.