"Data is the soul of research-they endure; study design and methodology are its heartthey evolve with time."
India has a large and diverse population of women transitioning through menopause and living for several decades thereafter. Yet systematically collected, longitudinal real-world data describing their symptoms, comorbidities, risk factors and changing health needs remain limited. Much of the evidence informing menopause care originates from populations outside India and may not fully reflect the demographic, socioeconomic, cultural and healthcare characteristics of Indian women. Systematically collected Indian real-world data are therefore needed to complement evidence from randomised controlled trials, population-based studies and international cohorts. Recognising this evidence gap, the Indian Menopause Society (IMS) conceived the Indian Mid-Life Registry (IMLR) as a national platform for generating structured clinical data on women at midlife and beyond.
The IMLR is a prospective, longitudinal, multicentric registry designed for 10 years of structured digital data collection and follow-up. Participating clinicians contribute standardised clinical information from women seen in routine practice. The registry has no predetermined population-sampling strategy and therefore represents women accessing participating clinical services rather than a population-based sample. Data are collected across domains relevant to menopause and healthy ageing, including menopausal status and symptoms, menstrual and gynaecological history, medical and surgical history, personal and family history, lifestyle and social factors, anthropometric measurements, general and systemic examination, and relevant health-risk assessment. A particular strength of the registry is its prospective annual follow-up, which allows evaluation of trajectories of menopausal symptoms, risk factors, comorbidities, and health outcomes over time. Its digital structure supports standardised data capture in routine clinical practice. The objectives include generating Indian real-world evidence, promoting structured electronic health records, enabling collaborative research, and using India-specific evidence to refine future clinical practice recommendations.
Meeta, the Founder Chair, conceptualised the IMLR in 2020, coinciding with the IMS Silver Jubilee, and briefed the IMS leadership. The IMS funds the project, with initial support from Pfizer. Development and brainstorming took place in 2021 in collaboration with the IMS and Medeva teams. The team signed a Memorandum of Understanding with Medeva in April 2021, followed by a pre-pilot at Tanvir Hospital, Hyderabad, on April 10, 2021. We published an invitation to participate in the Journal of Mid-life Health in June 2021. After ethics submission and approval, we invited pilot participants in October 2021, and individual training began in November. Hands-on workshops and pilot meetings continued as we developed standardised clinical proformas and data-entry processes. The IMLR was formally inaugurated on 19 January 2022 and has since evolved into an ongoing multicentric IMS initiative. Regular IMLR meetings have also become a peer-learning forum where clinicians discuss menopause care, challenging clinical scenarios, risk-assessment approaches, and data-quality issues. This educational dimension complements the registry's primary role as a platform for generating real-world evidence.
The registry is fully digital, with Medeva serving as the scientific and technology partner and the platform customised to the requirements of the IMS registry. Importantly, the registry also collects follow-up information, enabling it to move beyond a snapshot of menopause health and provide an opportunity to understand changes in symptoms, risk factors, and health outcomes over time.
TheAugust 2026 IMLR Status Reportrecords 7,097 consultations and 5,392 patients overall. The registry continuesto expand through participating IMS clinicians across India.
The Indian Mid-Life Registry acknowledges the valuable contribution of all participating clinicians to this national real-world evidence initiative. Contributors are listed below in descending order of cumulative patient enrolment, based on the August 2026 IMLR Status Report:
Meeta Meeta (3,261), A. B. Chitra (556), Sangeeta Pahwa (428), Asna Ashraf (153), Amrita Sarkari (140), Madhubala Manickavasagam (110), Jyoti Shah (115), Manjit Mohi (73), Geeta Reddy (67), Jyothika A. Desai (63), Kiran Aggarwal (76), Kunwar Shipra (46), Neelam Aggarwal (37), Jyoti Jaiswal (35), Sudha Sharma (33), Bipasa Sen (30), Sheela Mane (30), Pratibha Singh (27), Jignesh R. Shah (25), Jyothi Unni (20), Ami Yogesh Mehta (19), N. Hephzibah Kirubamani (17), Seema Sharma (12), Ritu Jain (11), M. Lakshmi Rathna (8), Choranur Ambuja (6), Naini Tandon (6), Kiran Pandey (5), Maninder Ahuja (4), Tripura Sundari (3), Kiran Chandna (2), Renuka Malik (15), Shobhana Mohandas (2), Aarti Gupta (1), Anita Jayant Shah (1), Archana Dwivedi (1), Binal D. Shah (1), Gowri Meena Selvaraj (1), Jamuna Devi Gudidevuni (1), Manoj Chellani (1), Navneet Takkar (1), Pooja Gupta (1), Pushpa Sethi (1), Ratnabali Chakravorty (1), Reeta Agarwal (1), Rekha Rani (1), Revathy Janakiram (1), and Vandana Narula (1).
A major objective of the IMS Clinical Practice Guidelines is to contextualise international evidence for Indian women.2,3 The IMLR provides a mechanism for progressively strengthening this India-specific evidence base. Associations observed in registry analyses should not be interpreted as proof of causality. They provide important India-specific real-world evidence, while randomised trials, systematic reviews, and well-designed comparative studies remain essentialfor evaluating treatment efficacy,safety, and causal effects.
The long-term scientific value of the IMLR will depend on expanding geographic representation, improving the completeness and quality of longitudinal follow-up, standardising definitions, validating clinical variables, and using rigorous statistical methods. Longitudinal analyses will be particularly valuable for studying symptom trajectories, cardiovascular and metabolic risk, bone and musculoskeletal health, genitourinary health, and associations between therapeutic interventions and real-world outcomes. Continued peerreviewed publication of IMLR data will be important for scientific scrutiny and for incorporating valid findings into subsequent guidelines.
The IMLR's institutional strength lies in its democratic governance. Led by Founder Chair Meeta and Co-Chair Jyoti Shah, the registry uses an impartial requisition queue system. This allows any participating IMS member to submit research proposals and leverage the collective dataset for peer-reviewed publication. The IMLR remains open to IMS members interested in contributing to this national initiative. Participating in the IMLR offers clinicians multiple unique professional benefits
1. Clinical Practice Modernisation: Clinicians gain access to a world-class, customised clinical EMR platform that enhances daily patient care.
2. Training&ImplementationSupport:Upon onboarding, participating doctorsreceive standard protocols, ethics committee approvals valid acrossIndia, case record forms, and direct one-on-one digital training.
3. Academic Recognition: Contributing members have opportunities to lead, co-author, and publish original research papers using the national dataset.
Reach out directly via the following channels:Email drmeeta919@gmail.com | midliferegistry@gmail.com
The IMLR should therefore be viewed as a dynamic national evidence-generation platform rather than solely as a repository of clinical information. Its continuing value will lie in generating longitudinal India-specific evidence that identifies unmet needs, informs research priorities, contextualises international evidence and progressively strengthens future editions of the IMS Clinical Practice Guidelines.
1. Meeta M, Tandon VR. An Enriching Journey. J Midlife Health. 2022 Jan Mar;13(1):1-2. doi: 10.4103/jmh.jmh_78_22. Epub 2022 May 2. PMID: 35707310; PMCID:PMC9190961.
2. Ashraf AB, Meeta M, Chitra AB, Pahwa S, Shah J, Mohi M, et al. Genitourinary syndrome of menopause: a multicenter study from the Indian Midlife Registry. Climacteric. 2025;28(3):329-336. doi:10.1080/13697137.2025.2496681.
3. Meeta M, Anuradha M, Ashraf AB, Aggarwal K, Digumarti L, Singh T, et al. Clinical Practice Guidelines for Menopause: an executive summary and recommendations: Indian Menopause Society 2026. J Midlife Health. 2026;17(Suppl 1):S12-S116. doi:10.4103/jmh.jmh_302_25.
4. IndianMenopause Society.IndianMid-LifeRegistry protocol and registry records.IndianMenopause Society; 2021-2026. Unpublished data.