Psychosexual and Menstrual Health Impact of Husband’s Out-migration on Left-behind Women in the Central Himalaya: A Cross-sectional Study

Background: Male out-migration for work is widespread across the hill districts of the Indian Himalaya, leaving wives to manage the household alone for extended periods. The women left behind bear the burden of managing everything from household chores to societal duties. Such spousal separation is increasingly recognized as a determinant of women’s psychological and reproductive health. This research article examined the psychological impact of husbands’ absence and its interlinkage with menstrual health among women in the Kumaon Himalaya. Methods: A cross-sectional survey was undertaken among 250 married women whose husbands had migrated for work, residing in hill villages of the Kumaon region. This exploratory study employed a three-stage sampling design. In the first stage, Dhauladevi Development Block of Almora District, Uttarakhand, was selected purposively due to its relatively low educational development and high out-migration. In the second stage, 12 Gram Panchayats (approximately 10% of the total 122) were sampled using simple random sampling (lottery method). In the third stage, all households with at least one member who had migrated to an urban area for livelihood for 1 year or more were identified and included in the study. Data were collected through a well-structured interview schedule. Results: Approximately 35% of women reported deep anxiety about their migrant husbands, 25% harbored fears of an untoward incident, 12% reported loneliness, and 11% felt their social relationships were affected; rural women reported comparatively less loneliness, attributed to the joint family system in the hills. Overall, 62% of women reported feeling emotionally vulnerable during the husband’s absence. Menstrual irregularities were reported by approximately one-third of women even before the husband’s migration; this proportion rose to 46% after migration, with a further 21% uncertain about changes, reflecting an approximate 12% point increase attributable to migration. Conclusion: Husband’s out-migration is linked to significant psychological distress and emotional vulnerability among left-behind women, and appears to compound pre-existing menstrual irregularities, consistent with earlier findings associating spousal separation with poorer mental health and psychological stress with menstrual dysfunction.