Challenges in perimenopause research and the application of existing criteria for staging reproductive aging in low and middle-income countries: a scoping review

OBJECTIVE: Perimenopause is an important stage of reproductive aging, yet research in low and middle-income countries (LMICs) is limited and reproductive-stage classification is inconsistent. This narrative review examines methodological and contextual challenges affecting perimenopause research in LMICs, evaluates the application of the Stages of Reproductive Aging Workshop +10 (STRAW +10) framework and proposes practical considerations to strengthen future research. METHOD: The review was informed by a previously published comprehensive scoping review and supplemented with studies from LMICs published between 2025 and July 2026. Eligible studies applied STRAW, STRAW +10 or comparable reproductive-stage classification methods. Data were synthesized using descriptive and narrative approaches. RESULTS: Of 288 full-text articles assessed, 90 studies published between 2005 and June 2026 were included. Most were cross-sectional, seven studies (7.8%) were longitudinal and four studies (4.4%) were nationally representative. Considerable heterogeneity in reproductive-stage classification was observed. STRAW +10 was applied in 20.0% of studies, STRAW in 21.0% and World Health Organization (WHO) criteria in 10.0%, while 48.9% relied on menstrual history without explicitly referencing a recognized staging framework. CONCLUSION: Perimenopause research in LMICs is limited and characterized by substantial heterogeneity in reproductive-stage classification. Wider adoption of standardized frameworks such as STRAW +10, together with greater methodological rigor, is needed to improve the quality, comparability and applicability of future research.