June 27, 2023 – How does HIV have an effect on menopause? 

HIV, or the human immunodeficiency virus,  impacts the physique’s immune system and may result in AIDS if it goes untreated. HIV has been referred to as a “graying” illness, as these 50 or older make up virtually half of infections in the US. 

Amongst girls newly recognized with HIV, 19% had been ages 45 to 54, and 17% had been 55 and older, in response to the CDC. Researchers are actually inspecting the connection between HIV and menopause – and the virus’s affect on a girl’s well being may be vital. 

“Research have proven that early menopause might happen 5 years earlier in girls with HIV than girls with out HIV,” mentioned Monica Gandhi, MD, MPH, a professor of drugs on the College of California, San Francisco, and director of the Ward 86 HIV Clinic at San Francisco Normal Hospital/UCSF. “The explanations for this embrace persistent an infection, decrease estrogen ranges, persistent stress response, immunodeficiency, metabolic adjustments that may happen with HIV similar to weight adjustments or insulin resistance, or persistent medicine use.”

There are a selection of well being implications for girls who enter menopause sooner, together with a better danger for osteoporosis as a result of their bones aren’t as dense. 

“HIV is a well-studied danger issue for osteoporosis,” mentioned Anna Hachfeld, MD, MSCi, a senior doctor within the Division of Infectious Illnesses at Bern College Hospital in Switzerland, and co-lead creator of a current research trying on the well being implications of early menopause and HIV. “Individuals dwelling with HIV have basically extra non-HIV associated danger elements similar to smoking or alcohol use. Like HIV, menopause is a danger issue for osteoporosis – that is possible mediated via hormonal adjustments.”

However there’s loads you are able to do to remain wholesome. A brand new Canadian research discovered that HIV-positive girls who’ve entry to good well being care undergo menopause at comparable ages to girls who’re HIV-negative, for example. Right here’s the data you could work finest together with your physician, get aid from menopausal signs, and preserve treating HIV successfully and safely.

How Do Older Ladies Contract HIV? 

HIV is transmitted in the identical methods to everybody – via sure physique fluids, particularly blood, vaginal fluid, or semen. The Mayo Clinic explains that HIV is unfold via sexual contact and thru contaminated blood that enters your physique. HIV can also be unfold via breastfeeding or throughout childbirth. 

It is  truly simpler for an older girls than different folks to turn into contaminated with HIV via intercourse, in response to the U.S. Division of Well being and Human Companies Workplace on Ladies’s Well being. It is because after menopause, lack of lubrication within the vagina raises the danger for tiny cuts, via which the virus may be transmitted. To guard your self and others, it’s essential to make use of condoms when you will have intercourse, and to get examined for HIV should you don’t know your standing.

What Are the Signs of HIV?

HIV.gov explains that though some folks with HIV don’t have any indicators in any respect, others can have flu-like signs, together with: 

  • Fever and chills
  • A pores and skin rash
  • Evening sweats
  • Achy muscle groups
  • Feeling drained
  • A sore throat
  • Lymph node swelling
  • Ulcers in your mouth

What Are the Signs of Menopause? 

Some signs of menopause embrace

  • Vaginal infections
  • Irregular bleeding, like skipped durations or a change in circulate
  •  Urinary issues 
  • Sexual issues
  • Scorching flashes
  • Evening sweats
  • Disrupted sleep
  • Low temper
  • Despair
  • Nervousness
  • Hassle concentrating or remembering issues 
  • Joint and muscle pains 
  • Complications

Do Ladies with HIV Have Totally different Signs of Menopause? 

In brief: Sure. 

“Research have proven that girls with HIV have a larger prevalence of menopausal signs than girls with out HIV even at comparable ages. In one giant research, the most typical signs of menopause amongst girls with HIV had been joint ache, sizzling flashes, exhaustion, and sleep disturbances,” Gandhi mentioned. 

In case you’re HIV-positive, you may additionally discover that your durations don’t change step by step – they may simply cease altogether immediately. 

“Ladies with HIV are thrice extra more likely to have absent durations, in comparison with these with out HIV,” mentioned Anna M. Powell, MD MS, an assistant professor of gynecology and obstetrics and co-director of the Johns Hopkins HIV Ladies’s Well being Program at Johns Hopkins Drugs in Baltimore.

It’s potential, although, {that a} lack of menstruation truly has to do with one other well being challenge. A College of British Columbia assessment discovered that in quite a few research, HIV-positive girls reached menopause on common between 46 and 50 years outdated. Among the many girls who reached early menopause, a excessive share had main ovarian insufficiency (POI), which might additionally trigger durations to cease. (Whereas POI is just not a situation particularly linked to HIV, each circumstances do hyperlink to osteoporosis.) 

In case you cease having durations, it is a good suggestion to ask your physician to check you for the reason for your amenorrhea, the medical time period for missed durations. Your physician can do a biochemical affirmation of menopause so you’ll be able to then handle any troublesome signs you’re having with the best therapy. 

What Well being Modifications Ought to You Make to Handle Each Menopause and HIV?

It’s vital to focus in your total well being at the moment. British researchers who handled HIV-positive girls throughout their menopause transition discovered that these sufferers had a excessive fee of different circumstances throughout menopause, which speaks to the necessity for girls to handle HIV at this stage of their lives. Additionally, a multi-university analysis crew discovered that menopause is linked to immune activation in girls with HIV. This occurs via dysfunction within the intestine microbiome and may make girls extra more likely to have HIV issues similar to coronary heart illness and most cancers. 

Ensuring you’re consuming a balanced eating regimen is an effective way to chop your danger for each of these illnesses. Additionally, new analysis reveals that HIV-positive girls typically reduce weight as an alternative of gaining it at menopause. This can be as a consequence of a response to antiretroviral remedy (ART), which makes use of commonplace HIV medicine. It is key that when you take your HIV medicine, you additionally get sufficient energy.

Consuming alcohol might not be best for you if in case you have HIV– particularly extreme alcohol use. It’s vital to debate whether or not you’ll be able to or ought to drink alcohol together with your physician. 

Altering your medicine is just not one thing to fret about, almost definitely. 

“Except somebody is on an older antiretroviral routine containing sure protease inhibitors like fosamprenavir, or sure NNRTIs [non-nucleoside reverse transcriptase inhibitors] like efavirenz, HIV drugs don’t have to be adjusted,” mentioned Powell. 

To stop osteoporosis, ask your physician about upping your calcium consumption – a vitamin D complement could also be best for you. 

You probably can take hormone substitute remedy for a short interval should you and your physician really feel that’s a good selection for symptom aid.

“Menopausal signs are undertreated and HRT is under-utilized in girls with HIV,”  Powell mentioned. 

Make the wholesome decisions which might be best for you – you’ll be able to really feel higher than ever.

“Secure and efficient therapies for menopause can be found,” Powell mentioned. “With the appearance of extra tolerable and protected ART regimens, girls with HIV reside effectively into their post-menopausal years.”

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