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 nearly half of infections in america. 

Amongst ladies newly identified with HIV, 19% have been ages 45 to 54, and 17% have been 55 and older, based on the CDC. Researchers are actually analyzing the connection between HIV and menopause – and the virus’s impression on a girl’s well being might be vital. 

“Research have proven that early menopause might happen 5 years earlier in ladies with HIV than ladies with out HIV,” stated Monica Gandhi, MD, MPH, a professor of medication on the College of California, San Francisco, and director of the Ward 86 HIV Clinic at San Francisco Basic Hospital/UCSF. “The explanations for this embody 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 treatment use.”

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

“HIV is a well-studied threat issue for osteoporosis,” stated 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 wanting on the well being implications of early menopause and HIV. “Individuals residing with HIV have on the whole extra non-HIV associated threat components similar to smoking or alcohol use. Like HIV, menopause is a threat issue for osteoporosis – that is seemingly mediated by means of hormonal adjustments.”

However there’s lots you are able to do to remain wholesome. A brand new Canadian research discovered that HIV-positive ladies who’ve entry to good well being care undergo menopause at related ages to ladies who’re HIV-negative, for example. Right here’s the knowledge you want to work greatest together with your physician, get reduction from menopausal signs, and hold treating HIV successfully and safely.

How Do Older Ladies Contract HIV? 

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

It is  really simpler for an older ladies than different individuals to change into contaminated with HIV by means of intercourse, based on the U.S. Division of Well being and Human Providers Workplace on Ladies’s Well being. It is because after menopause, lack of lubrication within the vagina raises the danger for tiny cuts, by means of which the virus might be transmitted. To guard your self and others, it’s essential to make use of condoms when you’ve intercourse, and to get examined for HIV in case you don’t know your standing.

What Are the Signs of HIV?

HIV.gov explains that though some individuals 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 muscular tissues
  • Feeling drained
  • A sore throat
  • Lymph node swelling
  • Ulcers in your mouth

What Are the Signs of Menopause? 

Some signs of menopause embody

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

Do Ladies with HIV Have Completely different Signs of Menopause? 

In brief: Sure. 

“Research have proven that girls with HIV have a greater prevalence of menopausal signs than ladies with out HIV even at related ages. In one massive research, the commonest signs of menopause amongst ladies with HIV have been joint ache, sizzling flashes, exhaustion, and sleep disturbances,” Gandhi stated. 

If you happen to’re HIV-positive, you might also discover that your intervals don’t change regularly – they may simply cease altogether all of a sudden. 

“Ladies with HIV are 3 times extra prone to have absent intervals, in comparison with these with out HIV,” stated 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 Medication in Baltimore.

It’s attainable, although, {that a} lack of menstruation really has to do with one other well being concern. A College of British Columbia evaluation discovered that in quite a few research, HIV-positive ladies reached menopause on common between 46 and 50 years previous. Among the many ladies who reached early menopause, a excessive proportion had major ovarian insufficiency (POI), which may additionally trigger intervals to cease. (Whereas POI isn’t a situation particularly linked to HIV, each circumstances do hyperlink to osteoporosis.) 

If you happen to cease having intervals, it is a good suggestion to ask your physician to check you for the reason for your amenorrhea, the medical time period for missed intervals. Your physician can do a biochemical affirmation of menopause so you possibly can then tackle any troublesome signs you’re having with the best therapy. 

What Well being Adjustments Ought to You Make to Deal with Each Menopause and HIV?

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

Ensuring you’re consuming a balanced food plan is an effective way to chop your threat for each of these ailments. Additionally, new analysis exhibits that HIV-positive ladies typically drop a few pounds as a substitute of gaining it at menopause. This can be as a result of a response to antiretroviral remedy (ART), which makes use of customary HIV medicine. It is key that when you take your HIV treatment, you additionally get sufficient energy.

Ingesting alcohol might not be best for you in case you have HIV– particularly extreme alcohol use. It’s essential to debate whether or not you possibly can or ought to drink alcohol together with your physician. 

Altering your treatment isn’t 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 medicines don’t should be adjusted,” stated 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 quick interval in case you and your physician really feel that’s a good selection for symptom reduction.

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

Make the wholesome selections which might be best for you – you possibly can really feel higher than ever.

“Protected and efficient therapies for menopause can be found,” Powell stated. “With the arrival of extra tolerable and secure ART regimens, ladies with HIV reside effectively into their post-menopausal years.”

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