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Management guidelines needed for HIV-infected women with accelerated menopause
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Age at onset of menopause in HIV-infected Thai women has reached a significantly earlier age than previously reported, affecting some who are aged as young as 47 years.
In a cross-sectional study performed from June 2010 to March 2011 in Bangkok, Pongrak Boonyanurak, MD, and colleagues enrolled 268 HIV-infected Thai women aged 40 years or older (median age, 44.6 years) who had not received hormone therapy in the 8 weeks preceding the study.
The women reported symptoms for the 30 days before the study by completing the Menopause-Specific Quality of Life survey. Researchers identified those experiencing menopause as women who had their last menstrual period more than 1 year before the study. Additional factors were taken into consideration using the multivariate Cox proportional hazard regression analysis.
“Currently, the approximate number of human immunodeficiency virus (HIV)–infected women worldwide is 15.4 million. In the era after the widespread availability of highly active antiretroviral therapy (HAART), HIV-infected individuals are surviving to middle and older age. Previous studies reported that HIV infection is independently associated with the onset of menopause symptoms,” researchers wrote.
The ratio of their CDC clinical classification (A:B:C) was 53%:34%:13%; with 95% of the patient population using HAART, researchers said.
Of the 268 enrolled, 55 reached menopause by an average of 47.3 years. According to data, this age was once 49.5 years in non–HIV-infected Thai women; a difference of 2.2 years (95% CI, –3.1 to –1.2). Researchers reported that postmenopausal women had more symptoms, including night sweats (P=.03), change in sexual desire (P=.01) and avoiding intimacy (P=.01) vs. women who were not postmenopausal.
Moreover, based on the multivariate Cox proportion hazard regression analysis, factors related to menopause were CDC clinical classification B or C (HR=1.7; 95% CI, 1.0-3.03), and no sexual act in the past month (HR=4.9; 95% CI, 1.5-16).
“More studies are needed to investigate the cause and appropriate interventions for accelerated menopause in HIV-infected women. In HIV-negative women, early onset of menopause is associated with a greater risk of fracture and cardiovascular disease, but we lack data on the impact of early onset of menopause in HIV-positive women,” researchers concluded.
Boonyanurak and colleagues said proper management guidelines for premenopausal and postmenopausal HIV-infected women are needed.
Disclosure: The researchers report no relevant financial disclosures.
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