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Human immunodeficiency virus and menopause

Kanapathipillai, Rupa MBBS; FRACP1; Hickey, Martha BA (Hons), MSc (Clin Psych), MBChB, FRANZCOG, MD2; Giles, Michelle MBBS (Hons), FRACP, PhD1,2,3

doi: 10.1097/GME.0b013e318282aa57
Review Article

Objective This article aims to review currently available evidence for women infected with human immunodeficiency virus (HIV) and menopause and to propose clinical management algorithms.

Methods Key studies addressing HIV and menopause have been reviewed, specifically age of menopause onset in HIV-infected women, frequency of menopausal symptoms, comorbidities associated with HIV and aging (including cardiovascular disease and bone disease), treatment of menopausal symptoms, and prevention of comorbidities in HIV-infected women.

Results Studies suggest an earlier onset of menopause in HIV-infected women, with increased frequency of symptoms. Cardiovascular disease risk may be increased in this population, with combination antiretroviral therapy (cART) and chronic inflammation associated with HIV, contributing to increased risk. Chronic inflammation and cART have been independently implicated in bone disease. No published data have assessed the safety and efficacy of hormone therapy in relation to symptoms of menopause, cardiovascular risk, and bone disease among HIV-infected women.

Conclusions Few studies on menopause have been conducted in HIV-infected women compared with HIV-uninfected women. Many questions regarding age of menopause onset, frequency of menopausal symptoms and associated complications such as bone disease and cardiovascular disease, and efficacy of treatment among HIV-infected women remain. The incidence and severity of some of these factors may be increased in the setting of HIV and cART.

From the 1Infectious Diseases Unit, Alfred Hospital, Prahran, Victoria, Australia; 2Royal Women’s Hospital, Parkville, Victoria, Australia; and 3Department of Infectious Diseases, Monash Medical Center, Clayton, Victoria, Australia.

Received October 16, 2012; revised and accepted December 11, 2012.

Funding/support: None.

Financial disclosure/conflicts of interest: None reported.

Address correspondence to: Michelle Giles, MBBS (Hons), FRACP, PhD, Department of Infectious Diseases, Alfred Hospital, Commercial Road, Prahran, Victoria 3181, Australia. E-mail:

© 2013 by The North American Menopause Society.