The Synchrony Between Menopause And HIV

There is indeed increasing number of evidences to suggest for a possible link up between HIV infection and menopause. So, if you were wondering about this unholy nexus then yes you are quite right. HIV infected menopausal women are obvious to present some unique problems which is not common among their uninfected counterparts. Among all, studies suggest that early onset of menopause due to loss of ovarian function is one of the biggest threats posed by HIV 1.

Menopausal transition and influence of HIV

Transition into the state of menopause is associated with the quick observations of sexual dysfunctions and mood alterations that can affect your quality of life. In the long run menopause has been linked with the induction and acceleration of chronic ailments such as diabetes, reduced bone mineral density, hypertension, and cardiovascular disease. Such deterioration in your health status can be exaggerated if you happen to be infected with HIV. The problem can be enhanced manifold if a HIV infected woman is on anti-retroviral therapy and enter the age of menopause early 2.

Age at menopause

You might be aware by now that an early onset of menopause is associated with increased medical complications as well as mortality. Several investigators have established the fact that HIV infection can reduce the menopause median age significantly. According to Dr. Schoenbaum 3 who had conducted a large study on the onset of menopause in HIV infected and uninfected women, HIV can independently induce the early menopause onset.

Menopausal symptoms

So, how can HIV infection influence your menopause symptoms? If we go by what the scientific reports have to say it can be ascertained that HIV infection can lead to enhanced menopausal symptoms. According to a published report in the journal Gynecology Endocrinology by a group of researchers from Brazil, HIV infected participants presented increased prevalence of genitourinary, sleeplessness, psychological and vasomotor related problems 4. Dr. Magalhães, the leader of this group suggests that according to their findings there is nearly 65% more chances of menopause like symptoms in the HIV infected women. These findings have been corroborated by other researchers like Miller. Fantry et al. reported for higher incidences of vaginal dryness and hot flashes in the HIV infected women 5.

Reproductive hormones

BY now it is clear to you that most important aspect of menopause in your life is the sudden and rapid decline in the levels of the reproductive hormones. Going by the recent trend of events it seems that one of the ways HIV infection can influence menopause is through the fluctuation in the levels of reproductive hormones. Rapid fluctuations in the levels of estradiol, inhibinB and FSH are quite common in HIV infection. Therefore, increased care for the menopause transitory stage in case you are infected by HIV is of utmost importance.

Cognition

Cognitive changes associated with menopause are not well understood. However, it is suggested by the available literature that HIV infection can lead to the development of cognitive decline like dementia or mild cognitive impairment. Such changes are more prevalent in the post-menopausal women. In particular HIV mediates such changes by interfering with the central nervous system through the stimulation of chronic immune activation and increased inflammatory cytokine production. More sensitive testing is a prerequisite for the earlier identification of cognitive decline experienced by HIV infected menopausal women

Summary

HIV infection and menopause are intricately linked to each other. The need of the hour is to precisely delineate the changes that HIV infection can render to facilitate early menopause so as to develop strategies in slowing it down. At present anti-HIV treatments like retrovirus therapy seems to be of little use in this regard.

Notes:

  1. Carr MC. The emergence of the metabolic syndrome with menopause. J Clin Endocrinol Metab 2003; 88: 2404-2411. http://press.endocrine.org/doi/pdf/10.1210/jc.2003-030242
  2. Ferreira CE1, Pinto-Neto AM, Conde DM, Costa-Paiva L, Morais SS, Magalhães J. Menopause symptoms in women infected with HIV: prevalence and associated factors. Gynecol Endocrinol. 2007; 23(4): 198-205. http://informahealthcare.com/doi/abs/10.1080/09513590701253743
  3. Schoenbaum EE1, Hartel D, Lo Y, Howard AA, Floris-Moore M, Arnsten JH, Santoro N. HIV infection, drug use, and onset of natural menopause. Clin Infect Dis. 2005; 41(10): 1517-1524. http://cid.oxfordjournals.org/content/41/10/1517.long
  4. Ferreira CE1, Pinto-Neto AM, Conde DM, Costa-Paiva L, Morais SS, Magalhães J. Menopause symptoms in women infected with HIV: prevalence and associated factors. Gynecol Endocrinol. 2007; 23(4): 198-205. http://informahealthcare.com/doi/abs/10.1080/09513590701253743
  5. Fantry LE1, Zhan M, Taylor GH, Sill AM, Flaws JA. Age of menopause and menopausal symptoms in HIV-infected women. AIDS Patient Care STDS. 2005; 19(11): 703-711. http://online.liebertpub.com/doi/abs/10.1089/apc.2005.19.703

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