Menstruation

If your viral load is detectable you can pass on HIV. The risk varies depending on where you are in your menstrual cycle.

The levels of HIV in vaginal fluid vary. They are likely to be highest around the time of your period, if you have a detectable viral load.

Someone giving you oral sex will be at higher risk of HIV infection around the time of your period if they have bleeding gums, sores, wounds, a sore throat, inflammation or an untreated infection in their mouth.

If your viral load is detectable and someone gives you oral sex, they can use a dental dam (a sheet of latex) or a piece of latex cut from a condom as protection.

However, if you’re on effective treatment and have an undetectable viral load, you cannot pass on HIV.

As well as affecting your immune system, HIV can sometimes affect your hormonal system and change the frequency of your periods. This may be the case if you have a low CD4 cell count and/or a high viral load.

Here are some changes to the menstrual cycle that HIV can cause:

• long intervals between periods
• missed periods without pregnancy.

Tell your doctor if you notice any changes to your periods as they may need to do further tests.

You can use hormonal contraception to regulate or suppress your period (whether or not you're wanting to prevent pregnancy). Speak to your HIV doctor first as there are possible interactions between anti-HIV drugs and hormonal contraceptives that might affect the contraception.

This is also important for emergency contraception (the ‘morning-after pill’).

• A missed period might mean that you are pregnant or that you are starting to go through the menopause.
• Abnormal bleeding (for example, after sex) or very heavy periods could be signs of a health problem and should always be reported to your doctor.
• Heavy periods can be caused by several factors, including fibroids (growths that develop in the uterus or around it). If left untreated, the blood loss from heavy periods could lead to anaemia (a lack of iron).