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Menopause and HIV

how hiv is passed on

Some evidence suggests that women living with HIV may start the menopause a few years earlier than women without HIV, especially if they have a low CD4 count.

Will I need medical treatment for the menopause?

Some women prefer not to take any treatment and others find it a useful way to reduce symptoms they find unpleasant.

Hormone replacement therapy (HRT) can be prescribed to reduce some symptoms of menopause, prevent osteoporosis or to treat the early onset of menopause.

HRT involves taking oestrogen in the form of tablets, an implant or gel to replace the decline in your own levels. HRT is generally not used as a long-term treatment because it may increase the risk of developing other conditions such as breast cancer.

Because of this your doctor will discuss the benefits and risks of taking HRT before prescribing it to you.

Can HRT be taken with HIV treatment?

Yes, HRT can be taken with HIV treatment - ask your doctor if there are any interactions between HRT and the anti-HIV drugs you are on.

HIV clinics don’t provide HRT, so you'll need to have it prescribed by your GP or another doctor.

Will my HIV treatment still be as effective?

In the past, there was some concern that older women may not respond as well to HIV treatment.

However, it's now known that treatment works just as well in women who have gone through the menopause as it does in younger women.

What is the menopause?

Menopause is when your monthly periods (known as the menstrual cycle) stop and you can no longer get pregnant naturally. This usually happens between the ages of 45-55 after months or years of periods becoming less frequent.

There can be changes to your body and your menstrual cycle in the years leading up to your menopause which is called the perimenopause.

The menopause happens because the levels of the hormone oestrogen being released from the ovaries drops over time. Oestrogen causes:

  • your periods to start in adolescence
  • your ovaries to release an egg every month
  • your womb lining to thicken up in order to receive a fertilised egg.

At the same time the number of eggs in your ovaries also reduce, but you can still become pregnant up until you have your last period.

What symptoms could I have?

During the months and years leading up to the menopause women may notice changes to their periods. They may happen more or less often and get heavier or lighter until they stop altogether.

According to NHS Choices you may also experience:

  • hot flushes to the face, neck and chest
  • night sweats
  • disturbed sleep
  • a reduced sex drive
  • headaches
  • changes to your mood including anxiety, mood swings and low mood
  • joint aches, pains and stiffness
  • urine infections
  • heart palpitations
  • an increased risk of osteoporosis.

Symptoms can carry on for about four years (sometimes more) after your last period.

How should I look after my health after the menopause?

Everyone loses bone density as they get older, but this process speeds up in women who have gone through the menopause because they have lower levels of the hormone oestrogen. HIV infection and antiretroviral treatment can also both cause bone loss, which can lead to osteoporosis. Eating well and exercise can both reduce the risk of developing osteoporosis and help deal with bone loss if it occurs.

Calcium and vitamin D are essential to bone health, so you should try to get plenty of both. Many foods are rich in calcium:

  • milk and other dairy products,
  • leafy green vegetables such as kale and broccoli (but not spinach),
  • beans such as soy and baked beans,
  • nuts and sesame seeds
  • types of fish where you eat the bones, such as salmon and sardines.

In the UK from April to September, you get most of your vitamin D from sunlight on your skin but it is also found in oily fish and eggs, as well as in foods that are specially fortified, such as some breakfast cereals. Some people may choose to take a vitamin D supplement, however please speak to a clinician before deciding.

Resistance, or weight-bearing, exercise can reduce the risk of osteoporosis, and help once it is diagnosed by encouraging new bone to grow.

Some women may be prescribed antidepressants or a course of cognitive behavioural therapy - known as CBT - (a type of talking therapy) if their mood is low. Some women find activities like yoga can help as well.

If you have any vaginal bleeding after the menopause, see your doctor as this could be a symptom of another health problem.

More help and information:

If you have questions about symptoms of the menopause, or possible interactions between treatments, talk to your healthcare team.

If you live in Brighton or London, our Health Wealth and Happiness Project for over 50s living with HIV might be for you.

You could also ask about attending a menopause clinic. Call THT Direct on 0808 802 1221 for a referral.

Next: Menstruation and HIV ››

‹‹ Back to: HIV and cognitive problems



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The Information Standard: Certified member

This article was last reviewed on 30/10/2017 by Anna Peters

Date due for the next review: 30/10/2020

Content Author: S. Corkery, NAM

Current Owner: Kerri Virani

More information:

Menopause – symptoms
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Bone loss
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How to get vitamin D from sunlight
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Bone problems and HIV
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Hormone Replacement Therapy
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Cognitive Behaviour Therapy (CBT) for Menopausal Symptoms
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HIV Infection, Drug Use, and Onset of Natural Menopause
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Volume 41, Issue 10, 15 November 2005, Pages 1517–1524

Patterson KB et al. Treatment responses in antiretroviral treatment-naïve premonpausal and postmenopausal HIV-1-infected women: an analysis from AIDS Clinical Trials Group Studies. Clin Infect Dis 49 (online edition), 2009.

Yin MT et al. Low bone mass and high bone turnover in postmenopausal HIV-infected women. J Clin Endocrinol Metab (advance online publication, January 2010) doi:10.1210/jc.2009-0708.

de Pommerol M et al. Menopause and HIV: age at onset and associated factors, ANRS CO3 Aquitaine Cohort. Fifth IAS Conference on HIV Pathogenesis, Treatment, and Prevention, Cape Town, abstract CDB009, 2009.

Gold E et al. Factors Associated with Age at Natural Menopause in a Multiethnic Sample of Midlife Women Am. J. Epidemiol. (2001) 153 (9): 865-874. doi: 10.1093/aje/153.9.865.

Childs K et al. Effects of vitamin D deficiency and combination antiretroviral therapy on bone in HIV-positive patients. AIDS 26: 253-62, 2012

Menopause, NHS Choices