Nine in ten women living with HIV aged 45 to 60 have hot flushes and other somatic symptoms of the menopause, but often have difficulties getting advice and care to manage them, according to an English study released today. Only 8% of women with these symptoms were currently using menopausal hormone therapy (MHT).
Thanks to effective HIV treatment, increasing numbers of women with HIV are reaching the years when women usually go through the menopause. It is a natural part of ageing that usually happens between the ages of 45 and 55. Periods usually become less frequent over a few months or years, before they stop altogether. The menopause is a gradual process and is linked to a range of symptoms that can affect women’s quality of life, work and relationships.
There are now over 10,000 women living with HIV aged 45-56 in the UK – five times the number a decade earlier.
However, there are very few data on the menopause in women living with HIV. Dr Shema Tariq of University College London and colleagues designed the PRIME Study (Positive Transitions Through the Menopause) to address gaps in our knowledge. The study combined quantitative and qualitative methods – a questionnaire survey of women attending HIV clinics across England, a survey of 88 GPs, in-depth interviews with 20 women and three focus group discussions with a total of 24 women. PRIME is one of the largest studies of the menopause in women living with HIV ever conducted.
The main questionnaire survey of women aged 45 to 60 years recruited 869 participants, 81% of those who were approached. Just under half the participants were university educated and two-thirds were employed, full or part time. In terms of ethnicity, 72% were black African, 8% white British and 19% mixed or other.
While 98% were taking antiretroviral therapy, 12% had a detectable viral load and 7% a CD4 cell count below 200 cells/mm3.
The median age of participants was 49 years. The sample included 21% of women who were pre-menopausal (regular periods), 44% who were peri-menopausal (irregular periods within the last two years) and 35% post-menopausal (no periods for at least a year).