title: Substance use and psychotherapeutic medications: a likely contributor to menstrual disorders in women who are seropositive for human immunodeficiency virus.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the impact of substance use and psychotherapeutic medications on menstrual characteristics in women who are human immunodeficiency virus seropositive and seronegative.
  
  
  METHODS
  Menstrual calendars were prospectively collected for 1075 women who were human immunodeficiency virus seropositive and seronegative and who were enrolled in the Women's Interagency Human Immunodeficiency Virus Study or the Human Immunodeficiency Virus Epidemiology Research Study; several of the women were substance users or recipients of psychotherapeutic medications.
  
  
  RESULTS
  Women who received methadone maintenance and who used injection drugs had substantially increased odds of a cycle of >or=90 days (odds ratio, 2.28; 95% CI, 1.23-4.22; and odds ratio, 3.87; 95% CI, 2.16-6.95, respectively). The use of psychotherapeutic medications increased the odds of having very short cycles, <18 days, and cycles of >or=90 days (odds ratio, 1.69; 95% CI, 1.16-2.45; and odds ratio, 1.86; 95% CI, 1.03-3.36, respectively).
  
  
  CONCLUSIONS
  Clinicians should evaluate substance use, participation in methadone maintenance programs, and the use of psychotherapeutic medications and consider the neuroendocrinologic effects of these medications as a potential cause of menstrual disruptions.
authors.affiliation: Department of Epidemiology, University of Michigan, Ann Arbor, USA.
authors.forename: Siobán D
authors.initials: SD
authors.lastname: Harlow
authors.forename: Mardge
authors.initials: M
authors.lastname: Cohen
authors.forename: Suzanne E
authors.initials: SE
authors.lastname: Ohmit
authors.forename: Paula
authors.initials: P
authors.lastname: Schuman
authors.forename: Susan
authors.initials: S
authors.lastname: Cu-Uvin
authors.forename: Xihong
authors.initials: X
authors.lastname: Lin
authors.forename: Ruth
authors.initials: R
authors.lastname: Greenblatt
authors.forename: Alejandra
authors.initials: A
authors.lastname: Gurtman
authors.forename: Ann
authors.initials: A
authors.lastname: Khalsa
authors.forename: Howard
authors.initials: H
authors.lastname: Minkoff
authors.forename: Mary A
authors.initials: MA
authors.lastname: Young
authors.forename: Robert S
authors.initials: RS
authors.lastname: Klein
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D018023:HIV Seronegativity; D006679:HIV Seropositivity / Q000150:complications*; D006801:Humans; D008599:Menstruation Disturbances / Q000209:etiology* / Q000503:physiopathology; D008691:Methadone / Q000627:therapeutic use; D008875:Middle Aged; D009294:Narcotics / Q000627:therapeutic use; D016017:Odds Ratio; D011446:Prospective Studies; D011619:Psychotropic Drugs / Q000009:adverse effects*; D015819:Substance Abuse, Intravenous / Q000150:complications / Q000188:drug therapy; D019966:Substance-Related Disorders / Q000150:complications* / Q000188:drug therapy; D013997:Time Factors
chemical_list: D009294:Narcotics; D011619:Psychotropic Drugs; D008691:Methadone