title: Effects of HIV infection and its treatment on self-reported menstrual abnormalities in women.
abstract: OBJECTIVE
  To describe menstrual abnormalities among women with HIV.
  
  
  METHODS
  Women in a multicenter prospective cohort study of HIV natural history reported menstrual abnormalities every 6-months between October 1994 and September 2002. Logistic regression and Cox proportional-hazards models were applied.
  
  
  RESULTS
  The prevalence and incidence of menstrual abnormalities were <20%. HIV serostatus was not associated with prevalent menstrual abnormalities, but in HIV-seropositive women, higher CD4 counts were associated with fewer problems: compared with women with CD4 counts <200/mm3, in women with counts 200-500/mm3, odds ratio (OR) for amenorrhea was 0.55, p = 0.02, and for oligomenorrhea was 0.54, p = 0.0003; for women with counts >500/mm3, OR for amenorrhea was 0.67, p = 0.14, and for oligomenorrhea was 0.55, p = 0.001. HIV serostatus was not associated with incident abnormalities. Highly active anti-retroviral therapy (HAART) use was not associated with prevalent abnormalities, but both HAART use and higher CD4 counts were linked to lower rates of incident menstrual problems.
  
  
  CONCLUSIONS
  Compared with seronegative women, HIV-seropositive women are at increased risk for some menstrual changes, although the absolute frequency of most abnormalities is low. Higher CD4 counts and HAART protect against incident abnormalities.
authors.affiliation: Southern Illinois University School of Medicine, Springfield, Illinois 62794-9640, USA. LSMASSAD@ameritech.net
authors.forename: L Stewart
authors.initials: LS
authors.lastname: Massad
authors.forename: Charlesnika T
authors.initials: CT
authors.lastname: Evans
authors.forename: Howard
authors.initials: H
authors.lastname: Minkoff
authors.forename: D Heather
authors.initials: DH
authors.lastname: Watts
authors.forename: Ruth M
authors.initials: RM
authors.lastname: Greenblatt
authors.forename: Alexandra M
authors.initials: AM
authors.lastname: Levine
authors.forename: Kathryn
authors.initials: K
authors.lastname: Anastos
authors.forename: Mary
authors.initials: M
authors.lastname: Young
authors.forename: David B
authors.initials: DB
authors.lastname: Seifer
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Golub
authors.forename: Mardge
authors.initials: M
authors.lastname: Cohen
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D015897:Comorbidity; D016001:Confidence Intervals; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology*; D018023:HIV Seronegativity; D006679:HIV Seropositivity / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008599:Menstruation Disturbances / Q000453:epidemiology*; D015337:Multicenter Studies as Topic; D016017:Odds Ratio; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D016387:Women's Health