HIV and the menopause.
Dramatic improvement in the survival of the HIV population has occurred with the ascendance of highly active antiretroviral therapy (HAART). In the foreseeable future, HIV-infected women who acquired disease during the peak years of the epidemic are expected to survive to experience menopause and even years beyond. The HIV epidemic may be viewed as 'mature', as its earlier victims become part of the geriatric population. Research about the process of menopause in HIV-infected women and, conversely, about HIV infection in women undergoing menopause is currently limited. Existing research suggests that the process of menopause is affected by HIV infection, inasmuch as infected women appear to experience menopause at an earlier age, with greater symptomatology, and with different reproductive hormone profiles compared with HIV-uninfected women. HIV infection also appears to affect bone mineral density, cardiovascular disease and cognition, with some age-related interactions. Lifestyle and demographic factors have pervasive importance for both HIV infection and the menopause in women. This article reviews the current state of knowledge about the menopausal process in HIV-infected women, and the common conditions in postmenopausal women that are likely to be affected by HIV infection. Clinicians should appreciate the potential role of HIV infection in caring for menopause-aged women.
Fan
Maria D
MD
Professor and Director, Division of Reproductive Endocrinology and Infertilty, Department of Obstetrics, Gynaecology and Women's Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Mazer 314, Bronx, NY 10461, USA.
Maslow
Bat-Sheva
BS
Santoro
Nanette
N
Schoenbaum
Ellie
E
D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects; D015519:Bone Density; D002318:Cardiovascular Diseases / Q000139:chemically induced; D003071:Cognition; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology*; D006801:Humans; D008593:Menopause / Q000502:physiology* / Q000523:psychology; D008875:Middle Aged; D012307:Risk Factors