title: Age at menopause and menopause-related symptoms in human immunodeficiency virus-infected Thai women.
abstract: OBJECTIVE
  There are limited data for age at menopause (AM) and menopause-related symptoms in human immunodeficiency virus (HIV)-infected Asian women. We investigated AM and menopause-related symptoms in HIV-infected Thai women.
  
  
  METHODS
  HIV-infected Thai women 40 years or older who did not receive any hormone therapy in the 8-week period preceding the study were enrolled. Participants completed the Menopause-Specific Quality of Life survey for their symptoms in the past 30 days. Menopause was defined as having the last menstrual period more than 1 year ago. Multivariate Cox proportional hazard regression analysis was used to identify factors associated with menopause.
  
  
  RESULTS
  Two hundred sixty-eight HIV-infected women were enrolled; their median age was 44.6 (41.8-48.7) years, and the ratio of their Centers for Disease Control and Prevention clinical classifications (A:B:C) was 53%:34%:13%; 95% were using highly active antiretroviral therapy. The median (interquartile range [IQR]) CD4 count was 575 (437-758) cells/μL, and 93% had HIV-RNA of less than 1.7log10 copies/mL. Among the 55 women who had reached menopause, the mean (SD) AM was 47.3 (5.1) years. The mean (SD) AM in our study was earlier than the previous report of 49.5 (3.6) years in non-HIV-infected Thai women (difference, -2.2 y; 95% CI, -3.2 to -1.2, P < 0.01). Postmenopausal women had more symptoms, including night sweats (P = 0.03), change in sexual desire (P = 0.01), and avoiding intimacy (P = 0.01), compared with nonpostmenopausal women. No differences in psychosocial or physical domains between groups were found. Factors associated with menopause were Centers for Disease Control and Prevention clinical classification B or C (hazard ratio, 1.7; 95% CI, 1.0-3.03, P = 0.04), and no sexual act in the past month (hazard ratio, 4.9; 95% CI, 1.5-16.0, P = 0.01). No associations of later age of menarche, parity, marital status, educational level, income, body mass index, CD4 count, and HIV-RNA with menopause were found.
  
  
  CONCLUSIONS
  AM in HIV-infected Thai women was 47.3 years, which is significantly earlier than the findings of a previous AM report on non-HIV-infected women. Postmenopausal HIV-infected women had more vasomotor and sexual symptoms. More studies are needed to investigate the cause and appropriate interventions for accelerated menopause in HIV-infected women.
authors.affiliation: Phramongkutklao Hospital of the Royal Thai Army, Bangkok, Thailand.
authors.forename: Pongrak
authors.initials: P
authors.lastname: Boonyanurak
authors.forename: Torsak
authors.initials: T
authors.lastname: Bunupuradah
authors.forename: Kittisak
authors.initials: K
authors.lastname: Wilawan
authors.forename: Aksorn
authors.initials: A
authors.lastname: Lueanyod
authors.forename: Parawee
authors.initials: P
authors.lastname: Thongpaeng
authors.forename: Duangjai
authors.initials: D
authors.lastname: Chatvong
authors.forename: Jiratchaya
authors.initials: J
authors.lastname: Sophonphan
authors.forename: Siriporn
authors.initials: S
authors.lastname: Saeloo
authors.forename: Jintanat
authors.initials: J
authors.lastname: Ananworanich
authors.forename: Surasith
authors.initials: S
authors.lastname: Chaithongwongwatthana
mesh_terms: D000328:Adult; D000367:Age Factors; D023241:Antiretroviral Therapy, Highly Active / Q000706:statistics & numerical data; D018791:CD4 Lymphocyte Count; D003430:Cross-Sectional Studies; D005260:Female; D006678:HIV; D015658:HIV Infections / Q000188:drug therapy / Q000503:physiopathology*; D006801:Humans; D006945:Hyperhidrosis / Q000503:physiopathology*; D008593:Menopause; D008875:Middle Aged; D016016:Proportional Hazards Models; D011788:Quality of Life; D012735:Sexual Dysfunction, Physiological / Q000503:physiopathology*; D012893:Sleep Wake Disorders / Q000503:physiopathology*; D011795:Surveys and Questionnaires; D013785:Thailand / Q000453:epidemiology; D016387:Women's Health