Menopause

Menopause, or cessation of menstruation, is a natural process that usually occurs between ages 38 and 58 years, after gradual changes. It’s caused as the ovaries slowly stop producing the sex hormone estrogen.

Menopause, or cessation of menstruation, is a natural process that usually occurs between ages 38 and 58 years, after gradual changes. It’s caused as the ovaries slowly stop producing the sex hormone estrogen.

Menopause is defined as the lack of menstruation for 12 months; however the presence of HIV can lead to irregularities in menstruation including, in a small number of women, the cessation for 12 months when the ovaries are fully functional.

Since treatments, as more women with HIV reach menopause, research suggests that their experience does not differ much from that of uninfected women.

Some studies have shown that women with HIV undergo menopause at an earlier age, but it is unclear if this is due to HIV or other lifestyle factors. Women with HIV more commonly have irregularities in their menstrual cycle that may be mistaken for menopause.

Common symptoms of menopause include:

• Hot flushes and night sweats.
• Insomnia.
• Vaginal dryness and thinning of the vaginal wall.
• Reduced libido.
• Tiredness and fatigue.
• Mood changes.

It remains unclear whether HIV-infected women experience more severe or more frequent symptoms, possibly because they tend to associate their symptoms with health problems related to HIV rather than menopause.

The loss of estrogen with the start of menopause is associated with decreases in bone mineral density leading to conditions such as osteoporosis. Women living with HIV who are approaching menopause have an increased prevalence of these bone changes. Your risk of cardiovascular disease also goes up with menopause.

What you can do to live well:

• If you are experiencing sleeping problems, keeping the windows open, wearing breathable fabrics to bed and drinking plenty of water (as well as keeping water by the bed) can help.
• If you are tired or fatigued, a regular exercise program may make you feel more energetic. Try preparing food for when you are too tired to cook.
• Hot flushes can be relieved by taking vitamin E. Foods like tofu and soy milk are often suggested because they contain things similar to estrogen.
• Practice slow deep breathing whenever a hot flush starts.
• Avoid caffeine, excess alcohol and spicy foods
• The steps you can take to reduce your risks associated with bone changes.
• Talk with your doctor about hormone replacement therapy (HRT) as an option for short term treatment of menopausal symptoms. This can also be an option to address your increased risk of osteoporosis. The decision to go on HRT may be more complex for HIV-positive women so discuss this with your doctor.
• The steps you can take to reduce your risks associated with cardiovascular disease, such as stopping smoking, increasing your fitness and include weight-bearing exercise in your program, and adopting a heart-healthy diet.
• Consider an acupuncturist
• Perform pelvic floor exercises daily to strengthen the muscles of your vagina and pelvis.
• Use water-based lubricants during sex
• Talk to other positive women about their experiences and useful strategies.