British Menopause Society Tools for Clinicians: HIV and the menopause

Clinical considerations for menopause and associated symptoms in women with HIV

“…Recommendations for WWH from the British Menopause Society endorse baseline assessment of menstrual cycles with annual review and concurrent assessment of menopause symptoms in WWH aged older than 45 years (or postmenopausal). 3 Similarly, the Association of Medical Microbiology and Infectious Disease of Canada recommends routine screening of menstrual cycles in WWH beginning at age 40. 4 Both groups support counseling and education on the menopause transition for WWH.…”

“…In addition to the approved indications and recommendations for the use of HT in women without HIV, summaries of general principles and perspectives on the use of HT and nonhormone and nonpharmaceutical treatments in WWH have been outlined. 3,4 Mood symptoms are observed during the menopause transition. Of concern, many premenopausal WWH experience depression and anxiety that can potentially worsen during menopause.…”

“…For reasons including provider and patient uncertainty, few WWH are prescribed HT. In addition to the approved indications and recommendations for the use of HT in women without HIV, summaries of general principles and perspectives on the use of HT and nonhormone and nonpharmaceutical treatments in WWH have been outlined 3,4 …”

“…The British Medical Society recommendations support screening for mental health symptoms as part of routine consultations in WWH approaching or experiencing menopause 3 . Assessment of new, persistent, or elevated affective symptoms, specifically depression or anxiety, is essential, and initiating or adjusting current psychological health treatment regimens may help reduce adverse downstream consequences that may affect well-being.…”

“…Although trends of new infection rates remained relatively stable between 2015 and 2019 in women across most age groups, rates were up 7% in women aged 55 years and older 2 . In other regions, including the United Kingdom and Canada, similar numbers of women are living with HIV or newly diagnosed with HIV at age 50 years or older have been reported 3,4 . The growing population of older women with HIV (WWH), coupled with the upward trend of midlife women newly diagnosed with HIV, has resulted in increasing numbers of WWH entering menopause.…”