Care of the human immunodeficiency virus–infected menopausal woman

Abstract

More women than ever before are both Human Immunodeficiency Virus-infected and menopausal, because of increased survival and more frequent diagnosis in older women. Such a woman has the combined burden of her infection, its treatment, comorbid conditions, and aging. Thus she is at risk for a variety of problems such as disorders of bone mineral density and deficiencies in cognitive functioning. In addition to this, she experiences menopause in a unique fashion, with more symptoms and perhaps at an earlier age. The clinician caring for her must take a proactive approach to this multitude of factors that may affect her health and well-being.

Primary Care of Women Aging with HIV

“…Women in the United States who are HIV‐infected have a number of risk factors for early menopause, including black race, lower body mass index, smoking, stress, less education, methadone use, illicit substance use (particularly opiates and cocaine), and use of psychotropic drugs . However, when compared to demographically similar uninfected women, those with HIV do not experience menopause at an earlier age .…”

“…Recent guidelines recommend against the use of hormone therapy (HT) for disease prevention among women with HIV, as is the case for the general population of women. There is evidence, however, that these women experience more, and more severe, menopausal symptoms than their uninfected counterparts, thus supporting the use of HT for symptom management …”

“…Hot flashes, and night sweats in particular, need to be differentiated from HIV‐associated conditions . Although a common experience for postmenopausal women, night sweats could also be a marker for tuberculosis or non‐Hodgkins lymphoma.…”

Primary Care of Women Aging with HIV (2014/116)

“…There is evidence, however, that these women experience more, and more severe, menopausal symptoms than their uninfected counterparts, thus supporting the use of HRT for symptom management. 4 Hot flashes, night sweats in particular, need to be differentiated from HIV-associated conditions. 4 While a common experience for postmenopausal women, night sweats could also be a marker for tuberculosis or non-Hodgkins lymphoma.…”

“…4 Hot flashes, night sweats in particular, need to be differentiated from HIV-associated conditions. 4 While a common experience for postmenopausal women, night sweats could also be a marker for tuberculosis or non-Hodgkins lymphoma. Evaluation should include a careful history for possible exposure to tuberculosis, and testing to rule out tuberculosis using a QuantiFERON test or the purified protein derivative (PPD) tuberculin skin test.…”