Menopausal status, age and management among women living with HIV in the UK

Sabin, Caroline; Haag, Katharina; Sherr, Lorraine; Dhairyawan, Rageshri; Burns, Fiona; Gilson, Richard; Post, Frank A.; Ross, Jonathan; Mackie, Nicola; Sullivan, Ann; Shepherd, Jane; Tariq, Anjum; Jones, Rachael; Fox, Julie; Rosenvinge, Melanie; Tariq, Shema

doi:10.1111/hiv.13138

Cited by 7 publications

(11 citation statements)

References 32 publications

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“…We observed that many women living with HIV answered "don't know" to questions about menopause phase or timing, a finding that may reflect low health literacy of reproductive midlife changes and need for education in this area. Similarly, a low awareness of MHT, which has been previously described among women living with HIV, 16 may make women less inclined to bring up symptoms of menopause. Lack of care provider confidence in menopause management is also likely contributing to these low rates of discussion because a past study reported that 96% of primary care providers (85 of 88) surveyed in the United Kingdom had concerns about managing menopause in the context of HIV.…”

Section: Discussionmentioning

confidence: 94%

Brief Report: Undertreated Midlife Symptoms for Women Living With HIV Linked to Lack of Menopause Discussions With Care Providers

King

Kaida

Mayer

et al. 2022

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Section: Discussionmentioning

confidence: 94%

Brief Report: Undertreated Midlife Symptoms for Women Living With HIV Linked to Lack of Menopause Discussions With Care Providers

King

Kaida

Mayer

et al. 2022

JAIDS Journal of Acquired Immune Deficiency Syndromes

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“… 28 Among women with HIV, it has been reported that the prevalence of menopausal symptoms is high and includes hot flushes, pain, mood changes, fatigue and sleep disturbance. 8 , 9 , 29 – 31 With further evidence to suggest that the severity of vasomotor and psychological symptoms of menopause is greater in women living with HIV than those without. 32 , 33 Although we know that hormone replacement therapy (HRT) and topical vaginal oestrogens alleviate menopausal symptoms and improve women’s HR-QoL, 34 , 35 use of both treatment modalities remains low among women living with HIV, as has been previously reported in the PRIME study.…”

Section: Discussionmentioning

confidence: 99%

“…For each symptom, perceived severity was scored on a Likert-type scale from 0 ( symptoms not present ) to 4 ( very severe ). A composite score was calculated by summing the scores and was categorized as: no/few (0–4), mild , 5 – 8 moderate 9 – 16 and severe (⩾ 17) symptoms. 19 …”

Section: Methodsmentioning

confidence: 99%

Association between health-related quality of life and menopausal status and symptoms in women living with HIV aged 45–60 years in England: An analysis of the PRIME study

Dragomir¹,

Pool

Sabin

et al. 2022

Womens Health (Lond Engl)

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Objectives: The aim of this study was to compare the health-related quality of life between mid-life women with HIV and the general population and to investigate the association between health-related quality of life and menopausal (1) status and (2) symptoms among women with HIV. Methods: Cross-sectional data of women with HIV aged 45–60 years from the Positive Transitions Through the Menopause Study. Health-related quality of life was assessed using the Euroqol questionnaire with utility scores categorizing health as perfect (score = 1.00), sub-optimal (0.75–0.99) or poor (< 0.75). Scores were compared between Positive Transitions Through the Menopause study participants and women (aged 45–59 years) from the Health Survey for England. Associations between health-related quality of life and menopausal status/symptoms in Positive Transitions Through the Menopause participants were assessed using a multivariable two-part regression model, the results of which are combined to produce a single marginal effect. Results: In total, 813 women from the Positive Transitions Through the Menopause study were included (median age 49 (interquartile range: 47–53) years); the majority were of Black African ethnicity (72.2%). Overall, 20.9%, 43.7% and 35.3% of women were pre-, peri- and post-menopausal, respectively, and 69.7% experienced mild/moderate/severe menopausal symptoms. Approximately, 40% reported perfect health, 22.1% sub-optimal health and 39.0% poor health, similar to women from the Health Survey for England (perfect health: 36.9%, sub-optimal health: 25.2%, poor health: 37.9%). In multivariable models, we found an association between health-related quality of life and peri-menopausal status (marginal effect: 0.07 (0.02, 0.12)); however, the association with post-menopausal status was attenuated (marginal effect: 0.01 (–0.05, 0.06)). There remained a strong association between lower utility scores and moderate (marginal effect: 0.16 (0.11, 0.20)) and severe (marginal effect: 0.32 (0.27, 0.39)) menopausal symptoms. Conclusion: There were no differences in health-related quality of life between women with HIV (Positive Transitions Through the Menopause participants) and women from the Health Survey for England dataset. Among Positive Transitions Through the Menopause participants, health-related quality of life was reduced in peri-menopausal women and those with increasingly severe menopausal symptoms. Our findings highlight the importance of proactive assessment of menopausal status and symptoms to optimize health-related quality of life in women living with HIV as they reach mid-life and beyond.

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“…For each symptom, perceived severity was scored on a Likert scale from 0 (symptom not present) to 4 (very severe). A composite score was calculated by summing the scores and categorized as: no/few (0–4), mild [ 5 – 8 ], moderate [ 9 – 16 ] and severe symptoms (≥ 17) [ 19 ].…”

Section: Methodsmentioning

confidence: 99%

“…As greater numbers of women with HIV reach midlife, evidence has accrued to suggest a high prevalence of menopausal symptoms in this population [ 5 – 9 ], with these symptoms potentially being more severe than in the general population [ 10 , 11 ]. It is essential that women with HIV are aware of menopause and its associated symptoms [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

The Prevalence and Patterns of Menopausal Symptoms in Women Living with HIV

et al. 2022

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Increasing numbers of women with HIV are experiencing menopause. We use data from a large, representative sample of women with HIV to describe the prevalence and clustering of menopausal symptoms amongst pre-, peri- and post-menopausal women using hierarchical agglomerative cluster analysis. Of the 709 women included, 21.6%, 44.9% and 33.6% were pre-, peri- and post-menopausal, respectively. Joint pain (66.4%) was the most commonly reported symptom, followed by hot flashes (63.0%), exhaustion (61.6%) and sleep problems (61.4%). All symptoms were reported more commonly by peri- and post-menopausal women compared to pre-menopausal women. Psychological symptoms and sleep problems clustered together at all menopausal stages. Somatic and urogenital symptom clusters emerged more distinctly at peri- and post-menopause. We recommend regular and proactive assessment of menopausal symptoms in midlife women with HIV, with an awareness of how particular patterns of symptoms may evolve over the menopausal transition.

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Menopausal status, age and management among women living with HIV in the UK

Abstract: This is an open access article under the terms of the Creat ive Commo ns Attri bution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 7 publications

References 32 publications

Brief Report: Undertreated Midlife Symptoms for Women Living With HIV Linked to Lack of Menopause Discussions With Care Providers

Brief Report: Undertreated Midlife Symptoms for Women Living With HIV Linked to Lack of Menopause Discussions With Care Providers

Association between health-related quality of life and menopausal status and symptoms in women living with HIV aged 45–60 years in England: An analysis of the PRIME study

The Prevalence and Patterns of Menopausal Symptoms in Women Living with HIV

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