Premature and early menopause among US women with or at risk for HIV

Abstract

Objective: Little is known about the prevalence and treatment of premature and early menopause among people with HIV. We described premature and early menopause and subsequent hormonal treatment in a longitudinal cohort of women living with or at risk for HIV in the US.Methods: Data from the Women's Interagency HIV Study between 2008 and 2020 were analyzed to describe premature and early menopause among cohort participants under the age of 51.Results: Of 3,059 eligible women during the study period, 1% (n ¼ 35) underwent premature menopause before age 41, 3% (n ¼ 101) underwent menopause between ages 41 and 46, and 21% (n ¼ 442) underwent menopause between ages 46 and 50, inclusive. Of participants who experienced menopause before age 41, between age 41 and 45, and between ages 46 and 50, 51%, 24%, and 7% (respectively) received either menopausal hormone therapy or hormonal contraception.Conclusion: These findings suggest that disparities in receipt of recommended hormone therapy for premature and early menopause may contribute, in part, to evident health disparities, such as cardiovascular disease, osteoporosis, and overall mortality. They also suggest a substantial need for education among people experiencing early menopause and their providers, with the goal of improving access to hormone therapy based on guidelines to address health disparities and minimize future health consequences.

Collection of menopause data in studies of women living with HIV: A systematic literature review

“…Three of these more detailed cohort descriptions were preferred for inclusion, and the articles through which they were found were subsequently excluded, as described in the methods section [4,38,39]. One was included along with the article through which it was retrieved because it reported details on MHT not mentioned in the cohort description [40]. One cohort description article was retrieved from the website for the cohort [41].…”

Age at menopause and risk of ischemic stroke: a systematic review and meta-analysis

“…Although the vast majority of women will follow the law of natural ovarian aging, there are still a few women who experience a decline in ovarian function decline or even failure before the age of 40. About 1% women underwent premature menopause before the age of 41, 3% women underwent menopause between the age of 41 and 46 [30] . Early menopause can affect all systems of women, but for the occurrence of diseases in different systems, the effects of different age at menopause are also different.…”

Cardiovascular disease risk in women living with HIV

“…Early reproductive aging was additionally correlated with residence in sub-Saharan Africa and Latin America, making this the first study to describe geographic disparities in reduced ovarian reserve. In high-resourced settings, WLWH have been shown to receive hormonal therapy for early menopause at inappropriately low rates, suggesting that this condition may be underrecognized and its subsequent risks undertreated regardless of world region [50].…”