Thanks to effective treatment, many women with HIV can expect to have a near-normal lifespan. That means most women will go through the menopause, which is the ending of your menstrual cycle (periods).
In the general population, women of African ethnicity and women who have injected drugs are likely to have an earlier menopause than other women. There is also some evidence that HIV positive women may start the menopause a few years earlier than women without HIV, especially women with a low CD4 count. If you have some bleeding after the menopause, you should tell your doctor as this could be a symptom of another health problem. Hormone replacement therapy (HRT) can be prescribed to prevent or lessen some symptoms of menopause, or to treat the early onset of menopause. HRT is generally not used as a long-term treatment because it may increase the risk of developing other conditions such as breast cancer. HRT can be taken with HIV treatment; ask your doctor if there are any interactions between HRT and the anti-HIV drugs you are on. HIV clinics don’t provide HRT, so you will need to have it prescribed by your GP or another doctor. Everyone loses bone density as they get older, but this process speeds up in women who have gone through the menopause because they have lower levels of the hormone oestrogen. HIV infection and antiretroviral treatment can also both cause bone loss, which can lead to osteoporosis. Eating well and exercise can both reduce the risk of developing osteoporosis and help deal with bone loss if it occurs.
Calcium and vitamin D are essential to bone formation, so you should try to get plenty of both. Many foods are rich in calcium, including milk and other dairy products, leafy green vegetables such as kale and broccoli, beans such as soy and baked beans, nuts, sesame seeds and many types of fish, such as salmon and sardines. You get most of your vitamin D from sunlight on your skin but it is also found in oily fish and eggs, as well as in foods that are specially fortified, such as some breakfast cereals. There is no clear evidence that vitamin D supplements help reduce the risk of bone loss in people with HIV. Resistance, or weight-bearing, exercise can reduce the risk of osteoporosis, and help once it is diagnosed by encouraging new bone to grow. In the past, there was some concern that older women may not respond as well to HIV treatment. However, it is now known that treatment works just as well in women who have gone through the menopause as it does in younger women. If you have questions about symptoms of the menopause, or possible interactions between treatments, talk to your healthcare team. You could also ask about attending a menopause clinic.
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This article was last reviewed on
Date due for the next review: 31/10/2014
Content Author: S. Corkery, NAM
Current Owner: S. Corkery, NAM
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