Attribution of menopause symptoms in human immunodeficiency virus-infected or at-risk drug-using women

Abstract

Objective-To examine the relationship of human immunodeficiency virus (HIV) and attribution of menopausal symptoms.Design-Peri-and postmenopausal women participating in a prospective study of HIV-infected and at-risk midlife women (the Ms. Study) were interviewed to determine whether they experienced hot flashes and/or vaginal dryness and to what they attributed these symptoms.Results-Of 278 women, 70% were perimenopausal; 54% were HIV-infected; and 52% had used crack, cocaine, heroin, and/or methadone within the past 5 years. Hot flashes were reported by 189 women and vaginal dryness was reported by 101 women. Overall, 69.8% attributed hot flashes to menopause and 28.7% attributed vaginal dryness to menopause. In bivariate analyses, age 45 years and older was associated with attributing hot flashes and vaginal dryness to menopause, and postmenopausal status and at least 12 years of education were associated with attributing vaginal dryness to menopause, but HIV status was not associated with attribution to menopause. In multivariate analysis, significant interactions between age and menopause status were found for both attribution of hot flashes (P = 0.019) and vaginal dryness (P = 0.029). Among perimenopausal women, older age was independently associated with attribution to menopause for hot flashes (adjusted odds ratio = 1.2, 95% CI: 1.1-1.4, P = 0.001) and vaginal dryness (adjusted odds ratio = 1.3, 95% CI: 1.1-1.6, P = 0.011). None of the tested factors were independently associated with attribution to menopause among postmenopausal women.Address correspondence to: Ellie E. Schoenbaum, MD, Belfer Building, Room 1312, 1300 Morris Park Avenue, Bronx, NY 10461. schoenba@aecom.yu.edu. Financial disclosure: None reported. HHS Public Access Author Manuscript Author ManuscriptAuthor Manuscript Author ManuscriptConclusion-Tailored health education programs may be beneficial in increasing the knowledge about menopause among HIV-infected and drug-using women, particularly those who are perimenopausal. KeywordsMenopause; HIV; Menopause symptoms; Attribution; Drug useAs the human immunodeficiency virus (HIV)/acquired immunodeficiency virus (AIDS) epidemic evolves, more women are becoming affected, and in 2005, an estimated 23% of the people living with AIDS in the United States were women, 1 compared with 10% in 1990. 2 As people with HIV are living longer and healthier lives, HIV infection is increasingly viewed as a chronic disease. As a result, many of these women will traverse menopause. Recent data suggest that an earlier onset of natural menopause may be associated with opioid use 3 and HIV. 3,4 However, information about menopause in this population is very limited.Menopause is associated with many symptoms including vasomotor symptoms, vaginal dryness, sleep disturbances, and psychological and cognitive problems. 5 However, hot flashes and vaginal dryness are the two symptoms most conclusively associated with a hypoestrogenic state. 6,7 Studies in middle class and educated women found that hot flashes ...

Increased hot flash severity and related interference in perimenopausal human immunodeficiency virus–infected women

“…Smoking and illicit substance use has been shown to influence the presence and/or severity of hot flashes in prior studies among non-HIV-infected women 30–32 . In a study among menopausal HIV-infected and non-HIV-infected drug using women, a higher prevalence of hot flashes was observed among the HIV-infected women 20 .…”

Age at menopause and menopause-related symptoms in human immunodeficiency virus–infected Thai women

“…Menopause was defined as having had the last menstrual period 1 year or more before enrollment in this study. 13 The results of CD4 count and HIV-RNA before HAART and history of HAART were extracted from medical records. Plasma HIV-1 RNA was determined using the CobasAmpliprep/TaqMan HIV-l Viral load assay (Roche Molecular Systems Inc., Branchburg, NJ).…”

“When You Get Old Like This … You Don't Run Those Risks Anymore”: Influence of Age on Sexual Risk Behaviors and Condom Use Attitudes Among Methamphetamine-Using Heterosexual Women with a History of Partner Violence

“…Physiological and immunological manifestations associated with the natural aging process may also heighten the risk for HIV in midlife/older women (Johnson et al, 2008; Minkin, 2010). During menopause, women experience reductions in reproductive hormone levels (e.g., estrogen, progesterone) that physically alter sex organs (e.g., vaginal dryness, reduced vaginal canal elasticity, thinning vaginal mucosa), increasing midlife/older women’s risk for vaginal tearing and abrasions during intercourse (Bachmann & Leiblum, 2004; Minkin, 2010).…”

“…Though the definition of midlife/older women varies in the scientific community, the current study uses 45 years as the age cut-off, the average age of perimenopause when immunologic and physiological changes arise (Johnson et al, 2008; Neundorfer et al, 2005). Utilizing emergent themes from qualitative data and review of the literature, we hypothesized that midlife/older MA-using women (ages 45+) with experiences of PV will show no difference in sexual risk behaviors when compared to younger women (ages 18–44).…”