Prolonged amenorrhea and resumption of menses in women with HIV

Helen E. Cejtin*, Charlesnika T. Evans, Ruth Greenblatt, Howard Minkoff, Kathleen M. Weber, Rodney Wright, Christine Colie, Elizabeth Golub, L. Stewart Massad

*Corresponding author for this work

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

Objective: To compare etiologies of prolonged amenorrhea in a cohort of HIV-infected women with a cohort of similar uninfected at-risk women. Materials and Methods: Women from the Women's Interagency HIV Study were seen every 6 months, and completed surveys including questions about their menstruation. Those who reported no vaginal bleeding for at least 1 year ("prolonged amenorrhea") with subsequent resumption of bleeding were compared with women in whom bleeding had stopped permanently ("menopause"). Characteristics associated with reversible prolonged amenorrhea were ascertained. Results: Of 828 women with prolonged amenorrhea, 37.6% had reversible amenorrhea and 62.4% never resumed menses. HIV-seropositive women with prolonged amenorrhea were significantly younger at cessation of menses than HIV-negative women (p < 0.0001). Of those with reversible prolonged amenorrhea, approximately half were taking medications associated with amenorrhea, including 95 (30.6%) hormonal contraception, 80 (25.7%) opiates/stimulants, 16 (5.1%) psychotropic medications, and 6 (1.9%) chemotherapy. HIV-seropositive women were less likely to have medications as a cause of amenorrhea than seronegative women (p = 0.02). In multivariable analysis, women with reversible prolonged amenorrhea of unknown etiology were younger (p < 0.0001), more often obese (p = 0.03), and less educated (p = 0.01) than those with permanent amenorrhea. Among HIV-seropositive women, markers of severe immunosuppression were not associated with prolonged amenorrhea. Conclusion: Women with HIV infection have unexplained prolonged amenorrhea more often than at-risk seronegative women. This is especially common among obese, less-educated women. Prolonged amenorrhea in the HIV-seropositive women should be evaluated and not be presumed to be to the result of menopause.

Original languageEnglish (US)
Pages (from-to)1441-1448
Number of pages8
JournalJournal of Women's Health
Volume27
Issue number12
DOIs
StatePublished - Dec 2018

Keywords

  • HIV
  • amenorrhea
  • anovulation
  • menopause

ASJC Scopus subject areas

  • Medicine(all)

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    Cejtin, H. E., Evans, C. T., Greenblatt, R., Minkoff, H., Weber, K. M., Wright, R., Colie, C., Golub, E., & Massad, L. S. (2018). Prolonged amenorrhea and resumption of menses in women with HIV. Journal of Women's Health, 27(12), 1441-1448. https://doi.org/10.1089/jwh.2018.7046