Substance use and menopausal symptoms among people with and without HIV in the US, 2008-2020

Andrea K. Knittel; Brooke W. Bullington; Andrew Edmonds; Lisa Rahangdale; Genevieve Neal-Perry; Catalina Ramirez; Deborah Konkle-Parker; Deborah L. Jones; Caitlin A. Moran; Elizabeth F. Topper; Helen Cejtin; Dominika Seidman; Seble G. Kasseye; Tracey E. Wilson; Anjali Sharma; Adaora A. Adimora

doi:10.1097/GME.0000000000002405

Substance use and menopausal symptoms among people with and without HIV in the US, 2008-2020

Andrea K. Knittel^*, Brooke W. Bullington, Andrew Edmonds, Lisa Rahangdale, Genevieve Neal-Perry, Catalina Ramirez, Deborah Konkle-Parker, Deborah L. Jones, Caitlin A. Moran, Elizabeth F. Topper, Helen Cejtin, Dominika Seidman, Seble G. Kasseye, Tracey E. Wilson, Anjali Sharma, Adaora A. Adimora

^*Corresponding author for this work

Obstetrics and Gynecology

Research output: Contribution to journal › Article › peer-review

Abstract

Objective The aim of the study is to assess associations between substance use and menopausal symptoms among US people living with and without HIV in a longitudinal cohort. Methods We analyzed self-reported menopausal symptoms and substance use from biannual Women's Interagency HIV Study (WIHS) visits from 2008-2020. Substance use since the last visit or lifetime cumulative use included tobacco, alcohol, marijuana, crack/cocaine, and opioids. Logistic regression quantified associations between each substance use and menopausal symptom frequency (vasomotor, mood, and musculoskeletal), adjusting for other substance use, HIV status, demographics, comorbidities, and trauma. Results A total of 1,949 participants contributed early perimenopausal, late perimenopausal, or postmenopausal study visits. Across reproductive-Aging stages, based on menstrual history, and among participants with and without HIV, participants reported frequent vasomotor (range 22-43%), mood (18-28%), and musculoskeletal (25-34%) symptoms. Many reported ever using tobacco (72%), heavy alcohol (75%), marijuana (73%), crack (50%), and opioids (31%). Current heavy alcohol use (odds ratio [OR]: 1.22; 95% confidence interval [CI]: 1.10-1.37), cumulative marijuana use (OR: 1.15, 95% CI: 1.01-1.32), and cumulative tobacco use (OR: 1.06, 95% CI: 1.01-1.12) were associated with a higher frequency of vasomotor symptoms; current heavy alcohol use (OR: 1.20, 95% CI: 1.04-1.39) and current opioid use (OR: 1.13; 95% CI: 1.01-1.25) were associated with mood symptoms; and current opioid use (OR: 1.11, 95% CI: 1.00-1.23) was associated with musculoskeletal symptoms. All other associations were found to be null. Conclusions Current and prior substance use may independently affect symptoms experienced during the menopausal transition and may indicate potential to benefit from additional intervention and referral to menopause specialty care.

Original language	English (US)
Pages (from-to)	911-920
Number of pages	10
Journal	Menopause
Volume	31
Issue number	10
DOIs	https://doi.org/10.1097/GME.0000000000002405
State	Published - Oct 1 2024

Funding

Financial disclosures/conflicts of interest: A.A.A. has received consulting fees from Merck and Gilead, and Merck and Gilead have provided her institution with funding for her research. A.S. receives funding from Gilead. S.G.K. has received funding from Integritas Communications and Vindico CME. G.N.P. receives ongoing institutional funding from the NICHD and AAMC, is on the scientific advisory board of Astellas, is the program chair for ASRM, is a CME speaker for Endocrine Society, and is a speaker for Prime. The other authors have nothing to disclose. D'Souza, Stephen Gange and Elizabeth Topper), U01-HL146193; Chicago-Cook County CRS (Mardge Cohen and Audrey French), U01-HL146245; Chicago-Northwestern CRS (Steven Wolinsky), U01-HL146240; Northern California CRS (Bradley Aouizerat, Jennifer Price, and Phyllis Tien), U01-HL146242; Los Angeles CRS (Roger Detels and Matthew Mimiaga), U01-HL146333; Metropolitan Washington CRS (Seble Kassaye and Daniel Merenstein), U01-HL146205; Miami CRS (Maria Alcaide, Margaret Fischl, and Deborah Jones), U01-HL146203; Pittsburgh CRS (Jeremy Martinson and Charles Rinaldo), U01-HL146208; UAB-MS CRS (Mirjam-Colette Kempf, Jodie Dionne-Odom, and Deborah Konkle-Parker), U01-HL146192; UNC CRS (Adaora Adimora and Michelle Floris-Moore), U01-HL146194. The MWCCS is funded primarily by the National Heart, Lung, and Blood Institute (NHLBI), with additional co-funding from the Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD), National Institute on Aging (NIA), National Institute of Dental & Craniofacial Research (NIDCR), National Institute of Allergy and Infectious Diseases (NIAID), National Institute of Neurological Disorders and Stroke (NINDS), National Institute of Mental Health (NIMH), National Institute on Drug Abuse (NIDA), National Institute of Nursing Research (NINR), National Cancer Institute (NCI), National Institute on Alcohol Abuse and Alcoholism (NIAAA), National Institute on Deafness and Other Communication Disorders (NIDCD), National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institute on Minority Health and Health Disparities (NIMHD), and in coordination and alignment with the research priorities of the National Institutes of Health, Office of AIDS Research (OAR). MWCCS data collection is also supported by UL1-TR000004 (UCSF CTSA), UL1-TR003098 (JHU ICTR), UL1-TR001881 (UCLA CTSI), P30-AI-050409 (Atlanta CFAR), P30-AI-073961 (Miami CFAR), P30-AI-050410 (UNC CFAR), P30-AI-027767 (UAB CFAR), P30-MH-116867 (Miami CHARM), UL1-TR001409 (DC CTSA), KL2-TR001432 (DC CTSA), and TL1-TR001431 (DC CTSA). Sources of funding: This project was supported by funds from the University of North Carolina at Chapel Hill School of Medicine (A.K.K., B.W.B.), the National Institute of Child Health and Human Development (NICHD) (A.K.K., K12HD103085, PI Neal-Perry; B.W.B., T32HD52468, and PI Julie Daniels), an infrastructure grant for population research (B.W.B., P2CHD050924, PI Elizabeth Frankenberg) to the Carolina Population Center at the University of North Carolina at Chapel Hill and the UNC site of MACS/WIHS Combined Cohort Study (MWCCS), which is primarily funded by the National Heart, Lung, and Blood Institute (NHLBI) (Bullington, U01-HL146194, PI Adimora). Data in this manuscript were collected by the WIHS, now the MACS/WIHS Combined Cohort Study (MWCCS). The contents of this publication are solely the responsibility of the authors and do not represent the official views of the National Institutes of Health (NIH). The MWCCS (principal investigators): Atlanta CRS (Ighovwerha Ofotokun, Anandi Sheth, and Gina Wingood), U01-HL146241; Baltimore CRS (Todd Brown and Joseph Margolick), U01-HL146201; Bronx CRS (Kathryn Anastos, David Hanna, and Anjali Sharma), U01-HL146204; Brooklyn CRS (Deborah Gustafson and Tracey Wilson), U01-HL146202; Data Analysis and Coordination Center (Gypsyamber D'Souza, Stephen Gange and Elizabeth Topper), U01-HL146193; Chicago-Cook County CRS (Mardge Cohen and Audrey French), U01-HL146245; Chicago-Northwestern CRS (Steven Wolinsky), U01-HL146240; Northern California CRS (Bradley Aouizerat, Jennifer Price, and Phyllis Tien), U01-HL146242; Los Angeles CRS (Roger Detels and Matthew Mimiaga), U01-HL146333; Metropolitan Washington CRS (Seble Kassaye and Daniel Merenstein), U01-HL146205; Miami CRS (Maria Alcaide, Margaret Fischl, and Deborah Jones), U01-HL146203; Pittsburgh CRS (Jeremy Martinson and Charles Rinaldo), U01-HL146208; UAB-MS CRS (Mirjam-Colette Kempf, Jodie Dionne-Odom, and Deborah Konkle-Parker), U01-HL146192; UNC CRS (Adaora Adimora and Michelle Floris-Moore), U01-HL146194. The MWCCS is funded primarily by the National Heart, Lung, and Blood Institute (NHLBI), with additional co-funding from the Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD), National Institute on Aging (NIA), National Institute of Dental & Craniofacial Research (NIDCR), National Institute of Allergy and Infectious Diseases (NIAID), National Institute of Neurological Disorders and Stroke (NINDS), National Institute of Mental Health (NIMH), National Institute on Drug Abuse (NIDA), National Institute of Nursing Research (NINR), National Cancer Institute (NCI), National Institute on Alcohol Abuse and Alcoholism (NIAAA), National Institute on Deafness and Other Communication Disorders (NIDCD), National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institute on Minority Health and Health Disparities (NIMHD), and in coordination and alignment with the research priorities of the National Institutes of Health, Office of AIDS Research (OAR). MWCCS data collection is also supported by UL1-TR000004 (UCSF CTSA), UL1-TR003098 (JHU ICTR), UL1-TR001881 (UCLA CTSI), P30-AI-050409 (Atlanta CFAR), P30-AI-073961 (Miami CFAR), P30-AI-050410 (UNC CFAR), P30-AI-027767 (UAB CFAR), P30-MH-116867 (Miami CHARM), UL1-TR001409 (DC CTSA), KL2-TR001432 (DC CTSA), and TL1-TR001431 (DC CTSA).

Keywords

Alcohol
Marijuana
Menopause
Opioids
Substance use
Tobacco
Vasomotor symptoms

ASJC Scopus subject areas

Obstetrics and Gynecology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1097/GME.0000000000002405

Cite this

Knittel, A. K., Bullington, B. W., Edmonds, A., Rahangdale, L., Neal-Perry, G., Ramirez, C., Konkle-Parker, D., Jones, D. L., Moran, C. A., Topper, E. F., Cejtin, H., Seidman, D., Kasseye, S. G., Wilson, T. E., Sharma, A., & Adimora, A. A. (2024). Substance use and menopausal symptoms among people with and without HIV in the US, 2008-2020. Menopause, 31(10), 911-920. https://doi.org/10.1097/GME.0000000000002405

@article{dd9d1ed8a2b24c9da45a16ac27ae2eb7,

title = "Substance use and menopausal symptoms among people with and without HIV in the US, 2008-2020",

abstract = "Objective The aim of the study is to assess associations between substance use and menopausal symptoms among US people living with and without HIV in a longitudinal cohort. Methods We analyzed self-reported menopausal symptoms and substance use from biannual Women's Interagency HIV Study (WIHS) visits from 2008-2020. Substance use since the last visit or lifetime cumulative use included tobacco, alcohol, marijuana, crack/cocaine, and opioids. Logistic regression quantified associations between each substance use and menopausal symptom frequency (vasomotor, mood, and musculoskeletal), adjusting for other substance use, HIV status, demographics, comorbidities, and trauma. Results A total of 1,949 participants contributed early perimenopausal, late perimenopausal, or postmenopausal study visits. Across reproductive-Aging stages, based on menstrual history, and among participants with and without HIV, participants reported frequent vasomotor (range 22-43%), mood (18-28%), and musculoskeletal (25-34%) symptoms. Many reported ever using tobacco (72%), heavy alcohol (75%), marijuana (73%), crack (50%), and opioids (31%). Current heavy alcohol use (odds ratio [OR]: 1.22; 95% confidence interval [CI]: 1.10-1.37), cumulative marijuana use (OR: 1.15, 95% CI: 1.01-1.32), and cumulative tobacco use (OR: 1.06, 95% CI: 1.01-1.12) were associated with a higher frequency of vasomotor symptoms; current heavy alcohol use (OR: 1.20, 95% CI: 1.04-1.39) and current opioid use (OR: 1.13; 95% CI: 1.01-1.25) were associated with mood symptoms; and current opioid use (OR: 1.11, 95% CI: 1.00-1.23) was associated with musculoskeletal symptoms. All other associations were found to be null. Conclusions Current and prior substance use may independently affect symptoms experienced during the menopausal transition and may indicate potential to benefit from additional intervention and referral to menopause specialty care.",

keywords = "Alcohol, Marijuana, Menopause, Opioids, Substance use, Tobacco, Vasomotor symptoms",

author = "Knittel, {Andrea K.} and Bullington, {Brooke W.} and Andrew Edmonds and Lisa Rahangdale and Genevieve Neal-Perry and Catalina Ramirez and Deborah Konkle-Parker and Jones, {Deborah L.} and Moran, {Caitlin A.} and Topper, {Elizabeth F.} and Helen Cejtin and Dominika Seidman and Kasseye, {Seble G.} and Wilson, {Tracey E.} and Anjali Sharma and Adimora, {Adaora A.}",

year = "2024",

month = oct,

day = "1",

doi = "10.1097/GME.0000000000002405",

language = "English (US)",

volume = "31",

pages = "911--920",

journal = "Menopause",

issn = "1072-3714",

publisher = "Wolters Kluwer Health",

number = "10",

}

Knittel, AK, Bullington, BW, Edmonds, A, Rahangdale, L, Neal-Perry, G, Ramirez, C, Konkle-Parker, D, Jones, DL, Moran, CA, Topper, EF, Cejtin, H, Seidman, D, Kasseye, SG, Wilson, TE, Sharma, A & Adimora, AA 2024, 'Substance use and menopausal symptoms among people with and without HIV in the US, 2008-2020', Menopause, vol. 31, no. 10, pp. 911-920. https://doi.org/10.1097/GME.0000000000002405

TY - JOUR

T1 - Substance use and menopausal symptoms among people with and without HIV in the US, 2008-2020

AU - Knittel, Andrea K.

AU - Bullington, Brooke W.

AU - Edmonds, Andrew

AU - Rahangdale, Lisa

AU - Neal-Perry, Genevieve

AU - Ramirez, Catalina

AU - Konkle-Parker, Deborah

AU - Jones, Deborah L.

AU - Moran, Caitlin A.

AU - Topper, Elizabeth F.

AU - Cejtin, Helen

AU - Seidman, Dominika

AU - Kasseye, Seble G.

AU - Wilson, Tracey E.

AU - Sharma, Anjali

AU - Adimora, Adaora A.

PY - 2024/10/1

Y1 - 2024/10/1

N2 - Objective The aim of the study is to assess associations between substance use and menopausal symptoms among US people living with and without HIV in a longitudinal cohort. Methods We analyzed self-reported menopausal symptoms and substance use from biannual Women's Interagency HIV Study (WIHS) visits from 2008-2020. Substance use since the last visit or lifetime cumulative use included tobacco, alcohol, marijuana, crack/cocaine, and opioids. Logistic regression quantified associations between each substance use and menopausal symptom frequency (vasomotor, mood, and musculoskeletal), adjusting for other substance use, HIV status, demographics, comorbidities, and trauma. Results A total of 1,949 participants contributed early perimenopausal, late perimenopausal, or postmenopausal study visits. Across reproductive-Aging stages, based on menstrual history, and among participants with and without HIV, participants reported frequent vasomotor (range 22-43%), mood (18-28%), and musculoskeletal (25-34%) symptoms. Many reported ever using tobacco (72%), heavy alcohol (75%), marijuana (73%), crack (50%), and opioids (31%). Current heavy alcohol use (odds ratio [OR]: 1.22; 95% confidence interval [CI]: 1.10-1.37), cumulative marijuana use (OR: 1.15, 95% CI: 1.01-1.32), and cumulative tobacco use (OR: 1.06, 95% CI: 1.01-1.12) were associated with a higher frequency of vasomotor symptoms; current heavy alcohol use (OR: 1.20, 95% CI: 1.04-1.39) and current opioid use (OR: 1.13; 95% CI: 1.01-1.25) were associated with mood symptoms; and current opioid use (OR: 1.11, 95% CI: 1.00-1.23) was associated with musculoskeletal symptoms. All other associations were found to be null. Conclusions Current and prior substance use may independently affect symptoms experienced during the menopausal transition and may indicate potential to benefit from additional intervention and referral to menopause specialty care.

AB - Objective The aim of the study is to assess associations between substance use and menopausal symptoms among US people living with and without HIV in a longitudinal cohort. Methods We analyzed self-reported menopausal symptoms and substance use from biannual Women's Interagency HIV Study (WIHS) visits from 2008-2020. Substance use since the last visit or lifetime cumulative use included tobacco, alcohol, marijuana, crack/cocaine, and opioids. Logistic regression quantified associations between each substance use and menopausal symptom frequency (vasomotor, mood, and musculoskeletal), adjusting for other substance use, HIV status, demographics, comorbidities, and trauma. Results A total of 1,949 participants contributed early perimenopausal, late perimenopausal, or postmenopausal study visits. Across reproductive-Aging stages, based on menstrual history, and among participants with and without HIV, participants reported frequent vasomotor (range 22-43%), mood (18-28%), and musculoskeletal (25-34%) symptoms. Many reported ever using tobacco (72%), heavy alcohol (75%), marijuana (73%), crack (50%), and opioids (31%). Current heavy alcohol use (odds ratio [OR]: 1.22; 95% confidence interval [CI]: 1.10-1.37), cumulative marijuana use (OR: 1.15, 95% CI: 1.01-1.32), and cumulative tobacco use (OR: 1.06, 95% CI: 1.01-1.12) were associated with a higher frequency of vasomotor symptoms; current heavy alcohol use (OR: 1.20, 95% CI: 1.04-1.39) and current opioid use (OR: 1.13; 95% CI: 1.01-1.25) were associated with mood symptoms; and current opioid use (OR: 1.11, 95% CI: 1.00-1.23) was associated with musculoskeletal symptoms. All other associations were found to be null. Conclusions Current and prior substance use may independently affect symptoms experienced during the menopausal transition and may indicate potential to benefit from additional intervention and referral to menopause specialty care.

KW - Alcohol

KW - Marijuana

KW - Menopause

KW - Opioids

KW - Substance use

KW - Tobacco

KW - Vasomotor symptoms

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SN - 1072-3714

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Substance use and menopausal symptoms among people with and without HIV in the US, 2008-2020

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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