What is HIV?
Human Immuno-Deficiency Virus, (HIV) was first identified in the early 1980s after a number of individuals became ill with a variety of previously rare conditions. At the time, there were no treatments available and as the immune system weakened it led to a condition known as Acquired Immune Deficiency Syndrome, (AIDS).
Whilst there is still no cure for HIV, treatments have been developed to enable the individual’s immune system to cope with the virus and keep them well. As a result of the treatment individuals are living longer and life expectancy for an HIV+ person is around the same as for someone without the virus.
What effects does menopause have on HIV+ individuals?
Whilst the effects of menopause on HIV+ individuals are largely under-researched; it is believed HIV+ people are more likely to suffer symptoms and enter the menopausal phase earlier than those without HIV, the reason for this is unknown. Symptoms often include psychological; urinary; vaginal; etc.
Bone health is vulnerable in menopause raising the risk of Osteoporosis. HIV also increases the risk of Osteoporosis so maintaining bone health at this time is essential.
Similarly, cardiovascular health is at greater risk of damage with menopause, and this is exacerbated by HIV.
Does HIV medication impact menopause medication?
Someone with HIV may be on a complex, combination of powerful anti-viral therapy and will be on this medication for the rest of their lives. Unfortunately, the medication is known to interact with many other drugs so when peri/menopause occurs the individual may be reluctant to commence medication for fear it could disrupt their HIV treatment.
Hormonal Replacement Therapy, (HRT) is the recommended treatment for menopause, this is the same for individuals with HIV with or without therapy. It is more important for HIV+ individuals to consider commencing HRT as the benefit of cardiovascular and bone protection far outweighs any risks.
The British Menopause Society advise the use of transdermal methods as opposed to oral routes as this reduces the risk of blood clotting and gastrointestinal problems. There may be some interactions between HIV therapies and HRT, I.e., it is believed the anti-viral medications may reduce the efficacy of HRT so doses will need to be monitored closely and increased as required.
Unfortunately, many GPs may not have up-to-date knowledge around menopause and HRT and may be reluctant to prescribe it. Add in HIV and the GP may prefer the individual have more specialist input. Regardless, the prescribing of HRT alongside HIV medication should be with the support of the HIV Specialist thus ensuring the best outcome for the individual and minimising the possibility of drug mishaps.
HIV is a complex condition which requires specialist, individualised management. Similarly, peri/menopause treatment should be dictated by the individual’s needs. Combine the two conditions and it requires support and reassurance for the individual whilst ensuring adequate medicinal stability for both. Specialist knowledge should be sought, and guidelines followed, thus providing the HIV+ individual with a smoother, easier transition to their post-menopause life.
If you have access to myTamarin virtual support with your employer and would like to discuss any concerns around Menopause book a 1-1 appointment with a specialist at myTamarin via your company-specific landing page or app.
Anon, (2023) HIV and AIDS: An Origin Story. www.publichealth.org
Hayes, R. (2021) Menopause and HIV. www.aidsmap.com
King, E.M., et al, (2021) Menopausal Hormone Therapy for Women Living with HIV. www.thelancet.com
Anon, (2021) HIV and the Menopause. www.bms.org.uk