Associations of Early Prolonged Secondary Amenorrhea in Women With and Without HIV.

amenorrhea human immunodeficiency virus hypothalamic adaptive menstrual cycle disturbances women

Journal

Open forum infectious diseases
ISSN: 2328-8957
Titre abrégé: Open Forum Infect Dis
Pays: United States
ID NLM: 101637045

Informations de publication

Date de publication:
Sep 2024
Historique:
received: 08 05 2024
accepted: 22 08 2024
medline: 20 9 2024
pubmed: 20 9 2024
entrez: 20 9 2024
Statut: epublish

Résumé

The menstrual cycle is a critical indicator of women's health. Early prolonged secondary amenorrhea increases risks for morbidity and mortality. Menstrual cycle research in women with HIV is inconsistent and often lacks an adequate comparison sample. We aimed to determine whether women with HIV have a higher lifetime prevalence of amenorrhea and whether this is independently associated with HIV and/or other biopsychosocial variables. With data from 2 established HIV cohorts, participants assigned female at birth were eligible if aged ≥16 years, not pregnant/lactating, and without anorexia/bulimia nervosa history. Amenorrhea was defined by self-reported history of (1) no menstrual flow for ≥12 months postmenarche not due to pregnancy/lactation, medications, or surgery or (2) early menopause or premature ovarian insufficiency. Multivariable logistic regression models explored biopsychosocial covariates of amenorrhea. Overall, 317 women with HIV (median age, 47.5 years [IQR, 39.2-56.4]) and 420 women without HIV (46.2 [32.6-57.2]) were included. Lifetime amenorrhea was significantly more prevalent among women with HIV than women without HIV (24.0% vs 13.3%). In the multivariable analysis, independent covariates of amenorrhea included HIV (adjusted odds ratio, 1.70 [95% CI, 1.10-2.64]), older age (1.01 [1.00-1.04]), White ethnicity (1.92 [1.24-3.03]), substance use history (6.41 [3.75-11.1]), and current food insecurity (2.03 [1.13-3.61]). Nearly one-quarter of women with HIV have experienced amenorrhea, and this is associated with modifiable risk factors, including substance use and food insecurity. Care providers should regularly assess women's menstrual health and advocate for actionable sociostructural change to mitigate risks.

Sections du résumé

Background UNASSIGNED
The menstrual cycle is a critical indicator of women's health. Early prolonged secondary amenorrhea increases risks for morbidity and mortality. Menstrual cycle research in women with HIV is inconsistent and often lacks an adequate comparison sample. We aimed to determine whether women with HIV have a higher lifetime prevalence of amenorrhea and whether this is independently associated with HIV and/or other biopsychosocial variables.
Methods UNASSIGNED
With data from 2 established HIV cohorts, participants assigned female at birth were eligible if aged ≥16 years, not pregnant/lactating, and without anorexia/bulimia nervosa history. Amenorrhea was defined by self-reported history of (1) no menstrual flow for ≥12 months postmenarche not due to pregnancy/lactation, medications, or surgery or (2) early menopause or premature ovarian insufficiency. Multivariable logistic regression models explored biopsychosocial covariates of amenorrhea.
Results UNASSIGNED
Overall, 317 women with HIV (median age, 47.5 years [IQR, 39.2-56.4]) and 420 women without HIV (46.2 [32.6-57.2]) were included. Lifetime amenorrhea was significantly more prevalent among women with HIV than women without HIV (24.0% vs 13.3%). In the multivariable analysis, independent covariates of amenorrhea included HIV (adjusted odds ratio, 1.70 [95% CI, 1.10-2.64]), older age (1.01 [1.00-1.04]), White ethnicity (1.92 [1.24-3.03]), substance use history (6.41 [3.75-11.1]), and current food insecurity (2.03 [1.13-3.61]).
Conclusions UNASSIGNED
Nearly one-quarter of women with HIV have experienced amenorrhea, and this is associated with modifiable risk factors, including substance use and food insecurity. Care providers should regularly assess women's menstrual health and advocate for actionable sociostructural change to mitigate risks.

Identifiants

DOI: 10.1093/ofid/ofae493 PMID: 39301109 PMC: PMC11412246
pubmed: 39301109
doi: 10.1093/ofid/ofae493
pii: ofae493
pmc: PMC11412246
doi:

Types de publication

Journal Article

Langues

eng

Pagination

ofae493

Informations de copyright

© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America.

Déclaration de conflit d'intérêts

Potential conflicts of interest. All authors: No reported conflicts.

Auteurs

Shayda A Swann (SA)

Experimental Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Women's Health Research Institute, BC Women's Hospital, Vancouver, British Columbia, Canada.
Edwin S. H. Leong Healthy Aging Program, University of British Columbia, Vancouver, British Columbia, Canada.
ORCID: 0000-0001-7507-3747

Elizabeth M King (EM)

Women's Health Research Institute, BC Women's Hospital, Vancouver, British Columbia, Canada.
Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada.
Oak Tree Clinic, BC Women's Hospital and Health Centre, Vancouver, British Columbia, Canada.

Davi Pang (D)

Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada.

Marcela A P Silva (MAP)

Women's Health Research Institute, BC Women's Hospital, Vancouver, British Columbia, Canada.
Oak Tree Clinic, BC Women's Hospital and Health Centre, Vancouver, British Columbia, Canada.

Amber R Campbell (AR)

Women's Health Research Institute, BC Women's Hospital, Vancouver, British Columbia, Canada.
Oak Tree Clinic, BC Women's Hospital and Health Centre, Vancouver, British Columbia, Canada.
ORCID: 0000-0002-3068-7849

Jerilynn C Prior (JC)

Women's Health Research Institute, BC Women's Hospital, Vancouver, British Columbia, Canada.
Centre for Menstrual Cycle and Ovulation Research, Division of Endocrinology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.
ORCID: 0000-0003-3232-0597

Mona Loutfy (M)

Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.
ORCID: 0000-0001-7887-8997

Angela Kaida (A)

Women's Health Research Institute, BC Women's Hospital, Vancouver, British Columbia, Canada.
Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada.
ORCID: 0000-0003-0329-1926

Hélène C F Côté (HCF)

Experimental Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Women's Health Research Institute, BC Women's Hospital, Vancouver, British Columbia, Canada.
Edwin S. H. Leong Healthy Aging Program, University of British Columbia, Vancouver, British Columbia, Canada.
Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Centre for Blood Research, University of British Columbia, Vancouver, British Columbia, Canada.
ORCID: 0000-0002-0535-8576

Melanie C M Murray (MCM)

Experimental Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Women's Health Research Institute, BC Women's Hospital, Vancouver, British Columbia, Canada.
Edwin S. H. Leong Healthy Aging Program, University of British Columbia, Vancouver, British Columbia, Canada.
Oak Tree Clinic, BC Women's Hospital and Health Centre, Vancouver, British Columbia, Canada.
Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
ORCID: 0000-0001-9538-2758

Classifications MeSH