Table 2.
Summary of studies assessing age of menopause in women with HIV
| Authors | Study design | Location | Population | Menopause definition | Findings |
|---|---|---|---|---|---|
| Clark et al84 | Cross-sectional | USA | 52 HIV-positive women ≥40 years with adequate menopausal information; 50% postmenopausal | • FSH >35 mU/mL or | Mean age of menopause was 47 years (range 32–57 years) |
| • Self-report of amenorrhea >6 months with age ≥55 years or | |||||
| • Investigator’s diagnosis | |||||
| Schoenbaum et al81 | Cross-sectional | USA | 571 women 52.9% HIV-positive; 17.8% postmenopausal |
Self-report of amenorrhea >12 months | HIV independently associated with risk of menopause (OR 1.73) |
| Among those with HIV, having a CD4 count >500 (OR 0.191) or CD4 200–500 (OR 0.346) associated with decreased risk of menopause | |||||
| In HIV-positive women: | |||||
| • median age of menopause was 46 years (IQR 39–49 years) | |||||
| • 26% had early menopause | |||||
| In HIV-negative women: | |||||
| • median age of menopause was 47 years (IQR 44.5–48 years) | |||||
| • 10% had early menopause | |||||
| Boonyanurak et al82 | Cross-sectional | Thailand | 268 HIV-positive women ≥40 years of age; 20.5% women postmenopausal | Self-report of amenorrhea >12 months | Mean age of menopause was 47.3 years (SD 5.1 years); this was 2.2 years earlier than the mean age of menopause in general population in Thailand of 49.5 years (SD 3.1 years) |
| Calvet et al19 | Prospective cohortstudy Study followed premenopausal women enrolled between 1996 and 2010 |
Brazil | 667 HIV-positive women ≥30 years of age who were followed for a median of 5 years | Self-report of amenorrhea >12 months | Natural menopause occurred in 132/667 women during follow-up: |
| • median age of menopause was 48 years (IQR 45–50 years) | |||||
| • 27% had early menopause (<45 years) | |||||
| • 2.3% had premature menopause (<40 years) | |||||
| Early natural menopause associated with: | |||||
| • early menarche (HR 2.70) | |||||
| • smoking (HR 3.00) | |||||
| • HCV coinfection (HR 6.26) | |||||
| • CD4 count <50 (HR 6.64) | |||||
| Fantry et al13 | Cross-sectional | USA | 120 HIV-positive women ≥40 years of age; 25% postmenopausal | Self-report of amenorrhea >12 months | Median age of menopause was 50 years (95% CI 49–53 years) |
| • 20% had early menopause (40–45 years) | |||||
| • 35% had premature menopause (<40 years) | |||||
| Cejtin et al85 | Cross-sectional evaluation of data collected from the prospective Women’s Interagency Health Study (WIHS) | USA | 1,431 women ≤55 years of age • 1,139 HIV-positive • 292 HIV-negative |
Self-report of no menstrual period on 2 sequential visits with elevated FSH (>25 mIU/mL) | Median age of menopause was 47 years (range 35–55 years) (no difference between HIV-positive and HIV-negative women) |
| In HIV-positive women, no association of menopause with CD4 count, virologic suppression, AIDS-defining illness or ART | |||||
| Ferreira et al80 | Cross-sectional | Brazil | 96 HIV-positive and 155 HIV-negative women ≥40 years of age | Self-report of amenorrhea >12 months | Median age of menopause in HIV-positive women was 47.5 years |
| de Pommerol et al74 | Prospective cohort study | France | 404 HIV-positive women, followed for a median of 8.8 years; 24.3% postmenopausal | Self-report of amenorrhea >12 months | 24.3% were postmenopausal with median age of menopause of 49 years (IQR 40–50 years) |
| • 22% had early menopause (40–45 years) | |||||
| • 12% had premature menopause (<40 years) | |||||
| Earlier onset of menopause associated with: | |||||
| • African–American ethnicity (HR 8.16) | |||||
| • injection drug use (HR 2.46) | |||||
| No association with smoking, ART, nadir CD4, or AIDS-defining illness |
Abbreviations: HR, hazard ratio; OR, odds ratio; HCV, hepatitis C virus; ART, antiretroviral therapy; FSH, follicle-stimulating hormone; SD, standard deviation; CI, confidence interval; IQR, interquartile range.