Important note: Information in this article was accurate in June 2000. The state of the art may have changed since the publication date.
Reports in the early 1990s suggested that abnormal menstrual cycles may occur in women with HIV infection. Later studies found no connection between the two however. To find out if HIV does cause menstrual disturbances, researchers in the United States conducted a study involving more than 1,000 women. In general, the researchers found that HIV infection had "little overall effect" on the menstrual cycle. They did, however, mention several other factors which could have an impact on the menstrual cycle in HIV-positive women. These factors are listed later in this article.
For the purposes of comparaison, the researchers studied data from 802 HIV-positive women and 273 HIV-negative women. In this article we focus on data from the HIV-positive women. The average age of the subjects was 36. Half the subjects had a CD4+ count that ranged between 200 and 500 cells; 25% had a count below 200 cells and the remaining 25% had a count that was greater than 500 cells. Fifty per cent of the women were taking anti-HIV therapy. Subjects were given diaries to record details about their menstrual cycles and were also interviewed regularly by researchers.
According to the researchers, being HIV-positive "appears to have little effect [on the length of the menstrual cycle], at least until immunodeficiency is advanced." Indeed, 50% of women who had fewer than 200 CD4+ cells were likely to have lengthy menstrual cycles. Overall, women with viral loads grater than 168,000 copies were likely to have either very short menstrual cycles or very long ones.
Other researchers have found that the following factors can cause menstrual dysfunction:
The researchers did not provide details but did note that menstrual cycles may grow longer in women using anti-HIV therapy. Indeed, data from another study on the side effects of protease inhibitors suggests that some women using the combination of ritonavir and saquinavir may experience changes in their menstrual cycle. This is not surprising as some protease inhibitors appear to raise levels of the hormone prolactin in the blood. In non-HIV-positive women, high levels of prolactin can cause abnormalities in the menstrual cycle. There may also be other reasons that anti-HIV drugs cause changes to the menstrual cycle.
1. Harlow SD, Schuman P, Cohen M, et al. Effect of HIV on menstrual cycle length.Journal of Acquired Immune Deficiency Syndrome 2000;24(1):68-75.
2. Bonfanti P, Valsecchi L, Parazzini F, et al. Incidence of adverse drug reactions in HIV patients treated with protease inhibitors: a cohort study. Journal of Acquired Immunodeficiency Syndromes 2000;23(3):236-245.
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