There is a possible association of HIV infection with menstrual disorders, abnormal uterine bleeding, and sexually transmitted diseases.

All of the causes for the irregularity in menstrual bleeding found in HIV+ women are not yet known. Scientists have started to look at this curious phenomenon. For example, low platelets could lead to heavier than normal bleeding. Other systemic illnesses, wasting, and stresses could initiate scanty periods or no periods at all. In some patients opiate use may have a similar effect. Some infections associated with HIV could possibly result in premature ovarian failure in HIV+ women.

Several small studies to date report menstrual bleeding abnormalities in about one-third of HIV+ women.

Researchers reported amenorrhea (amenorrhea means "no period") in 28% of 138 Ugandan women with Kaposi's sarcoma. Others found a slight increase in menstrual flow in 47 HIV+ women in London. Yet, another group of scientists reported that 34% of 73 HIV+ women had menstrual disorders equally distributed between amenorrhea and excess bleeding. Researchers found no correlation between CD4+ counts and menstrual disorders in 124 HIV+ women. Thirty-two percent of these women reported changes in menstrual bleeding over the previous 6 months, and 25% had irregular cycles. Other researchers compared the menstrual histories of 207 HIV+ and 215 HIV- women attending STD, methadone, and HIV clinics. The groups had similar duration's of bleeding and occurrence of extremely painful menstruation and the absence of menstruation, but the HIV+ group had more bleeding in-between periods and a trend toward more bleeding after sexual intercourse.

It appears that women with HIV infection commonly have menstrual abnormalities. However, there is no data to guide therapy in these patients. The research team that analyzed these findings recommends that women with HIV be carefully questioned about menstrual irregularities and receive treatment by standard means.

Further, it is important to prescribe estrogen replacement therapy to HIV positive women who are experiencing menopause, or women who are failing to produce estrogen. Lack of estrogen can cause a weakening of the vaginal tissue leaving women more susceptible to infection.

We are still not clear on the use of birth control medicine such as depoprovera shots and how it may interact with the virus.

References:

Korn AP, Landers DV, "Gynecologic Disease in Women Infected with Human Immunodeficiency Virus type 1", J Acquir Immune Defic Syndr Hum Retrovirol 1995 Aug 1;9(4):361-70. For a complete copy of the entire article in it's original form please call the Women Alive office at 1-800-554-4876.

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