Helen E Cejtin1, Charlesnika T Evans2, Ruth Greenblatt3, Howard Minkoff4, Kathleen M Weber5, Rodney Wright6, Christine Colie7, Elizabeth Golub8, L Stewart Massad9. 1. 1 Department of Obstetrics and Gynecology, John H. Stroger Jr. Hospital of Cook County, Feinberg School of Medicine, Northwestern University , Chicago, Illinois. 2. 2 Department of Preventive Medicine and Center for Healthcare Studies Northwestern University and Department of Veterans Affairs , Chicago, Illinois. 3. 3 Department of Clinical Pharmacy, University of California San Francisco , San Francisco, California. 4. 4 Department of Obstetrics and Gynecology, Maimonides Medical Center , New York, New York. 5. 5 Cook County Health and Hospitals System/Hektoen Institute of Medicine Chicago, Illinois. 6. 6 Department of Obstetrics and Gynecology, Albert Einstein College of Medicine , Bronx, New York. 7. 7 Department of Obstetrics and Gynecology, Georgetown University , District of Columbia, Washington. 8. 8 Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health , Baltimore, Maryland. 9. 9 Department of Obstetrics and Gynecology, Washington University School of Medicine , St. Louis, Missouri.
Abstract
OBJECTIVE: To compare etiologies of prolonged amenorrhea in a cohort of HIV-infected women with a cohort of similar uninfected at-risk women. MATERIALS AND METHODS: Women from the Women's Interagency HIV Study were seen every 6 months, and completed surveys including questions about their menstruation. Those who reported no vaginal bleeding for at least 1 year ("prolonged amenorrhea") with subsequent resumption of bleeding were compared with women in whom bleeding had stopped permanently ("menopause"). Characteristics associated with reversible prolonged amenorrhea were ascertained. RESULTS: Of 828 women with prolonged amenorrhea, 37.6% had reversible amenorrhea and 62.4% never resumed menses. HIV-seropositive women with prolonged amenorrhea were significantly younger at cessation of menses than HIV-negative women (p < 0.0001). Of those with reversible prolonged amenorrhea, approximately half were taking medications associated with amenorrhea, including 95 (30.6%) hormonal contraception, 80 (25.7%) opiates/stimulants, 16 (5.1%) psychotropic medications, and 6 (1.9%) chemotherapy. HIV-seropositive women were less likely to have medications as a cause of amenorrhea than seronegative women (p = 0.02). In multivariable analysis, women with reversible prolonged amenorrhea of unknown etiology were younger (p < 0.0001), more often obese (p = 0.03), and less educated (p = 0.01) than those with permanent amenorrhea. Among HIV-seropositive women, markers of severe immunosuppression were not associated with prolonged amenorrhea. CONCLUSION: Women with HIV infection have unexplained prolonged amenorrhea more often than at-risk seronegative women. This is especially common among obese, less-educated women. Prolonged amenorrhea in the HIV-seropositive women should be evaluated and not be presumed to be to the result of menopause.
OBJECTIVE: To compare etiologies of prolonged amenorrhea in a cohort of HIV-infectedwomen with a cohort of similar uninfected at-risk women. MATERIALS AND METHODS:Women from the Women's Interagency HIV Study were seen every 6 months, and completed surveys including questions about their menstruation. Those who reported no vaginal bleeding for at least 1 year ("prolonged amenorrhea") with subsequent resumption of bleeding were compared with women in whom bleeding had stopped permanently ("menopause"). Characteristics associated with reversible prolonged amenorrhea were ascertained. RESULTS: Of 828 women with prolonged amenorrhea, 37.6% had reversible amenorrhea and 62.4% never resumed menses. HIV-seropositivewomen with prolonged amenorrhea were significantly younger at cessation of menses than HIV-negative women (p < 0.0001). Of those with reversible prolonged amenorrhea, approximately half were taking medications associated with amenorrhea, including 95 (30.6%) hormonal contraception, 80 (25.7%) opiates/stimulants, 16 (5.1%) psychotropic medications, and 6 (1.9%) chemotherapy. HIV-seropositivewomen were less likely to have medications as a cause of amenorrhea than seronegative women (p = 0.02). In multivariable analysis, women with reversible prolonged amenorrhea of unknown etiology were younger (p < 0.0001), more often obese (p = 0.03), and less educated (p = 0.01) than those with permanent amenorrhea. Among HIV-seropositivewomen, markers of severe immunosuppression were not associated with prolonged amenorrhea. CONCLUSION:Women with HIV infection have unexplained prolonged amenorrhea more often than at-risk seronegative women. This is especially common among obese, less-educated women. Prolonged amenorrhea in the HIV-seropositivewomen should be evaluated and not be presumed to be to the result of menopause.
Authors: Sara E Looby; Amy Kantor; Tricia H Burdo; Judith S Currier; Carl J Fichtenbaum; Edgar T Overton; Judith A Aberg; Carlos D Malvestutto; Gerald S Bloomfield; Kristine M Erlandson; Michelle Cespedes; Esper G Kallas; Mar Masiá; Alice C Thornton; Mandy D Smith; Jacqueline M Flynn; Emma M Kileel; Evelynne Fulda; Kathleen V Fitch; Michael T Lu; Pamela S Douglas; Steven K Grinspoon; Heather J Ribaudo; Markella V Zanni Journal: Clin Infect Dis Date: 2022-10-12 Impact factor: 20.999
Authors: Sally B Coburn; Jodie Dionne-Odom; Maria L Alcaide; Caitlin A Moran; Lisa Rahangdale; Elizabeth T Golub; Leslie Stewart Massad; Dominika Seidman; Katherine G Michel; Howard Minkoff; Kerry Murphy; Todd T Brown; Kala Visvanathan; Bryan Lau; Keri N Althoff Journal: J Womens Health (Larchmt) Date: 2022-01-17 Impact factor: 2.681
Authors: Markella V Zanni; Judith S Currier; Amy Kantor; Laura Smeaton; Corinne Rivard; Jana Taron; Tricia H Burdo; Sharlaa Badal-Faesen; Umesh G Lalloo; Jorge A Pinto; Wadzanai Samaneka; Javier Valencia; Karin Klingman; Beverly Allston-Smith; Katharine Cooper-Arnold; Patrice Desvigne-Nickens; Michael T Lu; Kathleen V Fitch; Udo Hoffman; Steven K Grinspoon; Pamela S Douglas; Sara E Looby Journal: J Infect Dis Date: 2020-07-09 Impact factor: 7.759