Prolonged amenorrhea and resumption of menses in women with HIV

Helen E. Cejtin, Charlesnika T. Evans, Ruth Greenblatt, Howard Minkoff, Kathleen M. Weber, Rodney L. Wright, Christine Colie, Elizabeth Golub, L. Stewart Massad

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)1441-1448
Number of pages8
JournalJournal of Women's Health
Volume27
Issue number12
DOIs
StatePublished - Dec 1 2018

Fingerprint

Menstruation
Amenorrhea
HIV
Menopause
Opiate Alkaloids
Hemorrhage
Uterine Hemorrhage
Contraception

Keywords

  • amenorrhea
  • anovulation
  • HIV
  • menopause

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Cejtin, H. E., Evans, C. T., Greenblatt, R., Minkoff, H., Weber, K. M., Wright, R. L., ... Massad, L. S. (2018). Prolonged amenorrhea and resumption of menses in women with HIV. Journal of Women's Health, 27(12), 1441-1448. https://doi.org/10.1089/jwh.2018.7046

Prolonged amenorrhea and resumption of menses in women with HIV. / Cejtin, Helen E.; Evans, Charlesnika T.; Greenblatt, Ruth; Minkoff, Howard; Weber, Kathleen M.; Wright, Rodney L.; Colie, Christine; Golub, Elizabeth; Massad, L. Stewart.

In: Journal of Women's Health, Vol. 27, No. 12, 01.12.2018, p. 1441-1448.

Research output: Contribution to journalArticle

Cejtin, HE, Evans, CT, Greenblatt, R, Minkoff, H, Weber, KM, Wright, RL, Colie, C, Golub, E & Massad, LS 2018, 'Prolonged amenorrhea and resumption of menses in women with HIV', Journal of Women's Health, vol. 27, no. 12, pp. 1441-1448. https://doi.org/10.1089/jwh.2018.7046
Cejtin HE, Evans CT, Greenblatt R, Minkoff H, Weber KM, Wright RL et al. Prolonged amenorrhea and resumption of menses in women with HIV. Journal of Women's Health. 2018 Dec 1;27(12):1441-1448. https://doi.org/10.1089/jwh.2018.7046
Cejtin, Helen E. ; Evans, Charlesnika T. ; Greenblatt, Ruth ; Minkoff, Howard ; Weber, Kathleen M. ; Wright, Rodney L. ; Colie, Christine ; Golub, Elizabeth ; Massad, L. Stewart. / Prolonged amenorrhea and resumption of menses in women with HIV. In: Journal of Women's Health. 2018 ; Vol. 27, No. 12. pp. 1441-1448.
@article{fcc12253ed804970b74f1bacd0084003,
title = "Prolonged amenorrhea and resumption of menses in women with HIV",
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.",
keywords = "amenorrhea, anovulation, HIV, menopause",
author = "Cejtin, {Helen E.} and Evans, {Charlesnika T.} and Ruth Greenblatt and Howard Minkoff and Weber, {Kathleen M.} and Wright, {Rodney L.} and Christine Colie and Elizabeth Golub and Massad, {L. Stewart}",
year = "2018",
month = "12",
day = "1",
doi = "10.1089/jwh.2018.7046",
language = "English (US)",
volume = "27",
pages = "1441--1448",
journal = "Journal of Women's Health",
issn = "1540-9996",
publisher = "Mary Ann Liebert Inc.",
number = "12",

}

TY - JOUR

T1 - Prolonged amenorrhea and resumption of menses in women with HIV

AU - Cejtin, Helen E.

AU - Evans, Charlesnika T.

AU - Greenblatt, Ruth

AU - Minkoff, Howard

AU - Weber, Kathleen M.

AU - Wright, Rodney L.

AU - Colie, Christine

AU - Golub, Elizabeth

AU - Massad, L. Stewart

PY - 2018/12/1

Y1 - 2018/12/1

N2 - 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.

AB - 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.

KW - amenorrhea

KW - anovulation

KW - HIV

KW - menopause

UR - http://www.scopus.com/inward/record.url?scp=85058559464&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85058559464&partnerID=8YFLogxK

U2 - 10.1089/jwh.2018.7046

DO - 10.1089/jwh.2018.7046

M3 - Article

AN - SCOPUS:85058559464

VL - 27

SP - 1441

EP - 1448

JO - Journal of Women's Health

JF - Journal of Women's Health

SN - 1540-9996

IS - 12

ER -