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Characteristics of menstruation in women infected with human immunodeficiency virus
T V Ellerbrock1, T C Wright, T J Bush
1Division of HIV/AIDS, Centers for Disease Control and Prevention, Atlanta, Georgia.
Objective:
To determine the characteristics of menstruation in women infected with human immunodeficiency virus (HIV) and the impact of immunosuppression on menstruation in HIV-infected women.
Methods:
In this cross-sectional study, 197 HIV-infected and 189 HIV-uninfected women were interviewed about menstruation and abnormal vaginal bleeding during the previous 12 months. Information was also obtained about CD4+ T-lymphocyte levels of HIV-infected women and other factors, including drug use and weight loss, that might affect menstruation.
Results:
The number and duration of menses in HIV-infected women were not significantly different from those of uninfected women. During a 12-month period, 154 (78%) of 197 HIV-infected women and 150 (80%) of 188 uninfected women had 10-14 menses (P = .74). The proportions of women in the two groups with intermenstrual bleeding, postcoital bleeding, or no bleeding were also similar. In HIV-infected women, menstruation and the prevalence of abnormal vaginal bleeding were not significantly different by CD4+ T-lymphocyte level. By multiple logistic regression analysis, neither HIV infection nor CD4+ T-lymphocyte level less than 200 cells/microL was associated with intermenstrual bleeding, postcoital bleeding, or no bleeding.
Conclusion:
The results of this study suggest that neither HIV infection nor immunosuppression has a clinically relevant effect on menstruation or other vaginal bleeding. Most HIV-infected women menstruate about every 25-35 days, suggesting monthly ovulation and an intact hypothalamic-pituitary-ovarian axis.