Related Experiment Video

Updated: May 14, 2026

Collection, Isolation, and Flow Cytometric Analysis of Human Endocervical Samples
12:34

Collection, Isolation, and Flow Cytometric Analysis of Human Endocervical Samples

Published on: July 6, 2014

Cyclic changes in HIV shedding from the female genital tract during the menstrual cycle

Marcel E Curlin1, Wanna Leelawiwat, Eileen F Dunne

  • 1Centers for Disease Control and Prevention, Atlanta, Georgia, USA. mcurlin@th.cdc.gov

The Journal of Infectious Diseases
|February 19, 2013
PubMed

Insights

Genital human immunodeficiency virus (HIV) shedding in women coinfected with herpes simplex virus type 2 varies during the menstrual cycle. Shedding is highest after menses and lowest at ovulation, impacting female-to-male HIV transmission risk.

Area of Science:

  • Virology
  • Immunology
  • Gynecology

Background:

  • Genital human immunodeficiency virus (HIV) shedding is a key factor in HIV transmission.
  • Understanding shedding patterns throughout the menstrual cycle is crucial for assessing female-to-male transmission risk.
  • Coinfection with herpes simplex virus type 2 (HSV-2) may influence HIV shedding.

Purpose of the Study:

  • To investigate the relationship between the menstrual cycle and genital HIV shedding in women coinfected with HSV-2.
  • To determine how HIV shedding varies across different phases of the menstrual cycle.

Main Methods:

  • Prospective study involving 67 women with HIV type 1 and HSV-2 coinfection.
  • Collection of genital samples across two menstrual cycles for HIV shedding analysis.
  • Quantification of HIV shedding levels and assessment of variations by menstrual cycle phase and CD4 count.

Main Results:

  • HIV shedding was detected in 60% (follicular), 48% (periovulatory), and 54% (luteal) of samples (P = .01).
  • HIV shedding significantly declined from menses to ovulation (slope -0.054 log10 copies/swab/day, P < .001).
  • Increased luteal phase shedding was observed in women with CD4 counts <350 cells/µL.

Conclusions:

  • Genital HIV shedding frequency and magnitude fluctuate significantly during the menstrual cycle in reproductive-aged women.
  • HIV shedding is greatest immediately following menses and lowest at ovulation.
  • CD4 count influences luteal phase HIV shedding, suggesting immune status impacts transmission risk.

More Related Videos

Ex Vivo Infection of Human Lymphoid Tissue and Female Genital Mucosa with Human Immunodeficiency Virus 1 and Histoculture11:14

Ex Vivo Infection of Human Lymphoid Tissue and Female Genital Mucosa with Human Immunodeficiency Virus 1 and Histoculture

Published on: October 12, 2018

Rodent Estrous Cycle Monitoring Utilizing Vaginal Lavage: No Such Thing As a Normal Cycle09:05

Rodent Estrous Cycle Monitoring Utilizing Vaginal Lavage: No Such Thing As a Normal Cycle

Published on: August 30, 2021

Related Concept Videos

The Menstrual Cycle01:19

The Menstrual Cycle

The menstrual cycle is a recurrent sequence of changes in the uterine endometrium, specifically its functional layer, the stratum functionalis. This cycle prepares the uterus for potential pregnancy. This cycle typically spans 21–35 days, averaging 28 days, and aligns with the ovarian cycle, regulated by fluctuating levels of ovarian hormones, primarily estrogen and progesterone.
The menstrual phase occurs from days 1 to 5 and involves the shedding of the stratum functionalis, as a uterine...
Hormonal Regulation of the Menstrual Cycle01:22

Hormonal Regulation of the Menstrual Cycle

The ovarian cycle regulates endometrial changes throughout a single menstrual cycle via the coordinated action of gonadotrophin-releasing hormone (GnRH) and gonadotrophins.
At puberty, GnRH begins a pulsatile release pattern, which triggers the anterior pituitary gland to secrete follicle-stimulating hormone (FSH) and luteinizing hormone (LH). The frequency and amplitude of GnRH pulses vary across the menstrual cycle, with faster pulses favoring LH release and slower pulses favoring FSH release.
Menses Phase01:18

Menses Phase

The uterine cycle begins with the menstrual phase, which is considered day one of the cycle and typically lasts about five days. This phase is characterized by the degeneration and shedding of the stratum functionalis, the functional layer of the endometrium.
When fertilization does not occur, the corpus luteum deteriorates, causing a significant drop in the levels of estrogen and progesterone in the body. This hormonal decrease triggers the release of prostaglandins, which cause the uterine...
Secretory Phase01:19

Secretory Phase

The secretory phase of the menstrual cycle, spanning from day 14 to 28 in a typical 28-day cycle, is a period of significant physiological changes in the female reproductive system. This phase commences immediately after ovulation and is characterized by the preparation of the endometrium for potential embryo implantation.
Following ovulation, the corpus luteum, a temporary endocrine structure, produces progesterone and estrogens. These hormones stimulate the growth and coiling of endometrial...
Ovarian Cycle01:27

Ovarian Cycle

The menstrual cycle includes a critical component known as the ovarian cycle, which undergoes two main phases each month—the follicular phase and the luteal phase. The follicular phase is variable and averaging around 14 days. Ovulation, triggered by a surge in luteinizing hormone (LH), marks the transition between the two phases. The second phase, the luteal phase, is relatively consistent, lasting approximately 14 days, and is marked by the activity of the corpus luteum. While a cycle length...
Hormonal Control of the Ovarian Cycle01:30

Hormonal Control of the Ovarian Cycle

The ovarian cycle is meticulously regulated by the hypothalamic-pituitary-gonadal axis. This cycle orchestrates the release of a mature oocyte, essential for reproduction.
Before puberty, the hypothalamus releases GnRH in a low frequency, low amplitude pulsatile manner. This along with the immature hypothalamic-pituitary-gonadal axis activity, results in low estrogen levels and the absence of a fully functional ovarian cycle.  At puberty, GnRH secretion increases in both frequency and...