The menopause shouldn’t stop you living life to the full. Every woman will go through it, but each experience is different.
To help you plan for your next appointment, go to What To Ask section for helpful tips and downloadable questions.
- What is the menopause?
- What are the symptoms of menopause?
- Does the menopause differ for women living with HIV?
- How is the menopause managed?
- Osteoporosis after the menopause
WHAT IS THE MENOPAUSE?
The menopause is when a woman stops having periods and is no longer able to get pregnant naturally. The menopause is a natural part of ageing that generally occurs between 45 and 55 years of age, as a woman's oestrogen levels decline. This time of change leading up to a woman’s final period is called perimenopause. A number of studies have looked at whether women living with HIV experience menopause earlier than those not living with HIV. The results are conflicting, as some studies reported that women living with HIV did experience menopause earlier, whilst other studies reported no differences. This suggests that more research is needed in this area.
If you have any questions about the menopause or how it may affect you, please speak to your healthcare team.
INFORMATION FOR TRANSGENDER WOMEN ALREADY ON HRT
Transgender women who are taking hormone replacement therapy (HRT) may routinely experience period-like symptoms, such as cramps, bloating and nausea, but do not experience a period. Because of this, transgender women experience the menopause differently to cisgender women. Each transgender woman will also experience the menopause slightly differently so it is important to speak to your healthcare professional as they will be able to offer advice based on your individual experiences and symptoms.
Please do not avoid seeking treatment for your HIV if you are currently taking HRT. If you are concerned about HIV treatment interacting with your HRT, you should speak to your healthcare professional, as they can advise an appropriate HIV treatment according to your needs.
If you are taking HRT via injections, it is important to practice good needle hygiene (i.e. using new, sterilised needles each time, and disposing of used needles responsibly) to avoid contracting other infections, such as hepatitis C, as well as passing on HIV to others by sharing needles.
WHAT ARE THE SYMPTOMS OF MENOPAUSE?
Menopause has different symptoms in different women, these include:
- Changes in periods
- Hot flushes
- Night sweats
- Low mood
- Reduced sex drive
- Vaginal dryness
- Trouble sleeping
- Feeling tired
Symptoms can begin months or even years before your periods stop and last around four years after your last period, although some women experience them for much longer.
DOES THE MENOPAUSE DIFFER FOR WOMEN LIVING WITH HIV?
There isn’t much research available in this area and the studies that are available are conflicting. Some studies show that women living with HIV experience menopause earlier, with more symptoms than other women, whilst other studies do not. Some studies also suggest that women living with HIV may face challenges in recognising and managing menopause symptoms, not knowing if symptoms are related to HIV or the menopause.
Certain women may experience such severe symptoms of menopause they miss taking some doses of their HIV treatment. If you're struggling, you should let your healthcare team know as they're best placed to help you.
It has also been found that the risk of developing osteoporosis (thinning bones) is increased for people living with HIV and in women after the menopause. If you have any concerns, speak to your healthcare team.
HOW IS THE MENOPAUSE MANAGED?
Treatments to lessen symptoms during the menopausal transition are the same for women with HIV as for other women. Talk to your healthcare team if you have any questions on menopausal treatment.
LIFESTYLE CHANGES TO HELP MANAGE SYMPTOMS
- Eating a healthy, balanced diet and exercising regularly can improve some menopausal symptoms
- Natural supplements and herbal treatments may also help, but these may interact with your HIV medication so do discuss them with your healthcare team first
HORMONE REPLACEMENT THERAPY (HRT) AND OTHER TREATMENT
If you have severe menopausal symptoms that interfere with your day-to-day life, your healthcare team may suggest treatments including:
- Hormone replacement therapy – tablets, skin patches, gels and implants that relieve menopausal symptoms by replacing oestrogen
- Vaginal oestrogen creams, lubricants or moisturisers for vaginal dryness
- Cognitive behavioural therapy (CBT) – a type of talking therapy that can help with low mood and anxiety
If your menopausal symptoms are troubling you, have a chat about the risks and benefits of HRT with your healthcare team to help you decide if it is right for you.
WHAT IF I AM ALREADY ON HRT?
Transwomen who are taking HRT routinely do not experience a period but may experience period-like symptoms. The menopause, as it is more commonly known, will therefore differ for transgender in comparison to cisgender women and each experience is unique. There are very few studies about this topic so it is best to get the latest information and advice from your healthcare team, which will be tailored to your own experience and symptoms.
OSTEOPOROSIS AFTER THE MENOPAUSE
Your bones get weaker as you age and this happens to everybody, but the change is usually faster in women after the menopause. Because oestrogen is important for healthy bone growth, hormone replacement therapy (HRT) can help to protect your bones from osteoporosis whilst you’re on treatment. Visit the bone health page for more information.