Technically, menopause means stopping having monthly periods (menstruation). It marks the end of your fertility and is accompanied by significant hormonal changes. Most women begin to experience menopause somewhere between the ages of 38 and 58, with 51 being the average age for Australian women. Remember, menopause is a transition, not a disease.
Different women experience menopause very differently. Although menopause is not an illness, it does have ‘symptoms’. Hot flushes, mood changes, night sweats and fatigue are normal. You may become more prone to accidental urination. Sexual changes also accompany the end of menstruation including vaginal dryness, thinning of the vaginal walls and reduced libido. Some women experience loss of concentration, memory loss, anxiety or fatigue. Your risk of heart disease increases as does your risk of bone loss (osteoporosis) after menopause.
Menopause is usually a gradual process rather than an abrupt change. The first phase is called ‘peri-menopause’: periods become less frequent and other menopausal signs can appear.
If you are uncertain whether changes in your body are caused by the onset of menopause or something else, your doctor can do blood tests that check your hormone levels and can provide a clear answer.
For more general information about menopause (although not specific to women with HIV), check out About Menopause from Women’s Health Queensland. For information about HIV and menopause, see Your Body Blueprint.
Some health care providers suggest menopause can occur earlier in women with HIV. Early menopause can accelerate the loss of bone density, which increases the risk of early osteoporosis. HIV antiretroviral drugs such as Tenofovir may also contribute to loss of bone density.
Regular weight-bearing exercise and a calcium-rich (but not high fat) diet protect bone health. It is also important not to smoke. If you are concerned about your bone density, see your doctor. (For more information, see Osteoporosis).
Menopause does not cause heart disease, however, certain risk factors increase around the time of menopause. A decline in the natural hormone oestrogen may be one such factor. HIV treatments can increase fats in the blood, which may also increase risk of heart disease. The link between HIV treatments and menopausal factors increasing heart disease risk is not well understood.
Changing habits to decrease cardiovascular risk is an important way to increase your heart health: stopping smoking, improving your diet by reducing fat, and doing regular moderate exercise are the key factors here.
For more information on menopause and HIV, check out Your Body Blueprint.
Some women increase their consumption of soy products to treat menopausal problems. There is no research evidence proving the usefulness of these remedies, but in cultures where soy products are eaten in large quantities, menopausal problems are reported to be less severe.
Importantly, if you have had breast cancer or have a higher than average risk of breast cancer (assessed through family history), educators suggest you should avoid high-dose supplements of soy products where the active ingredients may be processed in a way that fuels oestrogen-receptor positive breast cancer. This is an issue to discuss with your doctor. Cancer Australia provides more detailed information about breast cancer.
There is a lack of research regarding the effectiveness of herbal preparations to help with menopausal symptoms and general enhancement of wellbeing but there are many preparations that have been reputed to be helpful, including black cohosh, dong qui, wild yam, evening primrose, ginseng, ginger, red clover and valerian for sleeping problems. Some of these products may be associated with other significant health problems, so check with your doctor before commencing.
When considering natural therapies, bear in mind: