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Evaluating the menopausal transition with the STRAW + 10 in a Brazilian cohort of women with HIV, 2015-2016

E M Jalil 1R M Domingues 1M Derrico 1M B Dias 2A C V Andrade 1V S O Rocha 1S Nazer 1M Feitosa 1S W Cardoso 1V G Veloso 1R K Friedman 1B Grinsztejn 1

Climacteric doi: 10.1080/13697137.2021.1889501. 

Abstract

Background: Menopausal transition is a physiological process encompassing hormonal and body changes that impact women’s health and life quality. This period may be characterized by the Stages of Reproductive Aging Workshop (STRAW + 10) criteria using menstrual patterns. Use of the STRAW + 10 is uncertain in HIV infection. We aimed to characterize menopausal transition in women with HIV (WWH) using the STRAW + 10 criteria, hormonal measures and menopause symptoms.

Methods: We performed a cross-sectional study, nested to the HIV-Infected Women’s Cohort, in Rio de Janeiro, Brazil. Eligible women included those aged 30 years or older, without clinical or surgical menopause, hormonal contraception, replacement therapy and ovarian disorders. We conducted face-to-face interviews and collected blood samples for follicle stimulating hormone (FSH) and estradiol measures.

Results: We enrolled 328 WWH (28.3% of women in the cohort). The distribution of age, hormonal levels and reported symptoms per each STRAW + 10 stage was consistent with the expected distribution in the menopausal transition. Age and FSH significantly increased and estradiol decreased from stage -2 (7 + days of menstrual delay) to stage +2 (8 + years of amenorrhea).

Conclusions: The present results support use of the STRAW + 10 to characterize the menopausal transition of WWH with good clinical and immunological control.