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

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.

摘要

背景：绝经过渡期是一个生理过程, 包含激素水平和机体变化, 影响女性健康和生活质量。这一时期可根据不同月经模式生殖衰老分期（STRAW + 10）标准进行描述。但并不确定STRAW + 10标准是否适用于艾滋病毒感染患者。我们的目的是应用STRAW+10标准、测量激素水平和更年期症状来描述艾滋病毒感染女性（WWH）的绝经过渡期。

方法：我们在巴西里约热内卢进行了一项横断面研究, 其中包含艾滋病毒感染女性队列。需符合的条件包括年龄在30岁或以上、无内外科因素导致绝经、未激素避孕、无激素替代治疗和卵巢疾病的女性。我们对其进行了面对面的访谈, 并采集了血液样本进行卵泡刺激素（FSH）和雌二醇的测定。

结果：我们登记了328名WWH（队列中28.3%的女性）。每一STRAW + 10分期的年龄、激素水平和症状分布情况与绝经过渡期预期分布一致。从STRAW 2期（月经延迟7天以上）到STRAW + 2期（闭经8年以上）, 年龄与FSH水平显著增加, 雌二醇水平下降。

结论：本研究结果支持应用STRAW + 10描述WWH的绝经过渡期情况, 具有良好的临床和免疫学对照。

Keywords:

• HIV
• women’s health
• menopause
• Brazil

Acknowledgements

The authors thank Janio A. Cordeiro for his help in analyzing hormonal measures, and Dr Mira Hunter for kindly authorizing use of the WHQ. Any views expressed in this paper are those of the authors, and not necessarily those of the funders.

Potential conflict of interest

No potential conflict of interest was reported by the authors.

Additional information

Funding

E.M.J. acknowledges funding from Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq). This study was funded by National Institute of Infectious Disease Evandro Chagas, FIOCRUZ and CNPq.