Characteristics of menstruation in women infected with human immunodeficiency virus

Objective: To determine the characteristics of menstruation in women infected with human immunodeficiency virus (HIV) and the impact of immunosuppression on menstruation in HIV-infected women. Methods: In this cross-sectional study, 197 HIV-infected and 189 HIV-uninfected women were interviewed about menstruation and abnormal vaginal bleeding during the previous 12 months. Information was also obtained about CD4+ T-lymphocyte levels of HIV-infected women and other factors, including drug use and weight loss, that might affect menstruation. Results: The number and duration of menses in HIV-infected women were not significantly different from those of uninfected women. During a 12-month period, 154 (78%) of 197 HIV-infected women and 150 (80%) of 188 uninfected women had 10-14 menses (P = .74). The proportions of women in the two groups with intermenstrual bleeding, postcoital bleeding, or no bleeding were also similar. In HIV-infeeted women, menstruation and the prevalence of abnormal vaginal bleeding were not significantly different by CD4+ T-lymphocyte level. By multiple logistic regression analysis, neither HIV infection nor CD4+ T-lymphocyte level less than 200 cells/mu L was associated with intermenstrual bleeding, postcoital bleeding, or no bleeding. Conclusion: The results of this study suggest that neither HIV infection nor immunosuppression has a clinically relevant effect on menstruation or other vaginal bleeding. Most HIV-infected women menstruate about every 25-35 days, suggesting monthly ovulation and an intact hypothalamic-pituitary-ovarian axis.