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HIV and your body
Periods
As well as damaging your immune system, you may notice that HIV causes menstrual problems.
You are more likely to experience menstrual changes if you have a low CD4 cell count and/or high viral load or if you use (or used) illegal drugs. Some of the menstrual changes you may experience include:
It's thought that these changes can occur because the damage to your immune system that HIV is causing can alter your hormone balance. If you have been ill, have lost a lot of weight, or have anaemia, you may also find that these cause changes to your menstrual cycle.
Make sure that you tell your doctor if you notice any changes to your periods. It could be a warning sign that HIV is damaging your immune system and that you need to consider taking anti-HIV treatment (often called highly active antiretroviral therapy, or HAART for short). Changes in your menstrual cycle can also be a symptom of health problems. But remember that a missed period might also mean that you are pregnant. Abnormal bleeding, for example after sex, after the menopause, or very heavy periods should also be reported to your doctor.
Menopause
It's thought that HIV can interfere with your ability to produce the hormones oestrogen and progesterone and that this can lead to an early menopause (the ending of the ability to became pregnant).
Symptoms of the menopause include:
Weakening of the bones (osteoporosis) can also be a result of the menopause and this can be of particular concern as HIV, and some anti-HIV drugs, may reduce the amount of important minerals in the bones causing bone weakness. You can help look after the health of your bones by light weight training, by losing weight if you are overweight, and by making sure that you don't drink too much alcohol.
Many women take hormone supplements to replace those they are losing naturally. This is called hormone replacement therapy (HRT) or oestrogen replacement therapy (ERT) and can relieve the symptoms of the menopause. HRT can have many complications, and long-term risks include heart disease, stroke, and breast cancer, and it is only recommended to relieve menopausal symptoms. If you are thinking about HRT, then talk it over with your doctor. You might also want to ask for a referral to a specialist menopause clinic.
HRT can also be effective if you are HIV-positive. But there might be more risks involved. This is particularly the case if you are taking HAART, as some anti-HIV drugs have been associated with an increased risk of heart disease and stroke.
Reproductive health issues
Some reproductive health (gynaecological) problems can be more common, more severe, or harder to treat if you have HIV.
Pelvic inflammatory disease (PID) is always a serious condition, particularly so if you have HIV. It can be treated with antibiotics, but there is a risk of long-term pain and the recurrence of the condition. PID can can also result in infertility. It can be caused by untreated sexually transmitted infections such as gonorrhoea and Chlamydia, as well as other bacteria and infections such as tuberculosis. Symptoms include long-lasting pain in the lower abdomen, vaginal discharge, cramping during sex, deep internal pain, fever, vomiting, tiredness and unusual bleeding from the vagina. A general sexual health check-up will include tests to see if you have gonorrhoea or Chlamydia. Scans may be needed to see if you have any cysts or abscesses that indicate that you have PID. An examination called a laparoscopy, which involves having a tiny camera put into the pelvic cavity through a small surgical cut below the navel, can be used if you have complicated PID. If you have PID you will be treated with a combination of antibiotics. If it becomes severe, you might need to be admitted to hospital and have treatment with intravenous antibiotics.
Your sexual partners will need to have a sexual health screen so they can have any infections diagnosed and treated.
HIV-positive women may be more likely to have abnormal cervical cells caused by human papilloma virus (HPV) which can lead to cervical cancer, so it's very important that you have regular cervical PAP smear tests to check for these cells so you can receive prompt treatment to remove them. HIV-positive women are much less likely than HIV-negative women to naturally clear HPV infection. HPV can cause warts on the sexual organs, however HPV can also infect cells in the cervix and cause abnormal cells to develop without causing any visible sign or symptoms and can only be detected using a PAP smear that looks for abnormal cells in the cervix. All HIV-positive women should have a PAP smear soon after they are diagnosed with HIV, again after six months and then every year. If you have visible genital warts you do not have increased risk of having an abnormal smear result. Treatment for abnormal cervical cells is highly effective, provided they are detected early.
You may also be more likely to get fungal infections, such as vaginal candidiasis (thrush), a yeast infection, but treatment works just as well if you are HIV-positive. If you are getting fungal infections on a regular basis, your doctor can give you drugs to prevent them.
Attacks of genital herpes (herpes simplex virus-2, or HSV-2) can last longer and be more painful if you have HIV. The antiviral drug aciclovir can help shorten the duration of attacks, and if you are getting regular attacks of herpes then you may wish to consider taking aciclovir everyday to prevent this.
Bacterial vaginosis, an overgrowth of bacteria in the vagina, occurs in many women, regardless of their HIV status. It can increase the risk of mother-to-baby transmission of HIV. Its symptoms include a discharge which has a "fishy" odour. It can be treated with antibiotics. Washing the vagina too frequently increases your risk of developing bacterial vaginosis.
As well as damaging your immune system, you may notice that HIV causes menstrual problems.
You are more likely to experience menstrual changes if you have a low CD4 cell count and/or high viral load or if you use (or used) illegal drugs. Some of the menstrual changes you may experience include:
- Long intervals between periods.
- Missed periods without pregnancy.
It's thought that these changes can occur because the damage to your immune system that HIV is causing can alter your hormone balance. If you have been ill, have lost a lot of weight, or have anaemia, you may also find that these cause changes to your menstrual cycle.
Make sure that you tell your doctor if you notice any changes to your periods. It could be a warning sign that HIV is damaging your immune system and that you need to consider taking anti-HIV treatment (often called highly active antiretroviral therapy, or HAART for short). Changes in your menstrual cycle can also be a symptom of health problems. But remember that a missed period might also mean that you are pregnant. Abnormal bleeding, for example after sex, after the menopause, or very heavy periods should also be reported to your doctor.
Menopause
It's thought that HIV can interfere with your ability to produce the hormones oestrogen and progesterone and that this can lead to an early menopause (the ending of the ability to became pregnant).
Symptoms of the menopause include:
- Less frequent periods, which then stop completely.
- A dry vagina and vulva.
- Hot flushes.
- Reduced, or lack of, sexual desire.
- Increased frequency of urination.
- Depression and other mood problems.
- Sleep problems.
- Aging skin, dry skin or spotty skin.
Weakening of the bones (osteoporosis) can also be a result of the menopause and this can be of particular concern as HIV, and some anti-HIV drugs, may reduce the amount of important minerals in the bones causing bone weakness. You can help look after the health of your bones by light weight training, by losing weight if you are overweight, and by making sure that you don't drink too much alcohol.
Many women take hormone supplements to replace those they are losing naturally. This is called hormone replacement therapy (HRT) or oestrogen replacement therapy (ERT) and can relieve the symptoms of the menopause. HRT can have many complications, and long-term risks include heart disease, stroke, and breast cancer, and it is only recommended to relieve menopausal symptoms. If you are thinking about HRT, then talk it over with your doctor. You might also want to ask for a referral to a specialist menopause clinic.
HRT can also be effective if you are HIV-positive. But there might be more risks involved. This is particularly the case if you are taking HAART, as some anti-HIV drugs have been associated with an increased risk of heart disease and stroke.
Reproductive health issues
Some reproductive health (gynaecological) problems can be more common, more severe, or harder to treat if you have HIV.
Pelvic inflammatory disease (PID) is always a serious condition, particularly so if you have HIV. It can be treated with antibiotics, but there is a risk of long-term pain and the recurrence of the condition. PID can can also result in infertility. It can be caused by untreated sexually transmitted infections such as gonorrhoea and Chlamydia, as well as other bacteria and infections such as tuberculosis. Symptoms include long-lasting pain in the lower abdomen, vaginal discharge, cramping during sex, deep internal pain, fever, vomiting, tiredness and unusual bleeding from the vagina. A general sexual health check-up will include tests to see if you have gonorrhoea or Chlamydia. Scans may be needed to see if you have any cysts or abscesses that indicate that you have PID. An examination called a laparoscopy, which involves having a tiny camera put into the pelvic cavity through a small surgical cut below the navel, can be used if you have complicated PID. If you have PID you will be treated with a combination of antibiotics. If it becomes severe, you might need to be admitted to hospital and have treatment with intravenous antibiotics.
Your sexual partners will need to have a sexual health screen so they can have any infections diagnosed and treated.
HIV-positive women may be more likely to have abnormal cervical cells caused by human papilloma virus (HPV) which can lead to cervical cancer, so it's very important that you have regular cervical PAP smear tests to check for these cells so you can receive prompt treatment to remove them. HIV-positive women are much less likely than HIV-negative women to naturally clear HPV infection. HPV can cause warts on the sexual organs, however HPV can also infect cells in the cervix and cause abnormal cells to develop without causing any visible sign or symptoms and can only be detected using a PAP smear that looks for abnormal cells in the cervix. All HIV-positive women should have a PAP smear soon after they are diagnosed with HIV, again after six months and then every year. If you have visible genital warts you do not have increased risk of having an abnormal smear result. Treatment for abnormal cervical cells is highly effective, provided they are detected early.
You may also be more likely to get fungal infections, such as vaginal candidiasis (thrush), a yeast infection, but treatment works just as well if you are HIV-positive. If you are getting fungal infections on a regular basis, your doctor can give you drugs to prevent them.
Attacks of genital herpes (herpes simplex virus-2, or HSV-2) can last longer and be more painful if you have HIV. The antiviral drug aciclovir can help shorten the duration of attacks, and if you are getting regular attacks of herpes then you may wish to consider taking aciclovir everyday to prevent this.
Bacterial vaginosis, an overgrowth of bacteria in the vagina, occurs in many women, regardless of their HIV status. It can increase the risk of mother-to-baby transmission of HIV. Its symptoms include a discharge which has a "fishy" odour. It can be treated with antibiotics. Washing the vagina too frequently increases your risk of developing bacterial vaginosis.