Perimenopausal Women with HIV Experience Worse COVID-19 Symptoms

menopause © Bovart - stock.adobe.com

Women living with HIV experience the worst COVID-19 symptoms during perimenopause, when compared with premenopause and postmenopause, the results of a recent survey show. This may be due to an increased state of inflammation caused by a combination of HIV, COVID-19 and menopause.

To come to this conclusion, a team of researchers led by Emily M. Cherenack, Ph.D., a post-doctoral associate at the University of Miami, used survey data from 2020 to 2022 from the Multicenter AIDS Cohort Study and Women's Interagency HIV Study to identify 880 women living with HIV and categorized them by menopause state and compared COVID-19 test results and symptoms.

Out of 880 women, 16% (138) were premenopausal, 8% (59) perimenopausal and 78% (683) postmenopausal. Although only 9% (78) tested positive for COVID-19, over half (59%) of perimenopausal women experienced hot flashes during COVID-19 while 33% of premenopausal women and 43% postmenopausal women reported hot flashes. The same can be said about night sweats, which are nocturnal hot flashes. Almost half (44%) of perimenopausal women with COVID-19 reported night sweats, while 28% of premenopausal women and 31% of postmenopausal women said they had night sweats during COVID-19.

Other symptoms, such as fatigue, were also more present in perimenopausal women with COVID-19 (83%) when compared with premenopausal and postmenopausal women combined (45%). Perimenopausal women also experienced more sore throats (61% vs 25%), aches (78% vs 43%) and smell loss (67% vs 25%).

COVID-19 infections and menopause stage (premenopause, perimenopause and postmenopause) were both self- reported.

Perimenopause typically begins for women in their early to mid 40’s. It is often the most symptomatic stage of menopause, marked by irregular periods, brain fog and hot flashes.

Previous limited research suggests that women living with HIV may also experience menopause sooner and have more severe menopause symptoms.

“Despite the potential health impacts of these co-occurring conditions and the possibility of some overlapping symptoms, little is known about the associations between menopause and COVID-19 among women living with HIV,” Cherenack and her team write. “Research is needed to explore if hormonal and behavioral changes in menopause are associated with immune responses to infectious disease among women living with HIV.”

The full details of this study will be presented at the 2024 Annual Meeting of the Menopause Society held September 10 – 14.