The Impact of HIV on Women’s Gynecological Health
Last updated: October 2021
While both men and women are susceptible to HIV, HIV can affect women in many different ways than it affects men. The effect on women’s gynecological health is very broad.
These issues showcase the importance for women living with HIV to be seen regularly by a gynecologist. A woman’s gynecologist can do preventive testing and can treat any acquired infections.
Women's gynecological health issues
HIV can affect a woman’s gynecological health by making them more vulnerable to issues such as vaginal yeast infections, cervical cancer, and menstrual cycle changes.1
Vaginal yeast infections
Vaginal yeast infections happen to everyone, regardless of their HIV status. A vaginal yeast infection occurs when there is an overgrowth of the normal yeast in the vagina and causes itching and burning of the vulva.1
Women living with HIV can have yeast infections that are harder to treat and occur more often. A doctor should take note of these infections and what treatments do work on them. Repeated yeast infections that are harder to treat are a common first sign of an HIV infection and a symptom of a weakened immune system.2,3
I personally have experienced many battles with yeast infections, especially when my CD4 count was lower than 200. However, as my CD4 count has increased, the frequency of yeast infections has drastically decreased.
Women who are HIV positive have a higher risk of developing cervical cancer. For women living with the virus, a diagnosis of cervical cancer is considered AIDS-defining cancer. This marks the point where HIV diagnosis has advanced to AIDS.1
While a condition may be considered an AIDS-defining condition, it does not mean that the condition is only seen in individuals with HIV. This means that somebody can get cervical cancer without being HIV positive. But it is more likely to be found in immunocompromised patients.
The human papillomavirus (HPV) causes abnormal cervical cells. Women who are HIV-positive typically have the types of HPV that commonly cause cervical cancer. Therefore, it is so important for women who are HIV-positive to have pap smears done by their gynecologist once a year.1
Women who are HIV positive can face several issues with their menstrual cycle. Some of the problems may include irregular periods, lighter or heavier periods, darker menstrual blood, and exacerbation of symptoms from pre-menstrual syndrome (PMS).3
While researchers do not know how HIV affects the reproductive system, it is believed that "problems with a woman's immune system due to HIV cause changes in her hormones and results in menstrual problems."3
Age-related health concerns
Since there have been advances in the treatment of HIV, individuals with HIV are living longer lives. As a result, women living with the virus are facing a variety of aging-related health conditions.
A normal part of aging is going through menopause. For most women, menopause occurs naturally during their early 50s and is marked by a year of no periods.
On the other hand, for some women, menopause occurs suddenly due to the surgical removal of the ovaries. This is the result of surgery - such as hysterectomy - and is considered surgically-induced menopause.
One HIV/AIDS resource guide explains that women who are HIV-positive may experience menopause at an earlier age. This may be due to "factors such as anemia, lower hormone production, chronic illness, weight loss, anti-HIV drugs, use of street drugs, and smoking."3
The US Department of Health and Human Service’s Office on Women’s Health explains that women who are HIV-positive tend to have more severe hot flashes. This is something nobody wants to deal with during menopause!1
Additionally, researchers believe that the decrease in estrogen that occurs during menopause may affect a woman’s CD4 count.1
Osteoporosis is a condition that is common in older individuals. While osteoporosis is not specifically a female issue, it is associated with menopause.1
The changes in estrogen levels during menopause affect the density levels of the bones. In this condition, the bones have lost some of their structural density. This causes them to be brittle and break easier than healthy bones.
Osteoporosis occurs faster in women (as well as men) living with HIV. Some of the HIV medications can increase the risk of osteoporosis. Personally, I encountered this issue while on Stribild. This required me to change medications.2
Due to the effect that HIV can have on women’s gynecological health, it is important for women need to be seen by a gynecologist and not just an infectious disease doctor or general physician.
Has HIV had an effect like any of these on your body?
Are you living with HIV? (select all that apply)
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