Browsing by Subject "Menopause"

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    Menopause experiences among women living with HIV (WLHIV) in Sub-Saharan Africa: a scoping review
    (2026) Themba, Nokwanda; Myer, Benjamin
    Menopause is a significant biological transition for women living with HIV (WLHIV) in Sub-Saharan Africa (SSA), presenting unique challenges such as increased risks for bone loss and more severe symptoms. With increasing life expectancy due to effective antiretroviral therapy (ART), the population of ageing WLHIV continues to grow, requiring tailored HIV services. However, research on the complex association between HIV and menopause remains limited. Objectives: This scoping review aims to provide a comprehensive overview of current knowledge on menopause among WLHIV in Sub-Saharan Africa, identify gaps in existing literature, and provide insights for future research and interventions. Methods: A scoping review was conducted following the JBI framework and PRISMA-ScR guidelines. Databases PubMed, Science Direct and Google Scholar were searched for studies published in English up to October 2023. Eligible studies included perimenopausal and postmenopausal WLHIV in Sub-Saharan Africa. Data were extracted and summarised based on study characteristics, methodology, menopause definitions, symptoms, and health outcomes. Results: A total of 138 articles were identified and screened for eligibility based on titles and abstracts; 72 articles were assessed for full-text eligibility, and 65 articles were excluded. Seven studies in South Africa, Nigeria, and Zimbabwe met the final inclusion criteria. Studies found a higher prevalence of early menopause, decreased bone mineral density, and more severe menopausal symptoms among WLHIV compared to women living without HIV. Furthermore, several studies reported a high BMI was strongly associated with symptom severity. Conclusion: Our scoping review highlights a significant association between HIV and menopause among WLHIV in Sub-Saharan Africa. WLHIV experience severe menopausal symptoms, earlier menopause, and lower bone mineral density compared to women without HIV. However, research is limited, and findings are inconsistent. Future longitudinal studies are required to understand the complex relationship between menopause and HIV for the development of effective interventions. Integrating menopause care into HIV services is crucial for improving health outcomes and quality of life among WLHIV in this region.
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    Open Access
    Prevention of diseases after menopause
    (2014) Lobo, R A; Davis, S R; de Villiers, T J; Gompel, A; Henderson, V W; Hodis, H N; Lumsden, M A; Mack, W J; Shapiro, S; Baber, R J
    AbstractWomen may expect to spend more than a third of their lives after menopause. Beginning in the sixth decade, many chronic diseases will begin to emerge, which will affect both the quality and quantity of a woman's life. Thus, the onset of menopause heralds an opportunity for prevention strategies to improve the quality of life and enhance longevity. Obesity, metabolic syndrome and diabetes, cardiovascular disease, osteoporosis and osteoarthritis, cognitive decline, dementia and depression, and cancer are the major diseases of concern. Prevention strategies at menopause have to begin with screening and careful assessment for risk factors, which should also include molecular and genetic diagnostics, as these become available. Identification of certain risks will then allow directed therapy. Evidence-based prevention for the diseases noted above include lifestyle management, cessation of smoking, curtailing excessive alcohol consumption, a healthy diet and moderate exercise, as well as mentally stimula...
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    Risks and benefits of hormone therapy: has medical dogma now been overturned?
    (2014) Shapiro, S; de Villiers, T J; Pines, A; Sturdee, D W; Baber, R J; Panay, N; Stevenson, J C; Mueck, A O; Burger, H G
    BACKGROUND In an integrated overview of the benefits and risks of menopausal hormone therapy (HT), the Women's Health Initiative (WHI) investigators have claimed that their 'findings … do not support use of this therapy for chronic disease prevention'. In an accompanying editorial, it was claimed that 'the WHI overturned medical dogma regarding menopausal [HT]'. OBJECTIVES To evaluate those claims. METHODS Epidemiological criteria of causation were applied to the evidence. RESULTS A 'global index' purporting to summarize the overall benefit versus the risk of HT was not valid, and it was biased. For coronary heart disease, an increased risk in users of estrogen plus progestogen (E + P), previously reported by the WHI, was not confirmed. The WHI study did not establish that E+ P increases the risk of breast cancer; the findings suggest that unopposed estrogen therapy (ET) does not increase the risk, and may even reduce it. The findings for stroke and pulmonary embolism were compatible with an increased risk, and among E+ P users there were credible reductions in the risk of colorectal and endometrial cancer. For E+ P and ET users, there were credible reductions in the risk of hip fracture. Under 'worst case' and 'best case' assumptions, the changes in the incidence of the outcomes attributable to HT were minor. CONCLUSIONS Over-interpretation and misrepresentation of the WHI findings have damaged the health and well-being of menopausal women by convincing them and their health professionals that the risks of HT outweigh the benefits.