Menopausal hormone therapy for women living with HIV

Lancet HIV. 2021 Sep;8(9):e591-e598. doi: 10.1016/S2352-3018(21)00148-X. Epub 2021 Aug 9.


People living with HIV are ageing, and a growing number of women living with HIV are entering menopause. Women living with HIV commonly have bothersome vasomotor symptoms and onset of menopause at earlier ages; both factors go on to affect quality of life and systemic health. Vasomotor symptoms and early menopause are both indications for menopausal hormone therapy; however, current evidence suggests that this therapy is seldom offered to women living with HIV. Additionally, women living with HIV have several risks to bone health and are likely to benefit from the bone-strengthening effects of menopausal hormone therapy. We present an assessment of the benefits and risks of menopausal hormone therapy in the context of HIV care and propose a practical approach to its prescription. If considered in the appropriate clinical context with discussion of risks and benefits, menopausal hormone therapy might provide substantial benefits to symptomatic menopausal women living with HIV and improve health-related quality of life.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anti-Retroviral Agents / therapeutic use
  • Drug Interactions
  • Female
  • HIV Infections / drug therapy*
  • HIV Infections / physiopathology
  • HIV Long-Term Survivors*
  • Hormone Replacement Therapy* / adverse effects
  • Hormone Replacement Therapy* / statistics & numerical data
  • Humans
  • Menopause, Premature
  • Quality of Life
  • Vasomotor System / drug effects
  • Vasomotor System / physiopathology


  • Anti-Retroviral Agents