# Psychological and Somatic challenges identified in a Menopause Rating Scale assessment of women living with HIV in Lagos, Nigeria

## TL;DR

This study compares menopausal symptoms in women living with HIV and HIV-negative women in Nigeria, finding similar psychological and physical challenges that impact quality of life.

## Contribution

The study provides insights into menopausal symptom prevalence among HIV-positive women in Lagos, Nigeria, using the Menopause Rating Scale.

## Key findings

- Women living with HIV experience significant psychological and somatic menopausal symptoms similar to uninfected women.
- Common symptoms include joint/muscle complaints, anxiety, depression, and exhaustion in both groups.
- Severe symptoms were reported by 3.2% of participants, highlighting the need for targeted clinical care.

## Abstract

Human immunodeficiency virus (HIV) infection remains a global health challenge disproportionately affecting women. Women living with HIV (WLWH) may experience earlier and more intense menopausal symptoms than others, which may influence their retention in therapy and treatment response. A standardized life quality assessment scale, the menopause rating scale (MRS), is a health-related quality-of-life tool for symptoms evaluation and is valuable in diagnosing menopause challenges. The objective was to assess the menopausal psychological and somatic challenges of WLWH on antiretroviral therapy using the MRS, and evaluate occurrence of menopausal symptoms, in comparison with women free from the infection.

A cross-sectional descriptive study was adopted. Adult WLWH (n=344), 35 to 65 years (encompassing the pre-, peri- and post-menopausal stages) on ART for at least two years were surveyed using the MRS questionnaire (psychological, somatic and urogenital) including socio-demographic queries. A control group (n=90) composed of age-matched women were also assessed for the same. Frequency distribution and p-values were calculated using Epi info (version 7).

Among the 344 WLWH, 157 (45.6%), 12 (3.4%) and 175 (51%), were pre-, peri-, and postmenopausal, respectively. Median age of menopause onset was 48 (IQR 42-52) and 49.3 (IQR 45-55) years. Somatic and psychological challenges were more experienced by the WLWH, comprising joint/muscle complaints, sleeping disorders, anxiety, depression, irritability and exhaustion at rates of 59.4%, 29.2%, 27.4%, 26.5%, 23.5%, and 22.3% respectively. Controls had somewhat similar levels of challenges, at 52.2%, 31.1%, 27.7%, 23.3%, 21.1%, and 18.8% respectively. Participants with severe symptoms were 3.2%.

WLWH had major psychological and somatic challenges indistinctive from uninfected women, which included joint/muscle complaints, depression and anxiety. Menopausal WLWHexperience unique challenges that require thoughtful solutions. To enhance clinical care, it is essential to prioritize these factors that improve their quality of life.