Women with HIV are living longer, so more are entering menopause. As they do, they suffer more severe hot flashes than women without HIV, and their hot flashes take a heavier toll on their quality of life and daily functioning, found researchers at Massachusetts General Hospital. Their study was published online in Menopause, the journal of The North American Menopause Society.

That toll has the potential to undermine an already shaky foundation for their lives, compromising their health, HIV treatment, and ability to abstain from drugs and alcohol, worried the authors. They urged clinicians who care for midlife HIV-infected women to evaluate hot flashes and their impact and offer treatment that can help.

The 33 HIV-infected women in the study, age 45 to 48, were in perimenopause - having irregular cycles. They answered questionnaires about their hot flash frequency and severity and other menopausal symptoms as well as about the effect the hot flashes had on their daily activities and quality of life. The answers were compared with those of a similar group of perimenopausal women without HIV.

While the women with HIV were experiencing moderate hot flashes, the uninfected women's hot flashes were mild. The women with HIV also had more sleep problems and more depressed moods, irritability, and anxiety. Hot flashes also interfered more with their work, social and leisure activities, concentration, relationships with others, sexuality, enjoyment of life, and overall quality of life than they did for women without HIV. In fact, the drag on quality of life was actually greater than what has been reported for breast cancer survivors, noted the authors.

It isn't clear why hot flashes are worse in women with HIV. That needs more research, they said.