Does HIV affect your period? We got your answers!

by Ann K. Avery, MD

By: Ann K. Avery, MD, Infectious Disease Physician at MetroHealth Medical Center

Oh, the dreaded time of the month for anyone with ovaries and a uterus around the globe. Many, including those who aren’t living with HIV, experience menstruation woes. But did you know that HIV can cause changes in your menstrual periods? Yuuuupp. It’s true. If you’re living with HIV and are experiencing any of these menstrual problems listed below, we recommend contacting your doctor.

  • Heavy bleeding
  • Very little bleeding
  • Light bleeding (or spotting) between periods
  • Missed periods
  • More than three months between periods
  • Severe premenstrual syndrome (PMS)

So, how does HIV cause menstrual issues?

HIV might be causing changes in your period because of the way the virus affects your immune system. And changes in your immune system can affect hormones like estrogen and progesterone - the hormones that ultimately control your periods. In short, the more active your HIV, the more likely you are to have problems with your period.

Which brings us to gender-affirming hormones. If you’re thinking about, or already in the process of gender-affirming hormone therapy, this could affect or contribute to period problems. In short, changes in your body’s level of estrogen and progesterone can affect your period cycles, also causing irregular periods. Make sure to disclose any hormone therapy treatments to your doctor when discussing period issues you might be experiencing.

In addition, your HIV drugs could cause you to have heavier periods. Having HIV can affect your periods in less direct ways too, though:

  • Stress
  • Weight loss
  • Anemia
  • Poor nutrition
  • Infections

You may have spotting or heavy bleeding if you have lesions on the cervix caused by human papillomavirus, aka HPV. You are more likely to have this infection if you are sexually active and have HIV.

Some other causes of period problems

Your period probs might not even be related to HIV. In fact, many face common period issues despite their HIV status.

Common causes of menstrual problems include:

  • Taking certain drugs, including over-the-counter, street, and prescription drugs
  • Sudden weight loss
  • Pelvic inflammatory diseases (PID), which are infections in your reproductive system
  • Non-cancerous growths such as ovarian cysts and uterine fibroids
  • Genital cancers, including ovarian, uterine, and cervical cancer
  • Thyroid problems
  • Pregnancy
  • Menopause

So, how do I fix my period issues?!

If you are in fact having problems with your period, you need to schedule a doctor appointment to find out exactly why. It may have nothing to do with HIV, but finding the cause is important to helping you feel better around that time of each month. Let your doctor know if you have heavy bleeding, bleeding between periods, or if you miss two periods in a row.

To figure out the cause of your period issues, your doctor might try one of the following:

  • Perform a pelvic examination
  • Test for sexually transmitted diseases
  • Do a Pap smear to check for cervical cancer
  • Order a blood test for hormone changes
  • Review your drug history
  • Use ultrasound to look for abnormal growths
  • Take a tissue sample to look for cancer or inflammation

Don’t have a doctor yet? That’s okay – this is your time to do your research to find the right doctor for your health needs. Women typically see an OB/GYN doctor for menstruation issues, but that might not be the best fit for someone who is gender non-conforming or trans.

We often hear language in the medical field solely “male or female” or “man or woman.” And that’s just the problem. This kind of language limits a nonbinary person’s ability to safely communicate their medical needs to a doctor. Before you make an appointment with a doctor (if you don’t already have one you like), scope them out. If applicable to you, ask them questions about their experience with queer, trans and nonbinary community. If you feel comfortable, schedule an appointment. But if you don’t – and trust your gut – keep searching. Make sure your doctor is sensitive to your needs and that they can help you the way you need. In fact, here is another blog we’ve written about finding the right doctor as a trans person.

Stay on top of your period health!

We know that time of month ain’t fun for anyone, but that’s no excuse for not staying on top of your period health. Y’all, just like it’s important to know your HIV status, it’s just as important for you to stay ahead of period problems! A few ways to be proactive is to keep track of your periods, keep – and show up – to all your doctor appointments, and get regular pelvic exams and Pap smears. Take care of yourself by eating healthy foods, getting regular exercise, and getting enough sleep.