Substance Use Linked to Increased Menopausal Symptoms in Women With and Without HIV: Study
Researchers have found in a study that substance use of alcohol, marijuana, tobacco, and opioids is independently associated with greater reported frequency of vasomotor symptoms, mood problems, and musculoskeletal complaints among women regardless of HIV status. A recent 12-year longitudinal study (2008-2020) provides insights into the potential role of substance use in the severity of menopausal symptoms. This study may serve as a guide for the need for targeted intervention and professional menopausal care for those affected. This study was recently published in the journal Menopause by Knittel A. and colleagues.
Menopausal symptoms, particularly vasomotor (e.g., hot flashes), mood disturbances, and musculoskeletal pain, increase in prevalence during the menopausal transition and can severely affect quality of life. The present investigation tests associations between various substance uses and frequency of menopausal symptoms among women living both with and without HIV.
The authors examined data from the WIHS, a longitudinal cohort study of 1,949 participants with biannual visits from 2008 to 2020. For this analysis, the authors selected self-reported menopausal symptoms and substance use: tobacco, alcohol, marijuana, crack/cocaine, and opioids. Logistic regression models were used to quantify the associations between each substance use and frequency of menopausal symptoms, adjusting for other variables such as HIV status, demographics, comorbidities, and trauma.
Results
• Participating women represented all three reproductive stages: early perimenopausal, late perimenopausal, and postmenopausal.
• By stage, the frequency of vasomotor symptoms ranged between 22% and 43%, mood symptoms from 18% to 28%, and musculoskeletal symptoms between 25% and 34%.
• The prevalence of substance use was high, with 72% reporting lifetime tobacco use, 75% heavy alcohol use, 73% marijuana use, 50% crack use, and 31% opioid use.
• Current heavy alcohol use was associated with a 22% increased odds of frequent vasomotor symptoms (OR: 1.22; 95% CI: 1.10‐1.37).
• Cumulative marijuana use was related to a 15% increased odds (OR: 1.15, 95% CI: 1.01‐1.32), and cumulative tobacco use was associated with a 6% increased odds (OR: 1.06, 95% CI: 1.01‐1.12).
• The likelihood of mood symptoms was 20% higher for current heavy use of alcohol (OR: 1.20, 95% CI: 1.04‐1.39).
• In the same way, current opioid use produced a 13% higher likelihood (OR: 1.13; 95% CI: 1.01‐1.25).
• In the case of current opioid use, the odds of musculoskeletal symptoms were raised by 11% (OR: 1.11, 95% CI: 1.00‐1.23).
Findings indicate both current and cumulative effects of substance use on the frequency of menopausal symptoms. The strong relationships between substance use and such symptoms as disturbances in vasomotor functioning, mood changes, and musculoskeletal pain point to the importance of obtaining a substance use history in the treatment of menopausal symptoms, particularly in women who have a history of heavy or chronic use.
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