Being in postmenopause may be associated with lower prevalence of COVID-19 symptoms among women over 45 years of age with and without HIV.

OBJECTIVE

Menopause is associated with COVID-19 severity among women without HIV (WWoH). Yet, little is known about menopause and COVID-19 among women with HIV (WWH).

METHODS

We conducted a cross-sectional analysis of survey data collected in 2020-2022 from WWH and WWoH over 45 years of age enrolled in the Multicenter AIDS Cohort Study/Women's Interagency HIV Study Combined Cohort Study. Women were categorized as premenopausal (no report of menstrual irregularities), perimenopausal (menstruating, with irregularities or self-reported menopause), or postmenopausal (amenorrhea for at least 1 year). Women who reported a positive COVID-19 test in any setting were asked about COVID-19 symptoms. COVID-19 symptoms during the most recent confirmed infection were compared across HIV status and menopause stage.

RESULTS

Among 1,244 eligible women (70% WWH), 15% were premenopausal, 9% were perimenopausal, and 76% were postmenopausal. Among 112 women with a prior positive COVID-19 test, HIV status was not associated with COVID-19 symptoms. We combined women across HIV status and compared symptoms during premenopause/perimenopause versus postmenopause. Having any COVID-19 symptom was more common among women in premenopause/perimenopause (89%) than in postmenopause (70%). Compared with women in postmenopause, women in premenopause/perimenopause had higher odds of reporting muscle aches, fatigue, and loss of smell/taste after controlling for HIV, age, race, and ethnicity. When examining premenopause and perimenopause separately and when using alternative criteria to define menopause stage in sensitivity analyses, aches, fatigue, and loss of smell/taste remained least common in postmenopause.

CONCLUSIONS

COVID-19 symptoms may be least prevalent in postmenopause and may overlap with menopause symptoms in WWH and WWoH.