In this two-part episode, Dr Naomi Sutton and Dr Shema Tariq have a rousing conversation on a topic rarely discussed in public: menopause in persons living with HIV. The first episode begins with Menopause 101: what is menopause and what happens to the body with oestrogen decline. Shema walks listeners through common symptoms like hot flushes, poor sleep, mood changes and dry vaginas; findings from the PRIME study; and how these menopausal symptoms interfere not only with wellbeing and sexual function but the ability of women to manage their HIV. We also learn that a little topical oestrogen goes a long way.

"One in four women will have hot flushes that are so severe that they impact their daily lives and we know it impacts women’s ability to work and also how they function in relationships.""If people listening to this just take home one thing, it’s to think about topical vaginal oestrogens."

In this two-part episode, Dr Naomi Sutton and Dr Shema Tariq have a rousing conversation on a topic rarely discussed in public: menopause in persons living with HIV. The second episode picks up with the benefits of using systemic HRT in menopausal women living with HIV weighed up against its risks, before moving onto premature ovarian insufficiency, FSH testing, and what HIV clinicians can be doing better. Shema signposts listeners to invaluable patient resources at the Sophia Forum, aidsmap, Positively UK and the GROWS project.

"If a woman is in her 40s, start asking her proactively about menopausal symptoms. It doesn’t take long. You just need to ask her about hot flushes, ask her about her mood, and ask her about sex, because otherwise she’s not going to volunteer it.""Women who don’t have that exposure to oestrogen up to the usual age of 50-51 are much more likely to develop cardiovascular disease and osteoporosis and a whole host of other things. The treatment for that is HRT."