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Avatar universal

Question for the ladies re hep c and menopause

I was just diagnosed with Hep C in Nov 2007. My liver functions were elevated slightly in 2006. I was blaming it on some meds I had started taking maybe two years prior to that for my heart but when my doc saw that my liver functions had quadrupled from 2006 to 2007, he had me go to a GI doc and that's when we discovered the Hep C. What I'm wondering, is if anyone has noticed that the virus seemed to have become more active when they went through menopause. That's the only other thing that has happened in the last few years that is a change. I'm thinking I was exposed to the virus way back in 1969 through blood transfusions that I had or maybe a needle stick I had on the job in 1997. I'm a nurse. That seems unlikely though because it was more of a scratch than an actual stick although it did draw blood. Back then they only checked us for Hep B, not C, if we had a stick and that was negative on me and the patient. (I had the Hep B vaccine back in 1991). All of my labs have been normal up until 2006, when my SGOT and SGPT were only slightly above normal. Of course, I had never been tested for Hep C and all of the other things I've had checked now. My Iron level and ammonia level are both elevated as well as the alphafetoprotein, tumor marker. I'm a Genotype 1 and stage 3-4. I'm just really wondering why all of a sudden all of this seems to have been stirred up after almost 40 yrs of nothing. Could it be the menopause? And if so, wonder if taking hormones would slow things back down. I don't take anything I don't have to take. Only those two heart meds. I'm 55 now, soon to be 56. Will be talking to the hepatologist about treatment plans probably in two weeks. Have an endoscopy scheduled this Tuesday. Thanks for your input ahead of time.
23 Responses
Avatar universal
What I'm wondering, is if anyone has noticed that the virus seemed to have become more active when they went through menopause.
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Yes, I have noticed this and that's when I made my decision to tx.

My vl pre-menopause was around 700,000.  Peri-menopause is was around 1.2 million,
and post menopause it went to about 5 million.
I am ra+ as well and I was constantly hurting and tired.  
My body was fighting hard and wasn't controlling the virus as well as
before menopause and I could feel it.  I could hardly move.

I made a decision to start tx, and I feel better on tx in many ways (not all) than before.
I just did shot 22 and have been UND since week 12.
enigma
223152 tn?1346981971
I don't know about that.  I think that it is well recorded that liver damage from hepatitis C is not linear -- that it does not progress at an even decline but rather may "head south" at any time.  I think you are very lucky indeed that your enzymes did cause your doctors to test for hep C since you are already a stage 3-4.  

I am 60 and went thru menopause at 50.  I knew I had the antibodies, but never had a viral load test until 2005.  My live enzymes have always been in the 20s so no doctor considered testing me for hep C.  (I know from donating blood in 1993 that I had the antibodies).  Like you, I was probably infected from about 1969 or 1970.  Why have I remained at grade 1, stage 1 for all these years?  I don't know.  I think it is the genetics of the immune system that govern here.

I can't answer your question, but I am glad you are here. Welcome to the forum.  You will find a lot of aswers here and people in the same boat as you.
frijole
Avatar universal
So did you go on hormones after going through menopause? Wonder if that would make a difference. It causes so many potential problems that I haven't even considered it up until now. I don't (knock on wood) have the night sweats, etc. so figured maybe I was going to be lucky and not have any of those symptoms and could go without. It's so strange how this disease works. People look at me and can't believe that I have something so bad and at the stage it is. They keep asking me why aren't I yellow and why aren't I having other symptoms. I just don't know. I tell everyone that I just don't have any answers for myself or for them. I'm just still digging trying to figure out something. I will take the treatments because I'm not ready to give up on something I feel like I haven't even started to fight. I want to be around to harass my kids when they have kids. Thanks for your input. I know I'm going to have lots more questions when I'm told about the treatment next week. Kinda dreading that but at the same time want to get going with it.
86075 tn?1238118691
of course it isn't linear, and it does play out differently in everybody...but they had a few major studies, if you put menopause and hep c in a search engine you'll find them, too tired to do it for you...one major French study on women, I think 400 women or something like that...they saw that many of the women didn't become symptomatic or have their damage go up, etc etc...till they reached menopause...another Irish study as well...they think it's because the estrogen level goes down at menopause, hence the estrogen no longer protects you as well against the virus...when some of these women supplemented with estrogen, they seemed to do better...oh well, I'll go look for it, some people are picky, come back later...lol....

Menopause, Hormone Contraception May Accelerate Liver Fibrosis; Perhaps Hormone Replacement Therapy Can Be Helpful
AASLD
Dallas, Nov 9-13, 2001

abstract 195. IMPACT OF PREGNANCIES, ORAL CONTRACEPTION AND MENOPAUSE ON LIVER FIBROSIS PROGRESSION IN WOMEN WITH CHRONIC HEPATITIS C

Vincent Di Martino, Pascal Lebray, Joseph Moussalli, GH Pitié-Salpêtrière and Réseau VHC Paris-Sud, Paris France; Catherine Buffet, HTMpital Bicêtre et Réseau VHC-Paris Sud, Kremlin-Bicêtre France; Thierry Poynard, GH Pitié-Salpêtrière and Réseau VHC Paris-Sud, Paris France

program abstract:
During chronic hepatitis C (CHC), liver fibrosis progression is faster in males than in females. Among all the factors involved in such difference, estrogenes may be a major one since experimental data recently supported that estrogenes may have direct antifibrosing effect. The aim of this work was to evaluate the influence of pregnancies, oral contraceptives and menopause on liver fibrosis (F) and fibrosis progression rate (FPR) in HCV-infected women, taking into account confusing factors such as age, alcohol consumption, and BMI.

Patients and methods: 472 women with CHC without HBV nor HIV coinfection received an anonymous questionnaire that asked for alcohol and tobacco consumption, presence of diabetes, age at first menstruation, age at pregnancies with or without children, hormonal contraception, age at menopause and its cause if any, and hormonal substitution. These data were completed by those collected in the DOSVIRC database. Liver biopsies performed before antiviral therapy were analyzed using the METAVIR scoring system. The FPR was estimated in case of known date of HCV infection and expressed in milli METAVIR Units of fibrosis per year. Statistical analyses were performed using Kruskall-Wallis rank test and logistic and multiple linear regression models for multivariate analyses.

Results: 212 (44%) women completed the questionnaire. 192 (48±1 years old) underwent adequate liver sample, among whom 99 had 1 to 7 pregnancies (0 to 5 children) during 15±1 months, 86 received oral contraceptive(s) during 31±4 months, 95 had menopause 11±1 years before liver biopsy, and 47 received hormonal substitution during 7±1 years. Only one woman had alcohol intake more than 50g/d. In univariate analysis, F score and/or FPR were significantly lower in women who had one or more pregnancies, who received hormonal contraception, who were seen before menopause or who received hormonal substitution, whereas liver necro-inflammatory lesions(A) were not different (table). After adjustment on age and BMI, multivariate analyses showed that menopause was associated with higher F score and FPR, and that pregnancies were associated with lower FPR ; the effect of oral contraceptives was not significant.

Conclusion: in women with CHC, menopause accelerates the liver fibrosis progression. Such effect seems prevented by hormonal substitution. Pregnancies may have a long-term beneficial impact on liver fibrosis.

editorial note: a pilot study presented at the AASLD Single Conference meeting in June 2001 showed HRT could improve response to HCV therapy for postmenopausal women.
   SEN Virus Variants Are "Unequivocally Transmitted By Blood Transfusion" in the US
Avatar universal
Wow, interesting. I'm going to mention the fact that I have just gone through menopause over the last few years to me hepatologist and see what he says. Wonder if taking replacement hormone therapy would once again slow down the progression. Will be interesting to see what he has to say. Thanks for the info.
86075 tn?1238118691
sorry to sound this way, but don't be surprised if he doesn't know beans about these studies...often docs don't have the time or the inclination to look at all these varying studies, though they should...they should pay someone to do it if they can't...

but we're not in perfect world...if I were you, I don't know how well you can research...but there are a few studies like this out there...I'd print them out and take them to him...and just to be on a safe side, give them to him in the nicest way possible...many of these guys have egos the size of spaceships, and they hate it when patients know more then they do about these things, they are very in to "keeping the facade or all knowing, all seeing" lol....not all of them but many...Some try to be good docs and they are grateful if you call things to their attention....try to hand them to him in the nicest way possible. For all you know, he might even know about them, which would be points for him.....
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