Dear Dr. Feinberg:

I wasn't sure which category this fit under, so I will ask you...

In July, 1999, My t-cell count was almost 1,000, and my viral load had been undetectable for some time and the side effects from the meds were ruining my life, so with a doctors care, I went on a "drug holiday" I am not sure about my counts that I took 2 days ago, but for the last 4 months previous, my viral load was hovering at 38,000 and my cd4 count went up slightly from 400 to 490 something. Now, I think that those counts have changed, even though they didn't change for 4 months, anyway, as my t-cells went down OR as my viral load went up, my pms went from bothersome to excruciating. I am even having burst ovarian cysts, which is extremely unusual, due to the fact that I run 4-5 miles a day, which before, meant that i barely had ANY pms. When I ask the doctor, and these are AIDS specialists, I get blank looks and "here, take some Prozac" which is fine, hey, I don't need a sex life! But I am getting worse! I wonder, do you know why this is happening?

I belong to a women's HIV support group and the consensus is frightening, so many of them are going through menopause in their 30's and EARLY 40's. HELP!

I'm not sure your PMS and other gynecologic symptoms have anything to do with your HIV disease. It may have been coincidental that these symptoms worsened when you were off your HIV meds. I suggest that you see if staying on your HIV meds has a beneficial effect on your gynecologic symptoms, and i think you need to be seen by a gynecologist (preferably one who is familiar with caring for HIV+ women) for specific care for your gynecology problems including the ovarian cysts. There are medications that may make you more comfortable.