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Treatment Issues for Women

By Angela Garcia, Jennifer McGaugh, Heidi Nass, Cathy Olufs and Claire Rappoport

November 2002

Muscle Mass

There is more benefit to having muscle than just looking good! Muscle provides important fuel for the day-to-day operations of the body, including fighting infections.

If you lose more than 5% of your weight without trying (7 lbs. for a 140 lb. woman) and you can't explain it, you should get help to figure out what's happening. Many of us are praised and told we look great when we lose weight, but much HIV-related weight loss is often a loss of muscle. Reduced muscle mass can be a sign of wasting, which is linked to faster disease progression. Weight loss may also be happening along with other changes in your body shape and metabolism that need to be watched.

There is a simple test -- called BIA (bioelectrical impedance analysis) -- to see if you have healthy levels of overall muscle, fat and water in your body. To measure the fat or muscle in any one part of your body, you would need a CT scan or DEXA scan. If these tests are not available, it's also possible to measure body dimensions with calipers, a tool that gently pinches flesh at different points on your body. You may want to measure your body composition periodically, since body shape changes aren't always immediately visible.

Gaining and maintaining muscle mass is critical to surviving HIV, because muscle helps keep hormones regulated and helps your body fight infection. It's also necessary to get enough calories from healthy foods and to drink plenty of water. A combination of resistance exercise (like lifting weights) and aerobic exercise (like climbing stairs or swimming) is important, since resistance work builds muscle and aerobic work burns fat.

There are unanswered questions about using testosterone in women, but human growth hormone (Serostim) or the anabolic steroid oxandrolone (Oxandrin), combined with exercise, may be options for women who need extra help to build muscle. Both of these treatments are extremely expensive, and Oxandrin can be particularly difficult to get. If you're considering either of these drugs, you may want to talk to other women about their experience using them.

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