Menopause is a significant life stage for all women, bringing physical and emotional changes. But for women with multiple sclerosis (MS), this transition may have a more profound impact, potentially worsening symptoms and accelerating disability, according to a new study published in Neurology.
The research, led by Dr. Riley Bove, an associate professor of neurology at the University of California San Francisco Weill Institute for Neurosciences, explored how menopause affects MS progression. “We know that early menopause, especially surgical menopause, is linked to a higher risk of brain-related conditions like dementia,” Dr. Bove explains. “We wanted to see if menopause also worsens MS severity due to changes in the brain.”
The findings? “We observed a small but significant acceleration in disability progression for women with MS after menopause,” Dr. Bove says.
Study Details
The study followed 184 postmenopausal women with MS for 13 years. Among them, 85% experienced natural menopause at an average age of 50, while 15% underwent surgical menopause after ovary removal.
Researchers used two key measures to track disease progression:
- The Multiple Sclerosis Functional Composite (MSFC), which evaluates walking speed, dexterity, and cognition.
- Blood tests to monitor nerve injury severity.
Combining these results, the team assessed participants’ disability levels using the Expanded Disability Status Scale (EDSS), a common tool for measuring MS disability.
“We found a subtle but consistent worsening in functional scores and nerve damage after menopause,” Dr. Bove notes. “Walking speed, in particular, declined more noticeably.”
The Link Between Menopause and MS
Women with MS often report that menopause worsens their symptoms. Hormonal changes during this time can amplify challenges like fatigue, sleep disruption, and mood swings. Hot flashes, a common menopausal symptom, can further disrupt sleep and increase fatigue, making MS symptoms harder to manage.
However, not all women experience worsening symptoms. A review in the International Journal of Women’s Health found that 40% of women with MS reported worse symptoms after menopause, 56% saw no change, and 5% even experienced improvement.
Dr. Bove’s previous research highlights that menopause often brings increased anxiety, depression, bladder issues, fatigue, and low libido for women with MS. “We structured this study to separate the effects of reproductive aging from biological aging,” she explains.
How Menopause Affects the Brain
The connection between menopause and MS lies in hormonal changes, particularly involving estrogen. During perimenopause (the years leading up to menopause), the brain develops more estrogen receptors to compensate for declining hormone levels.
“Hormones like estrogen and testosterone play a key role in MS,” says Dr. Tirisham Gyang, a neurologist and MS specialist at The Ohio State University Wexner Medical Center. “While MS is a chronic inflammatory disease, hormonal shifts can influence symptom severity and disease progression.”
Could Hormone Therapy Help
Hormone therapy (HT) is often used to ease menopausal symptoms, but its impact on MS remains unclear. In Dr. Bove’s study, only 17% of participants used estrogen-based HT for at least a year, making it difficult to draw firm conclusions.
However, earlier research suggests HT may benefit women with MS by slowing disease progression and improving brain function. A commentary in Multiple Sclerosis highlights its potential to enhance quality of life during menopause.
Dr. Bove emphasizes the importance of open communication with healthcare providers. “Understanding how menopause affects MS can help women and clinicians focus on healthy aging and maintaining function,” she says.
Key Takeaways
- Menopause may accelerate disability progression in women with MS.
- Hormonal changes during menopause can worsen symptoms like fatigue, mood swings, and walking difficulties.
- Hormone therapy may offer benefits, but more research is needed.
- Women with MS should discuss menopause-related changes with their healthcare providers to manage symptoms effectively.
By raising awareness of the menopause-MS connection, women and their doctors can better navigate this challenging phase and prioritize strategies for maintaining health and function.
Related topics:
- Study Reveals Rising Rates of Untreated Perimenopause Symptoms in Young Women
- New Study Cracks The Code On Ovarian Aging And Menopause Timing
- Surprising Link Between Heavy Periods And Fatigue In Perimenopause
