Menopause and MS

The effects of the menopause can feel similar to MS symptoms, and hot flushes and difficulty sleeping might make MS symptoms feel worse. Finding ways to manage the effects of the menopause could help with MS symptoms too.

Many women feel that their MS changes around the time of menopause. It’s an area that still hasn’t been researched very much, but we’ve looked into some of the questions you might have:

What’s the menopause and when does it happen?

The menopause is when the ovaries stop producing much, or any, of the hormone oestrogen. The ovaries also stop releasing eggs. It marks the time when a woman can no longer produce eggs to make a baby.

It happens to every woman, usually between the ages of 45 and 55. It can also happen because of medical treatments, surgery or as a result of some health conditions.

The effects can be similar to MS symptoms. With the menopause, you could notice:

  • hot flushes (or hot flashes) – short sudden feelings of heat, usually in the face, neck and chest, which can make your skin red and sweaty
  • night sweats
  • difficulty sleeping
  • a reduced sex drive (libido)
  • problems with memory and concentration
  • headaches

Other menopause symptoms can include:

  • vaginal dryness and pain, itching or discomfort during sex
  • mood changes, such as low mood or anxiety
  • palpitations – heartbeats that suddenly become more noticeable
  • joint stiffness, aches and pains
  • reduced muscle size
  • new or more frequent bladder problems

It’s not always easy to know if MS or the menopause is causing a symptom. Or if it’s something else entirely. Let your doctor or MS team know about your symptoms so they can help you find the best way to manage them.

What's the perimenopause?

The perimenopause is the time leading up to the menopause – before your periods stop. It’s when the ovaries have started to reduce their production of oestrogen. It can last for a few months to a few years.

During this time, menopausal symptoms can start, and they can be similar to MS symptoms. Symptoms can be constant, or come and go. You might have more than one symptom at a time.

Does the menopause affect MS relapses or progression?

At the moment we can't be sure about the effect of the menopause on MS relapses or progression.

Research in 2015 found that after the menopause disability might get worse a bit faster than before. But two more recent studies haven’t found this. One of these also suggested that relapses happened less often after the menopause.

We need bigger, good quality research studies to find out more.

Can hot flushes affect my MS symptoms?

In one survey, some women reported that hot flushes caused by the menopause made their existing fatigue and bladder problems flare up until they cooled down again. And no matter what your hormone levels are, feeling hot can trigger MS symptoms.

Find out more about temperature and MS and ways to manage it here

Read the NHS suggestions for managing hot flushes caused by the menopause

Can the menopause be mistaken for MS?

It can be really difficult to tell if some of your symptoms are related to your MS or the menopause. This can be especially hard to work out for symptoms like low sex drive, bladder problems, and fatigue.

If you think these symptoms, or increases in these symptoms, might be related to the menopause speak to your doctor or MS team. HRT (hormone replacement therapy) might improve things for many women. But it’s also important that other causes are considered too, so you can find the best ways to manage them.

Is the menopause affecting my mental health?

Mental health can be affected by the menopause and by MS. So it can be hard to work out if one or both are causing any mental health problems. You might find that adding or changing medication can help, so don’t suffer in silence.

If you're noticing problems with your mood or mental health, speak to your doctor or MS team.

Read more about mental health and MS

Can HRT (hormone replacement therapy) help with the menopause or with my MS?

There hasn’t been much specific research into how well HRT works when someone has MS. But there's no reason to think that MS affects how HRT works.

HRT tablets, patches, gels and implants can be safely used by women with MS.

Your doctor can discuss whether it might be right for you.

Can HRT help with my MS?

We can’t be sure if HRT can help with MS. The evidence from research is mixed.

Some small studies found that taking oestrogen had benefits for women with relapsing MS. In 2016, a study looked at women with MS who took the hormone oestriol along with the disease modifying therapy (DMT) glatiramer acetate. They had almost half the relapses of women taking only the DMT.

We need more and bigger studies for us to get better quality results. But if you want to manage menopause symptoms, HRT might be something to discuss with your doctor.

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