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Menopause and MS

The menopause is a time of hormonal upheaval for many women. With or without MS, it can be a quite difficult time.

During the menopause a woman’s body stops producing the hormone oestrogen in any significant quantity. Oestrogen plays a part in how her immune system works. It might protect the nerves in her brain and spinal cord that are damaged by MS.

Do oestrogen levels and the menopause affect how many relapses a woman has? Do they affect how quickly her MS might get worse?

We’ll need more studies before we can answer these questions with some certainty. Few studies have looked into this, and they often look at small numbers of women. Some have suggested menopause makes worsens MS symptoms, or causes disability to get worse quicker. Some show that for most women it doesn’t make MS worse.

Menopause and MS research

A study from 2015 found that, after the menopause, the rate at which women’s disability worsens might sped up a little. But a 2018 study of 37 women found disability didn’t get worse any faster after menopause, but relapses happened less often. 

The picture is complicated by the fact that MS gets worse as people get older. So research needs to find out whether it’s ageing or specifically the menopause that’s making MS get worse in women.

Also, no matter what your hormone levels are, just feeling hot can trigger 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.

Oestrogen, the menopause and MS 

Some small studies have found taking oestrogen had benefits for women with relapsing MS. One in 2016 found women who took oestriol, a type of oestrogen, along with a DMT saw their relapses almost halve after one year. That was compared to women who just took the DMT (which was glatiramer acetate; its brand name is Copaxone). We need more and bigger studies to look at this.

Hormone replacement therapy (HRT) for women with MS

The benefits of hormone replacement therapy for women with MS is another topic we need more research about. But we do know that all types of HRT can be used safely by women with MS (tablets, patches, gels and implants). If you’re thinking of hormone replacement therapy, speak to your doctor, MS nurse or other healthcare professional.