A to Z of MS Menopause

Menopause appears to have no effect on multiple sclerosis, although there has been little research in this area.

There is some anecdotal evidence which indicates that symptoms that worsen during menopause may be responsive to hormone replacement therapy (HRT), and a small pilot study in 1992 included data on the effects of menopause on MS. It consisted of a questionnaire asking about changes in the severity of symptoms of MS with the menstrual cycle, menopause and use of HRT which was answered retrospectively by 11 pre-menopausal and 19 post-menopausal women. Of the post-menopausal women 54% reported a worsening of symptoms with the menopause. 75% of those who had tried HRT reported an improvement.

It is thought that female hormones may have a neuroprotective effect. This is especially seen in the third trimester of pregnancy in MS, and this is why it is thought HRT may be useful. The majority of women with MS who have used this therapy report an improvement rather than deterioration in their condition. However, owing to the lack of evidence that oral oestrogen-progestogen combinations have an influence on MS, the condition remains a warning on the drug information sheet for HRT.

Given that loss of bone density may be a problem for people with MS, the beneficial effect of HRT in reducing the risk of osteoporosis for women with MS should be taken into account.

Reference

Smith R, Studd JWW.
A pilot study of the effect upon multiple sclerosis of the menopause, hormone replacement therapy and the menstrual cycle.
Journal of the Royal Society of Medicine 1992; 85(10): 612-613.
abstract

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