The overlap between menopause and multiple sclerosis (MS) can be confusing. Many women with MS notice worsening symptoms around the time their hormones change, but it’s not always clear whether menopause itself is driving the change, or if it’s simply the natural progression of the disease and aging. New research clarifies the relationship, and this article breaks down what it means for women managing both conditions.
The Overlap: Why Symptoms Blur Together
Menopause brings fluctuating and declining hormone levels, which can cause symptoms like sleep problems, difficulty concentrating, mood swings, and bladder/bowel changes. These symptoms often mimic those of MS, leading many women to ask: “Is this MS, menopause, or both?” It’s common for symptoms to be multifactorial, but it’s important to remember that these changes aren’t necessarily signs of worsening MS.
Hormones and MS: The Complex Connection
Sex hormones play a key role in MS. Before puberty, MS rates are similar in both sexes. After puberty, however, women are three times more likely to develop MS. During pregnancy, many women experience remission due to hormonal shifts. This suggests that hormones influence both the development and course of MS.
The question has been whether the decline in estrogen and progesterone during menopause could worsen MS. Some studies suggested a link, while others did not. The latest research sheds light on this debate.
New Research: Aging, Not Menopause, Drives Disability
A large-scale study found that menopause itself does not speed up MS disability or accelerate the shift to a progressive form of the disease. While age and disease duration still matter, menopause isn’t the major driver many experts suspected.
Researchers found that biological aging, rather than reproductive aging, is the primary factor driving physical disability. This means the natural decline in bodily functions with age is more influential than the hormonal changes of menopause.
Why MS Often Worsens in Midlife
MS tends to shift from relapsing to progressive around midlife. As the body ages, its ability to repair nerve damage decreases, leading to chronic inflammation and gradually worsening symptoms like balance problems, weakness, and memory difficulties.
What This Means for Women with MS
The latest findings don’t mean menopause has no impact on MS. It means that the worsening of symptoms is likely due to the natural progression of the disease and aging, rather than menopause itself.
However, the overlap between menopause and MS symptoms can still be distressing. Women experiencing hot flashes, sleep problems, or mood swings should discuss these concerns with their healthcare team.
Managing Menopause Symptoms When You Have MS
Managing menopause symptoms can improve quality of life for women with MS. Comprehensive care, including lifestyle measures like exercise and a healthy diet, can help. Hormone therapy or nonhormonal medications may also be beneficial.
While there isn’t solid evidence that hormone therapy prevents MS progression, it can alleviate bothersome symptoms like hot flashes and maintain bone density.
The Takeaway
Both aging and hormonal changes influence MS progression. While menopause can overlap with worsening symptoms, the latest research suggests it doesn’t directly accelerate disability.
Women with MS should track their symptoms, discuss preventive screenings with their doctor, and explore treatment options for menopause-related issues.
The key is to understand that aging and natural disease progression are the primary drivers of change, while menopause itself is not the sole culprit.
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