- International Women’s Day (8 March) celebrates the social, cultural, economic and political achievements of women. This year’s theme is Accelerate Action for gender equality.
- MS disproportionately affects more women than men – three out of four Australians diagnosed with MS are women.
- Pregnancy and menopause affect MS symptoms in women living with MS, but further research is required to understand the reasons behind these changes.
- MS Australia is supporting research into how menopause and midlife affect women with MS as well as the impact MS has on women’s earning capacity.
8 March is International Women’s Day and is dedicated to the advancement of women worldwide. It celebrates the social, economic, cultural and political achievements of women and marks a call to action for accelerating gender equality.
This year’s theme is Accelerate Action for gender equality. Highlighting the necessity to Accelerate Action underscores the critical need for prompt and decisive measures to attain gender equality. It stresses the urgency and increased momentum required to tackle the systemic barriers and biases that women encounter in both their personal and professional lives.
Why is gender inequality an issue in MS?
In people living with MS, MS has a greater impact on women:
- Three out of four people living with MS are women.
- Pregnancy and menopause have a unique impact on the symptoms that women with MS experience.
- Overall, women earn less than men in Australia and this may be further compounded by disability due to MS.
MS affects three times as many women as it does men
In Australia, three-quarters of people living with MS are women. Researchers have shown that this gender difference is not apparent in cases of MS that occur before puberty and after menopause. This shows that it is likely to be the sex hormones that influence the immune system in a way that contributes to the development of MS. However, more research is required to completely understand this.
Pregnancy and MS symptoms
A recent review published by Australian researchers in Nature Reviews Neurology highlighted that the female sex hormone, oestrogen, can have different effects on the immune system depending on its levels. At lower levels, like those found during the menstrual cycle, oestrogen can stimulate the immune system and have an inflammatory effect. At higher levels, like during pregnancy, oestrogen has anti-inflammatory effects. This high level of oestrogen is thought to be one reason for improved symptoms in women with MS during pregnancy.
Other sex hormones also increase in pregnancy (progesterone, testosterone and prolactin), but not as much as oestrogen does, and they all contribute to anti-inflammatory effects during pregnancy.
After pregnancy, the levels of oestrogen and the other sex hormones decrease, leading to increased inflammation. This may explain why the risk of relapse increases in the months following birth.
However, our understanding of the effects of pregnancy on MS in the long term is still developing.
Menopause – the impact of hormonal changes and MS
There’s still very little research on how menopause affects MS, leaving many unanswered questions about its impact on symptoms, disease progression, and treatment. One challenge for researchers is separating the effects of menopause from the effects of ageing when studying changes in MS symptoms.
During menopause, oestrogen levels decrease, to below that of non-pregnancy and menstrual cycle levels. This is associated with reduced activity in the pathways that protect the brain and spinal cord. Our knowledge about the impact of menopause on MS symptoms is still limited, and research so far suggests that MS symptoms may become worse after menopause.
The evidence for the impact menopausal hormone replacement therapy has on MS symptoms is also limited.
A recent study by researchers at the University of California, San Francisco, analysed MS progression and serum neurofilament light chain(sNfl, a protein released by injured nerve cells that can be measured in blood and cerebrospinal fluid) in 184 post-menopausal women with MS. Published in Neurology, the researchers found that menopause was a point in time where thinking and memory, fine motor skills and walking abilities became worse and the level of sNfl increased, indicating disease progression.
However, there were no changes to the total volume of lesions, indicating that menopause was not a time of changes in inflammation. The researchers also found that overall function (combining sensory, bowel, bladder, visual and some brain functions) improved.
MS Australia-funded research aiming to close the gender gap
MS Australia is helping to close the gender gap by supporting research that addresses critical issues affecting women and marginalised groups in the context of MS. As part of the 2025 grants announcement, MS Australia will fund two projects specifically aimed at addressing the gender gap.
Menopause and MS
Changes in society, like having children later, increased use of IVF, and more women working during menopause, can affect how menopausal symptoms impact women.
For women with MS, this period can be even more complex. Common menopausal symptoms like hot flushes and sweats can be mistaken for worsening MS symptoms. It can be challenging to tell if new symptoms are due to menopause or MS because they can overlap.
MS Australia is supporting Professor Susan Davis AO and Associate Professor Vilija Jokubaitis from Monash University, VIC to study the impact of menopause and midlife circumstances on the quality of life of women aged 40-69 years. The team will then compare their findings with the experiences of women in the general population.
It is anticipated that the comparison will help us understand which symptoms are due to MS and which ones are due to menopause and provide women with the information they need to choose the most suitable treatment for them.
Women with MS and its impact on financial earnings
In Australia, women earn less income than men. However, when disability and gender intersect, a double burden of wage discrimination occurs, which has been seen in Sweden. Dr Julie Campbell from the University of Tasmania, TAS and her team are interested in exploring whether the same findings apply in Australia.
This will be the first study in Australia to investigate whether women living with MS earn even less money than women without MS.
The findings of this study will provide the evidence needed to support advocating for wage equality for women living with MS.
Why is this important for women with MS?
Women face unique health challenges due to pregnancy and menopause, as well as socioeconomic challenges as they earn less income than men on average. MS disproportionately affects women and adds additional challenges to both their health and earning capacity.
In line with International Women’s Day’s theme Accelerate Action for gender equality, the research funded by MS Australia aims to provide evidence to empower women with MS to choose the most suitable treatments to manage their symptoms. Additionally, it will offer much-needed information on the impact of MS on women’s earning capacity and identify avenues for closing the wage gap.
