- MS affects three times more women than men in Australia, but the impact of menopause on MS has been unclear.
- A new Australian study found that menopause did not increase the speed of disability progression or of transitioning to secondary progressive MS.
- The results provide reassurance for women with MS undergoing menopause.
Does menopause affect MS?
In Australian women, the average age of menopause is 51 years. With MS onset between 20 and 40 years of age, most women with MS will experience menopause while living with MS.
Smaller studies in the past have given conflicting results on how menopause affects MS. MS disability may worsen after menopause, but it has been challenging for researchers to separate the effects of menopause from the effects of ageing. Also, common menopausal symptoms such as hot flushes can be mistaken for worsening MS symptoms.
What did the researchers do?
In a large study led by Australian researchers, 987 Australian women answered questions about their menopause status and age at menopause. Women with “relapse-onset MS” (either relapsing-remitting or secondary progressive MS) were included, and clinical data from the MSBase registry were used to monitor disability for an average of 7 years. Researchers analysed whether menopause reduced the time to confirmed disability progression (defined as sustained increases in Expanded Disability Status Scores (EDSS) for at least 6 months), as well as the time to progress to secondary progressive MS.
What did the researchers find?
The researchers found that menopause did not speed up disability progression, nor did it speed up the transition to secondary progressive MS.
Instead, faster disability progression was linked to being older at the onset of MS, as well as having MS for longer or a higher level of disability at baseline (“baseline” being when the first EDSS measurement was recorded). On the other hand, exposure to high-efficacy disease modifying therapies protected against disability progression.
Having more disability and having MS for longer at baseline were both associated with faster transition to secondary progressive MS, while exposure to high-efficacy disease modifying therapies was protective.
There was no difference between pre- and postmenopausal women in the speed of disability progression.
Time since menopause did not change the speed of disability progression.
What does this mean for women living with MS?
Menopause can be challenging for many women with MS. This study reassures women that menopause does not speed up the progression of disability or hasten the transition to secondary progressive MS. These findings will help women and their healthcare providers make informed decisions about managing their health as they navigate this stage of their lives.
