Menopause in women with multiple sclerosis: clinical symptoms, therapeutic considerations and possible impact on the course of the disease

Abstract

Menopause signals a major shift in hormonal levels in women and causes a variety of symptoms that can overlap and/or interact with those related to multiple sclerosis (MS). These symptoms can have considerable impact on the quality of life for many women living with MS. Menopause remains a largely unexplored period for women with MS and there are only a few studies that have attempted to investigate the potential effect that menopause may have on the clinical course of MS, including inflammatory activity and disability progression. However, the limitations of these studies, including small sample size and lack of controlling for confounding factors, such as aging and disease duration, undermine the reliability of their results. Larger longitudinal cohort studies are required to draw robust conclusions on whether menopause impacts the course of MS. It is important that clinicians facilitate open discussions around both MS and menopausal symptoms, given the potential considerable overlap many women are likely to experience. Understanding how to recognise and appropriately manage menopausal symptoms can have a major impact on the quality of life of the individual.