How Menopause Affects Women With Multiple Sclerosis

Menopause is a universal part of aging for women. During menopause, the body produces less of the hormone estrogen. A person's menstrual cycle fluctuates and then stops, and other changes and symptoms will occur.

Women who have multiple sclerosis (MS) may find their MS symptoms are similar to those of menopause, though the experience varies from person to person. There may be other connections between MS and menopause as well.

This article reviews the overlapping symptoms of MS and menopause and potential treatments for symptoms in menopausal women with MS.

Woman Experiencing Hot Flash From Menopause

Highwaystarz Photography / Getty Images

Menopause or MS Flare: Overlapping Symptoms

During menopause, which most women experience between the ages of 45 and 55, lower estrogen levels can cause symptoms that can resemble an MS flare (a time of new or worsening symptoms).

Both menopause and MS can affect:

  • Mood and anxiety levels
  • Clarity of thinking
  • Sleep patterns
  • Bladder function
  • Sensitivity to heat
  • Pain or difficulty during intercourse

Worsening MS Symptoms During Menopause

Some studies have shown that some women with MS felt their symptoms worsened during menopause.

A condition called Uhthoff's phenomenon, in which MS symptoms worsen when body temperature rises, may be linked to menopausal hot flashes. The evidence is not conclusive, however, and more research is needed to establish whether menopause worsens MS symptoms among some women.

Changes in MS symptoms may also be due to:

  • Low levels of vitamin D
  • Aging
  • Smoking
  • Changes in treatment

Not all women with MS experience more severe symptoms while going through menopause, and there is no test to confirm that hot flashes are causing the flares. You can, however, have a blood test to check hormone levels to confirm whether you are going through menopause.

MS Relief After Menopause

There's some potentially good news for women with MS. Preliminary research has indicated that relapses become less frequent after menopause. At the same time, it does not seem to have an effect on the progression of the disease.

Studies so far have not drawn a complete picture, and more research is needed to understand the relationship between MS and menopause.

MS and Hot Flashes

One of the most common symptoms of menopause is hot flashes, when you feel a sudden rush of heat and may sweat profusely. The cause of hot flashes isn't completely understood, but it may be linked to signals from the hypothalamus, a region in the brain that controls body temperature.

For some women with MS, hot flashes may intensify or trigger MS symptoms.

Quick Tips for Hot Flash Relief

No matter what's causing hot flashes, you can take steps to cool yourself down. These include:

  • Use bedding and wear clothing made from materials that promote cooling, like bamboo, cotton, linen, or Tencel.
  • Keep a portable fan or cool, damp towel nearby.
  • Stay hydrated with cool, clear liquids.

Menopause and MS Progression

There is some evidence that menopause may increase disability due to MS progression, but no final determination has been made. If menopause does lead to the loss of some function in people with MS, it may be due to lower estrogen levels reducing a protective effect on nerve fibers.

What to Expect

The experience of menopause can vary widely, as can the symptoms and progression of multiple sclerosis. Researchers are still studying the link between the two, and you may or may not notice worsening MS symptoms.

On the other hand, you may feel you have fewer relapses. What is known is that MS does tend to progress with aging, and menopause does cause some symptoms that are similar to multiple sclerosis.

When to See a Healthcare Provider

If hot flashes seem to make your MS worse, see your healthcare provider. They can evaluate your MS symptoms and determine if a change in treatment is necessary. They can counsel you on the benefits and risks of treatment for menopausal symptoms.

Treatment

Hormone therapy for menopausal women has a controversial history, based on the increased health risks it represents, including blood clots, stroke, and breast cancer. It is an effective treatment for menopausal symptoms, however, and the risks depend on factors that include your general state of health.

For women with MS, hormone therapy may reduce the number of relapses and improve cognitive function, which includes mental processes such as learning, attention, memory, decision making, reasoning, and language comprehension. Current guidelines recommend taking estrogen, or a combination of estrogen and progesterone, for the shortest amount of time and at the lowest effective dosage.

If you are considering hormone therapy, discuss it carefully with your provider and make sure you understand the potential upsides and downsides.

Summary

Multiple sclerosis and menopause share some symptoms, including mood changes, changes in sleep patterns, difficulty controlling urination, difficulty having sex, and sensitivity to heat. Researchers are still studying how one affects the other and whether menopause can cause worsening symptoms or reduce relapses, both of which have been reported.

Hormone therapy can relieve the symptoms of menopause, but it comes with health risks that should be discussed with a healthcare provider.

A Word From Verywell

New treatments for MS are changing the disease-management landscape for many people, but menopause is inescapable for all women. If you feel that menopause may be affecting your MS and your symptoms are getting worse, follow up with your provider. There are treatment options for menopause, and there may be other medications you can take for your MS that will help you maintain function and feel better.

Frequently Asked Questions

  • Does MS get worse with menopause?

    Some women with MS may feel their symptoms intensify during menopause, affecting urination, sleep patterns, anxiety or depression, or brain fog. Not every woman will experience this, and some may find they have fewer flares after menopause, though it does not affect the overall progression of MS.

  • How many hot flashes a day is normal during menopause?

    There is no particular number of hot flashes that women should expect during menopause. Some women have none, some women have an average of one or two a day, and some experience them often throughout the day and night.

  • What are the symptoms of menopause?

    Menopause can come with hot flashes, vaginal dryness, changes in sleep patterns, anxiety or depression, or a feeling of not thinking clearly. Not every woman will have these symptoms—the menopausal experience varies widely from individual to individual.

Was this page helpful?
8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. National Institute on Aging. What is menopause?.

  2. Bove R, Okai A, Houtchens M, et al. Effects of menopause in women with multiple sclerosis: an evidence-based review. Front Neurol. 2021;12:554375. doi:10.3389/fneur.2021.554375

  3. Bove R, Vaughan T, Chitnis T, Wicks P, De Jager PL. Women’s experiences of menopause in an online MS cohort: A case series. Mult Scler Relat Disord. 2016;9:56-59. doi:10.1016/j.msard.2016.06.015

  4. Davis S, Jay O, Wilson TE. Thermoregulatory dysfunction in multiple sclerosis. In: Handbook of Clinical Neurology. Vol 157. Elsevier; 2018:701-714. doi:10.1016/B978-0-444-64074-1.00042-2

  5. Bove R, Healy B, Musallam A, et al. Exploration of changes in disability after menopause in a longitudinal multiple sclerosis cohort. Mult Scler. 2016;22(7):935-943. doi:10.1177/1352458515606211

  6. Ladeira F, Salavisa M, Caetano A, Barbosa R, Sá F, Correia AS. The influence of menopause in multiple sclerosis course: a longitudinal cohort study. Eur Neurol. 2018;80(3-4):223-227. doi:10.1159/000496374

  7. National Health Service. Benefits and risks hormone replacement therapy.

  8. North American Menopause Society. Hormone therapy: benefits and risks.