Menopause and MS worsening

Bove R et al. Patients report worse MS symptoms after menopause: Findings from an online cohort Mult Scler rel Dis DOI:

Background Many women with multiple sclerosis (MS) are post-menopausal, yet the impact of menopause on MS symptoms is unknown.
Objective To investigate patient-reported impact of menopause in a large online research platform, PatientsLikeMe (PLM).
Methods A detailed reproductive history survey was deployed to PLM members, and responses were linked to PLM's prospectively collected patient-reported severity score (MS Rating Scale, MSRS). The MSRS has previously shown good correlation with physician-derived EDSS scores.
Results Of the 513 respondents, 55% were post-menopausal; 54% of these reported induced menopause. Median age at natural menopause was 51. Surgical menopause occurred at an earlier age (p<0.001) and was associated with more hormone replacement therapy use (p=0.02) than natural menopause. Post-menopausal status, surgical menopause, and earlier age at menopause were all associated with worse MSRS scores (p≤0.01) in analysis adjusting for age, disease type and duration.
Conclusion Post-menopausal patients in this study reported worse MS disease severity. Further, this study highlights a utility for online research platforms, which allow for rapid generation of hypotheses that then require validation in clinical settings.

Yesterday we had a post that MS was worse after puberty suggesting that female sex hormones may play a part in the development of MS and autoimmunity in general. In this study it appears that there are more problems after the menopause and again suggesting that female sex hormones are playing a part n the disease. However, the younger MSers have a problem with more sex hormones and the older MSers less hormones. This dictomy is also seen in animal studies where male and female sex hormones can have different influences on disease susceptibility. Studies are ongoing in MSers using sex hormones as treatments, it may not be a straight forward issue.