A landmark study has found that menopause does not increase the risk of disability progression in women with multiple sclerosis (MS).
In the largest study of its kind, researchers from around Australia analysed data from a global database as well as 987 Australian women with MS. The study, led by Monash University, found that menopause does not worsen MS-related disability.
The findings, published in JAMA Neurology, offer clarity and reassurance to women navigating midlife with MS.
“This is the first robust evidence that menopause itself does not worsen MS disability,” said Professor Bruce Taylor, study co-author and a neurologist at the University of Tasmania's Menzies Institute for Medical Research. “It’s a significant step forward in understanding how hormonal changes affect MS.”
MS is a chronic autoimmune and neurodegenerative condition that impacts the immune and nervous systems. One in 800 Australians live with MS, and it affects three times more women than men. Until now, the impact of menopause on MS disease trajectory remained unclear.
“MS disability typically gets worse in both men and women as people age, with a noticeable shift at about the age of 50, which is also around the age of menopause for most women,” said Associate Professor Jokubaitis, senior author and Deputy Head of Monash University’s School of Translational Medicine Department of Neuroscience.
Previous studies have investigated whether the loss of sex hormones at menopause might worsen MS symptoms in women at midlife, but those studies reported conflicting results and were limited by small sample sizes.
“Our research found that menopause is not associated with an increased risk of disability accumulation in women with MS. Therefore, the increases in disability we see around the age of 50 are not directly due to menopause but are likely due to other aging processes that affect all people irrespective of sex or gender,” said Associate Professor Jokubaitis.
The study used data from MSBase, the world’s largest MS clinical outcomes register that follows over 120,000 people with MS around the world.
It also observed 987 women with MS recruited from eight Australian neuroimmunology-specialist centres, of which 404 (40 per cent) had undergone menopause. They were followed on average for just over 14 years. The Menzies Institute for Medical Research in Tasmania contributed the data for around 100 of these cases.
Dr Francesca Bridge, first author and a neurologist who treats MS patients at Alfred Health in Melbourne, said the results should reassure women with MS undergoing menopause, and their doctors, that it wouldn’t make their MS worse.
“The menopausal transition can be challenging for many women,” Dr Bridge said. “This study gives women with MS one less thing to be concerned about. It will guide the health/clinical management of women with MS through the menopausal transition.”
Read the research paper in JAMA.
The data collection in the additional survey was part of a women's health grant from the NHMRC.