If you’re living with MS and approaching menopause, you might wonder how this life stage could impact your MS journey. Menopause is already a significant transition, bringing physical, emotional, and social changes. When combined with MS, it can feel even more complex, and many women have questions about how menopause might influence their symptoms, progression, and overall quality of life. Fortunately, new research is beginning to address these unique challenges, offering insights that could help guide care and support.
In this summary, we’ll dive into several recent studies that explore different aspects of menopause and MS. From understanding if menopause affects disability levels and relapse rates, to investigating how menopause might influence biological aging in women with MS, these studies provide valuable findings. Notably, one project led by Queen Mary University in the UK took an innovative approach by involving women with MS in designing the research itself, making the results especially relevant to real-world experiences.
Together, these studies offer a clearer picture of what menopause might mean for women with MS, and we’ll break down the key findings to help you understand what to expect and how this research might apply to your own journey.
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Table of Contents
The influence of menopause on multiple sclerosis
by Dr. Cecilia Simonsen et. al
Background and Purpose of the Study
Menopause is a significant stage in a woman’s life, and for women with MS, it raises questions about its potential effects on MS progression. Some previous studies suggested that menopause might speed up disability progression in MS, while others showed no change. This study aimed to clarify this by examining a large group of women with MS, comparing those who were menopausal with similarly aged men with MS.
Who Was Studied?
The researchers included 559 peri- or postmenopausal women with MS and compared them to 386 men of a similar age. They looked at the progression of disability (using the Expanded Disability Status Scale, or EDSS) and the frequency of relapses (measured by the Annual Relapse Rate, or ARR) over time, both before and after menopause.
Key Findings
Disability Progression (EDSS):
- For women with MS, there was no significant change in disability progression after menopause. This means that menopause didn’t lead to a noticeable increase in disability levels.
- When comparing women with men of similar ages, the study found that men showed a slightly faster progression in EDSS scores over time than women.
Relapse Rates (ARR):
- For women, there was also no significant difference in relapse rates before and after menopause.
- Similarly, when comparing relapse rates between men and women, there was no significant difference. This indicates that menopause doesn’t appear to increase the likelihood of relapses.
What This Means for You
This study provides reassuring news: menopause itself doesn’t seem to worsen MS progression in terms of disability or relapses. In fact, the data suggest that women, on average, might experience slightly slower progression than men in this age group. So, if you’re nearing or going through menopause, it’s good to know that this change likely won’t lead to a sudden worsening of your MS.
How Reliable Are These Findings?
To understand the quality of this data, let’s consider the Cochrane levels of evidence (often used to rank the reliability of medical studies):
- This study is based on observational data, meaning it looked at existing records from a large group of people but didn’t control or change any conditions (like a clinical trial would).
- Observational studies like this are generally at a moderate level on the Cochrane scale. While they provide valuable real-world insights, they’re not as definitive as randomized controlled trials (the highest level).
- However, because the study involved a large number of people and used thorough methods to analyze the data, the findings are meaningful and provide useful information for women with MS.
Takeaway
If you’re concerned about menopause and its impact on MS, this study offers comforting evidence that menopause is unlikely to speed up disability or increase relapses. It’s a reminder that every stage in life can be navigated with MS, and understanding how factors like menopause affect MS can help you feel more informed and in control.
Optimising menopause management in MS through multi-stakeholder collaboration and pathway development
by Ruth Stross et. al
Why This Study Matters for Women with MS
Women with MS may face overlapping symptoms between MS and menopause, such as fatigue, mood changes, and brain fog, making it hard to know what’s causing what. This project aimed to bring together perspectives from women with MS and healthcare providers to develop a clear, supportive pathway for managing menopause with MS. By understanding these overlapping symptoms, healthcare providers can give better advice and support during this transition.
What Was Studied?
This project involved discussions with women with MS, along with doctors, nurses, and other healthcare providers, to understand their experiences and challenges. Here’s what they focused on:
- Symptoms Overlap: Many MS and menopause symptoms look similar, which can make it confusing to know if symptoms are MS-related or part of menopause.
- Gaps in Care: Some women felt their healthcare providers didn’t fully understand the crossover between menopause and MS, leading to missed opportunities for support.
- Collaborative Solutions: The project looked at ways for primary care providers (like general practitioners) and MS specialists to work together more effectively to support women through menopause.
Key Findings and Improvements
The project identified several areas where care for women with MS going through menopause could be improved. Here’s what’s being proposed:
- Better Clinical Pathways for MS and Menopause: A standardized pathway has been created to guide doctors and nurses in providing clear, consistent care for women with MS during menopause.
- Education and Support Groups: New group sessions are being developed to help women with MS learn about menopause and feel supported by others going through similar experiences. This would include women aged 38-50, who are often beginning this transition.
- Resources for Primary Care: Educational tools are being made for general practitioners to help them understand the unique needs of women with MS during menopause. This will allow GPs to provide more effective, informed care.
How Reliable Are These Recommendations?
To evaluate the quality of the recommendations, it helps to understand Cochrane levels of evidence, which rank the strength of medical research. This study is based on focus groups and stakeholder collaboration, which means it’s observational and experiential rather than experimental. While it doesn’t have the highest level of evidence like a randomized controlled trial, the findings are still valuable. They reflect real experiences from women with MS and healthcare providers, making the recommendations relevant and practical.
What This Means for You
If you’re navigating menopause with MS, this study is a positive step toward better, more personalized care. It highlights the importance of educating healthcare providers on the unique challenges that women with MS face during menopause. As a result, you may find that your doctors are more informed and understanding of the overlapping symptoms and can offer more tailored support.
Takeaway
This new approach to managing menopause with MS is about creating a supportive, informed pathway for women. By focusing on education, collaborative care, and specialized support groups, the healthcare system in the UK is working to ensure women with MS feel empowered and supported through this life stage.
Practical learnings from a co-designed qualitative study exploring patient experiences of multiple sclerosis and menopause
by Imogen Collier et. al
Why Was This Study Different?
Most studies are designed by researchers alone, but this one used a co-design approach, meaning that women with MS who were going through or had gone through menopause helped shape every step. Their input made sure that the study focused on topics and experiences that truly matter to women with MS.
Key Goals of the Study
The study aimed to:
- Identify the key areas of concern and experience for women with MS going through menopause.
- Make sure the study was accessible and easy for participants to join.
- Create a welcoming environment so that participants felt comfortable sharing personal insights.
What Topics Did the Study Cover?
Women involved in the study identified important areas they wanted the research to cover, such as:
- Experiences with healthcare and support during menopause.
- Impact on mental health, employment, and family life.
- Sensitivity around discussing menopause symptoms that overlap with MS symptoms, like fatigue and mood swings.
Flexible and Accessible Participation
One of the best parts of this study was its flexibility. Women could choose to participate through in-person or online interviews, group discussions, or even by sharing their thoughts via email. The study also offered travel expenses and support for those who needed it, ensuring everyone could participate comfortably. This flexibility made it easier for women from all walks of life to contribute their experiences.
Inclusivity in Recruitment
To avoid being limited to a single location or a narrow group of participants, the researchers reached out to a diverse range of women. This inclusive recruitment made the study more representative of the wider MS community and allowed women from different backgrounds to share their unique perspectives on menopause and MS.
How Reliable Are These Findings?
In terms of reliability, it’s important to note that this study is based on qualitative research. This type of research collects rich, detailed insights from real people but doesn’t include statistical analysis like a clinical trial would. On the Cochrane evidence scale, which rates the strength of research, qualitative studies are generally seen as moderate-quality evidence. They’re valuable for understanding experiences and perspectives but are not as definitive as studies with statistical data. However, the real-world insights gained from this study provide a powerful foundation for further research and improvements in care.
Takeaways: What This Means for You
This study has paved the way for more inclusive and patient-centered research on MS and menopause. By involving women with MS at every step, the study has highlighted the unique challenges faced during menopause, from healthcare experiences to personal impacts on daily life. Something I would like to see on a regular basis not just in MS, but overall in healthcare topics.
If you’re going through menopause or anticipating it, this type of research can lead to better support and understanding from healthcare providers. And remember, your voice matters in shaping the future of MS care—just like the women in this study, who helped make sure their experiences were heard.
Key Insights
- Menopause can impact many aspects of life for women with MS, but sharing experiences openly can help shape more effective support.
- This study offers a model for future research by showing that involving patients in study design leads to meaningful, relevant results.
- If you’re facing menopause with MS, know that there is a growing awareness of your unique needs, and more personalized, supportive care could be on the horizon.
By putting patient voices at the center, studies like this are helping to build a healthcare approach that truly understands and supports women with MS during menopause.
Menopause affects DNA methylation and aging in women with multiple sclerosis
by Prof. Tone Berge et. al
What Was the Study About?
This study focused on a process called DNA methylation, a biological mechanism that can affect how our genes are expressed without changing the actual DNA sequence. Think of DNA methylation like dimming a light—it’s a way to control the „brightness“ of genes, turning them up or down depending on various factors. Scientists can use DNA methylation patterns to estimate a person’s biological age, which might be different from their chronological age (the age in years).
The researchers wanted to see if menopause impacts this biological aging process in women with MS. This is important because understanding biological age could give us more insights into how MS progresses differently in women as they age.
How Did the Study Work?
The study included 200 women with MS, divided into two groups: those who were pre-menopausal and those who were post-menopausal. They compared DNA methylation patterns and biological age in both groups, while also gathering information on hormone levels, lifestyle factors like smoking, and MS-related factors like disability level.
To get a precise idea of how menopause might affect biological aging, they also measured brain age by analyzing MRI scans. This allowed them to look at three types of age:
- Chronological Age: Your actual age in years.
- Biological (Epigenetic) Age: The age of your cells, based on DNA methylation.
- Brain Age: The estimated age of your brain based on MRI scans.
Key Findings
Reduced Gap Between Biological and Chronological Age: In post-menopausal women with MS, the difference between biological and chronological age appeared smaller, suggesting that menopause might „age“ cells in a way that reduces the gap between your actual age and your biological age.
Impact on Brain Aging: The study found a closer alignment between biological age and brain age in post-menopausal women, indicating that menopause might affect pathways in the brain related to MS progression.
Different DNA Methylation Patterns: There were distinct DNA methylation patterns between pre- and post-menopausal women. These changes could influence biological pathways specific to neurons (brain cells), possibly affecting how MS symptoms progress with age.
What This Means for You
This research suggests that menopause could impact how MS progresses by influencing biological aging at a cellular level. While the study doesn’t give a definitive answer on how much menopause accelerates or changes MS, it highlights that your MS journey might shift in ways related to age and hormonal changes.
Reliability of the Findings
In terms of reliability, this study is based on observational data, analyzing real people without altering any conditions, which is a moderate level on the Cochrane evidence scale. While it doesn’t have the highest level of reliability (like a randomized trial), it offers meaningful insights into biological aging and MS by using advanced DNA and brain imaging techniques. This type of data is valuable for forming hypotheses and guiding future research but doesn’t yet provide concrete clinical recommendations.
Takeaway
Understanding how menopause might influence MS at a biological level gives us a new perspective on managing the disease during this stage of life. This study is a step towards personalized MS care that considers both hormonal and aging factors. If you’re approaching or going through menopause, knowing that researchers are uncovering these connections can be empowering.
Talk to Your Healthcare Provider for Personalized Support
If you have questions about how menopause might affect your MS, talk to your healthcare provider about any changes or symptoms you’re experiencing. They can help interpret new findings and offer guidance that’s tailored to your unique journey, supporting you in managing symptoms and maintaining your quality of life through this transition.
See you soon and try to make the best out of your life,
Nele
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