b'Medicine & ResearchA s k t h e M S Nu rs eA s k t h e M S Nu rs eCherie Binns is a MS-certied nurse living with MS. She is the patient healthcare liaison for MS Focus and a member of the MS Lived Experience Advisory panel for the Foundation. Her monthly column addresses the issues of living with MS.Recently, I facilitated a discussion in a group of women living with MS about menopause and the effect it might have on their MS. The following are questions that were raised by members of that group.Dear MS Nurse,70. If you are nearing 60 and have been on I am curious about how menopause affectsHRT for ve years or longer, you should consider our MS. My doctor recommended hormonehavingadiscussionwithyourhealthcare replacementtherapytohelpmanagetheprovider about stopping it. HRT, while protecting symptoms I am having as I am perimenopausalbone and heart health, may also predispose and am experiencing hot ashes, which reallyan individual to certain reproductive cancers ramp up my MS symptoms that were generallyand blood clots, which can have serious health well-controlled before this started. I am alsoimplications. This is a therapy that should be noticing my fatigue is much worse than itused to manage declining hormone levels at was before all this began. Will HRT interferethe lowest possible dose for the shortest possible with my DMT or worsen my MS?Bevintimemaking it appropriate to use during Binns: Some symptoms of perimenopause,the perimenopausal years to manage symptoms the time when our estrogen and progesteroneof those changes. taper off before menopause, seem to magnifyDear MS Nurse, certain MS symptoms. Notably, the heat-relatedDoes HRT play a role (good or bad) in symptoms, fatigue, cognition, mood changes,secondary progressive MS?Karen and mental health. HRT, in most women, canBinns:ManypeoplereportthattheirMS relieve many of these symptoms since theysymptoms seem to improve when they start are caused by hormonal changes, resultingtaking hormone replacement therapy. While in an improvement in your MS symptomsthere have been several small clinical trials too. This therapy provides benets on severalconducted with women who have MS using different fronts, such as strengthening bonesHRT during perimenopause and menopause, and protecting against cardiovascular aging.evidence of slowing disease progression has HRTdoesnotnegativelyinteract withournot been seen despite about half of women disease-modifying therapies. Dear MS Nurse,reporting they feel better and their MS is more manageable. It is certainly worth having a How old is too old to go on HRT?Jeanconversation with your OB/GYN or primary Binns: There is no age cut-off for takingcare physician about starting an HRT trial for hormone replacement therapy, but it is generallya few months to see if your perimenopausal not prescribed to new users over the age ofsymptoms improve and, subsequently, whether msfocusmagazine.org 50'