The largest study of its kind has found menopause is not linked to an increased risk of disability in women with multiple sclerosis. Until recently, the effect of reduced sex hormones on women with MS had only been the subject of small studies, with conflicting results. The study assessed whether menopause modified the risk of disability progression for women with relapse-onset MS. The findings suggest it does not.

MS disability typically gets worse in both men and women as people age, with a noticeable shift around the age of 50, which is also the age of menopause for most women. During perimenopause, the amount of estrogen and progesterone in women fluctuates a lot, before levels of these hormones fall significantly at menopause. 

In this study, Monash University researchers asked whether the loss of sex hormones at menopause could be the reason for MS worsening in women at midlife. Previous studies have also looked at this question but have reported conflicting results. These studies have been small, reporting on between 74-148 post-menopausal women studied over long periods of time. 

The study used data from the MSBase Registry, the world’s largest MS clinical outcomes register that follows more than 120,000 people with MS around the world and is headquartered in Monash University’s Department of Neuroscience. It also observed 987 Australian women with MS were recruited from eight Australian neuroimmunology-specialist centers, of which 404 (40 percent) had undergone menopause. They were followed on average for a little more than 14 years.

The researchers found that menopause is not linked to an increased risk of disability accumulation in women with MS. Therefore, the increases in disability seen 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.

While reproductive ageing may be additive to the effects of somatic ageing, the study’s findings do not support menopause as the leading factor for disability progression in older women with MS.

The findings were published in JAMA Neurology.