Researchers at the University of California – San Francisco found that menopause onset is associated with increased functional decline and brain cell injury in MS. The study was funded in part by the National MS Society. Get tips on managing this transition below.
Background: The impact of menopause on MS is not well understood. In part, it is difficult to tease apart the effects of menopause versus normal aging. The Multiple Sclerosis Functional Composite (MSFC, a clinical test that measures cognition, motor skills, and walking tasks) and serum neurofilament light chain (sNfL, a blood marker for brain cell damage) are objective measurements that could prove helpful.
Study: Researchers evaluated data from 184 women with MS. Data were collected before menopause, during the menopausal transition, and/or after menopause. Individuals had an average natural menopause age of 50 years and were followed in the study for an average of 13 years. The primary outcomes were the MSFC and sNfL. The standard EDSS disability scale was also evaluated, and imaging with MRI was used as a marker of inflammation. Statistical tests were performed to look for associations with menopause and function, brain cell damage, and inflammation.
Results: Menopause was a turning point for both disability (measured by the MSFC) and brain cell injury (measured by sNfL). After menopause, the speed of disability worsening and brain cell damage were significantly increased. The EDSS showed a significantly slower worsening after menopause, and inflammation was not associated with menopause.
Why does this matter? As the current MS population ages, it becomes critical to understand how menopause and MS interact. This study highlights potential connections between menopause and objective MS changes that are impactful to patients and biologically relevant that should motivate further research. A better understanding of the clinical effects of menopause on MS could lead to better symptom and rehabilitation management around the time of menopause.
Learn more: Read more about managing the menopause transition with MS.
by Hannah E. Silverman, Alan Bostrom, Alyssa N. Nylander, Amit Akula, Ann A. Lazar, Refujia Gomez, Adam Santaniello, Adam Renschen, Meagan Michaela Harms, Tiffany P. Cooper, Robin Lincoln, Shane Poole, Ahmed Abdelhak, Roland G. Henry, Jorge Oksenberg, Stephen L. Hauser, Bruce Anthony Campbell Cree, and Riley Bove. Published in Neurology (2025).