Multiple Sclerosis May Worsen With Menopause Transition

FRIDAY, Jan. 24, 2025 (HealthDay News) — The menopausal transition may represent an inflection point for worsening of multiple sclerosis (MS) in women, according to a study published online Dec. 23 in Neurology.

Hannah E. Silverman, from the University of California San Francisco, and colleagues assessed the trajectory of objective functional outcomes and disease biomarkers in women with MS before and after menopause. The analysis included 184 postmenopausal women with MS followed for a median of 13 years.

The researchers found that the median age at natural menopause was 50 years (range, 33 to 60 years) and that 17 percent of participants used any systemic menopausal hormone therapy. The Multiple Sclerosis Functional Composite (MSFC) reached a worsening inflection point with menopause (slope difference, 0.08) and an increase in serum neurofilament light chain (slope difference, −0.95). For the Expanded Disability Status Scale (EDSS), the opposite was found (slope difference, 0.05). Significant findings persisted when adjusting for multiple covariates. Similar inflection points were found (within three years of the final menstrual period) for serum neurofilament light chain and EDSS but not MSFC when using additional nonlinear regression modeling.

“These findings suggest that further inquiry into the possible neurobiological effects of this major hormonal transition is warranted. Indeed, our results imply that changes in gonadal hormones may be associated with changes in functional and biological markers in MS,” the authors write. “Further research should investigate possible clinical implications, including need for more targeted disease, symptom, and rehabilitation management around the time of menopause.”

This analysis was supported through an investigator-initiated study sponsored by Genentech.

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