How Menopause Accelerates Multiple Sclerosis Progression

A recent study from the University of California, San Francisco (UCSF), highlights how hormonal changes during menopause can accelerate the progression of multiple sclerosis (MS), significantly affecting patients’ mobility, cognition, and dexterity.

Key Findings from the Study

The study, published in Neurology, tracked 184 women for 13 years using data from UCSF’s EPIC and ORIGINS studies. Researchers observed:

• Mobility Declines: Postmenopausal women took longer to complete a 25-foot walk, even after accounting for age and lifestyle factors.
• Cognitive and Dexterity Impairments: Subtle declines in fine motor skills and cognitive function were observed.
• Biomarker Evidence: Higher levels of neurofilament light chain (NfL) in the blood, a marker of nerve cell degeneration, validated these findings.

The Role of Hormones in Multiple Sclerosis

Women represent 75% of multiple sclerosis patients, with hormonal changes playing a pivotal role in the disease’s trajectory.

• Puberty and MS Risk: Hormonal shifts during puberty can trigger autoimmune responses.
• Pregnancy Effects: Relapse rates drop during the third trimester of pregnancy, followed by a postpartum rebound, further underscoring the influence of hormones.

Implications for Hormone Therapy

While only 17% of study participants used estrogen therapy, this wasn’t enough to draw definitive conclusions about its efficacy. However, animal research and small human trials suggest that sex hormones, including testosterone, may have neuroprotective benefits.

What This Means for Multiple Sclerosis Patients

The study highlights menopause as a critical factor in MS progression, separate from aging. It calls for large-scale randomized trials to explore the potential benefits of hormone therapy for MS.

Practical Takeaways for MS Management

• Mobility Monitoring: Patients and doctors should monitor walking speed and dexterity during menopause.
• Biomarker Insights: Tracking neurofilament light chain levels could provide early signs of disease progression.
• Potential Role of Hormones: While promising, hormone therapy needs more research to confirm its benefits and safety.

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More Information: University of California – San Francisco