Menopause causes reduced number of relapses but increased disability

After entering menopause, women diagnosed with multiple sclerosis (MS) experience a notable decrease in relapse rates. However, during this period, disability levels show a substantial increase, as revealed by a comprehensive analysis of multiple studies.

These findings align with the observed decline in immune activity as individuals age and the diminishing levels of oestrogen, which result in fewer MS-related relapses. Researchers suggest that oestrogen, known for its neuroprotective properties, may play a role in this dynamic, with its reduction potentially contributing to heightened nerve cell loss and increased disability.

MS activity is reduced during pregnancy, especially during the third trimester, due to changes in hormone levels that affect immune T-cell activity. Then, immediately after delivery, relapses may occur more often than before pregnancy.

A recent literature review by a team of researchers in Iran showed that women who were older at the time of their first menstrual cycle had a significantly lower risk of developing MS. This is likely because having a first menstrual cycle at earlier ages results in oestrogen imbalances that predispose people to MS. In this report, the same team conducted a follow-up literature review and pooled analysis to estimate the impact of menopause on relapse rates and disability progression in women with MS.

They found that menopause can be associated with relapse rate reduction. Researchers said relapses tend to reduce with age in general due to a less active immune system, while disability can increase as age does. With the menopause, they said the increase in MS-related disability might be due to oestrogen, which has neuroprotective effects, reducing. “Both human, and animal studies showed that oestrogen has neuroprotective effects, leading to better neural survival,” they said.