menopause and multiple sclerosis

Managing MS Through the Change

About 40-54% of women report worsening Multiple Sclerosis (MS) symptoms during and after menopause. MS is typically diagnosed between 20 and 40 years of age, meaning most women with MS will have symptoms during this transitional stage of life.

In this article, we explore the overlap between MS and menopause, including symptoms and COPAXONE® (a prescription medicine that is used to treat relapsing forms of multiple sclerosis) and other treatment methods. Let’s take a closer look.

Overlapping Symptoms of Multiple Sclerosis & Menopause

Due to fluctuating hormones and changes within the body, MS and menopausal symptoms may overlap. In other words, MS symptoms may be very similar to menopausal symptoms and vice versa.

Both MS and menopause can cause:

  • Mood changes.
  • Anxiety.
  • Reduced thinking clarity.
  • Disrupted sleep.
  • Heat sensitivity.
  • Pain during intercourse.
  • Fatigue.
  • Bladder issues.
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The lowering of estrogen levels that occur during menopause can frequently cause symptoms similar to an MS flare-up, making it hard to differentiate between the two. In fact, many individuals, as per the stat above, indicate that they find their MS symptoms get worse during this transition.

Additionally, a condition known as Uhthoff's phenomenon is when MS symptoms worsen with increasing body temperature. Since hot flashes are common during menopause, these symptoms can exacerbate MS symptoms in this way.

Yet, the good news is that after menopause, many women with MS report less frequent relapses and flare-ups.

Treatments for Multiple Sclerosis During Menopause

Multiple Sclerosis (MS) is an autoimmune disease that affects the central nervous system. The immune system attacks and may damage the protective sheath covering the nerve cells in the body.

As you may already know, symptoms can occur quickly without warning signs, such as in a matter of hours. MS can even affect the optic nerves, leading to temporary vision problems. However, in severe cases, this could become more permanent.

Considering MS symptoms may get worse during menopause, let’s take a closer look at treatments for this overlap to help you combat the worst on both sides.

Hormone Therapy

Hormone therapy, unfortunately, is intertwined with controversy and various opinions. Yet, it may help many menopausal women navigate this time with greater ease. At the same time, it isn’t for everyone, which is why you always want to discuss your options with your doctor.

However, hormone therapy may help women with MS by reducing MS relapses and improving cognition, such as reducing brain fog, enhancing learning and memory, and more.

Vaginal Creams

These may be recommended by your doctor if you’re experiencing vaginal dryness or pain during intercourse. These creams can offer the lubrication this tissue needs to stay healthy and prevent dysfunction.


This prescription medication is used to treat relapsing forms of MS, impacting the immune system and cardiovascular systems. COPAXONE® is a man-made version of the protein that makes up the myelin sheath of nerve cells, the same area that is often attacked due to MS.

This medication further works to block immune cells that damage the myelin sheath, which can reduce relapses and symptoms for those diagnosed with MS.

One thing to note here is that chest pain can be a common side effect of this medication. If you experience this and it's severe, make sure to visit your doctor to ensure you keep taking your medication. Alternatively, they may recommend a different treatment option for you.

Physical Therapy

Physical therapy can help both MS and menopausal symptoms. A physical therapist can help with any weakness or movement disabilities that present in conjunction with MS. They can also guide you on proper strengthening protocols for your specific situation to help build or maintain muscle; this can be important during menopause, specifically, to help maintain muscle mass and bone density which tends to decline around this age.

Anti-Fatigue Medications

Commonly prescribed medications for this include amantadine (Gocovri, Osmolex), modafinil (Provigil), and methylphenidate (Ritalin). Additionally, some medications used for depression may also be prescribed to combat extreme fatigue.

Other strategies used for fatigue include dietary, exercise, and other lifestyle changes, such as moving more or including more nutritious foods in your daily diet.

Other Medications

Medications may also be prescribed to increase walking speed, combat depression or anxiety, treat pain, improve sexual dysfunction, treat insomnia, and help with bladder or bowel control issues.

Your exact treatment approach will depend on your combination of overlapping symptoms. Discuss your options with your doctor. They know you and your health situation best and can give advice pertinent to you and your unique health history. It’s also worth noting that many of these medications come with an array of side effects, which your doctor and pharmacist will advise you about. Thus, if side effects occur, it may take some trial and error before finding a treatment approach that works.