HRT ⁣May ⁢Ease ⁣Menopause Symptoms for ‍Women With MS

⁤ Updated May 31, 2025

For ⁤aging women, the overlapping symptoms of menopause and multiple sclerosis ‍(MS) may be eased with hormone replacement therapy (HRT).According to Dr. Kate Petheram, consultant neurologist at ‍the Royal Sunderland Hospital, the benefits of HRT⁣ in managing these combined symptoms may outweigh the⁤ risks.

Speaking at⁤ the Consortium of Multiple Sclerosis Centers (CMSC) 2025 Annual Meeting, Petheram ⁢noted the importance of addressing⁣ the intersection⁣ of menopause and⁤ MS, given the disease’s ⁢prevalence in ⁤women.She emphasized that roughly 30% of individuals with⁣ MS are in the peri- or postmenopausal⁢ stage.

Petheram highlighted that while it’s suspected menopause can worsen MS symptoms like⁣ urinary dysfunction,⁤ sleep⁢ disturbances, and anxiety, HRT has ⁢shown promise in alleviating these issues.‍ she stated that managing menopause symptoms offers⁢ clear benefits for⁢ women with⁣ MS, regardless of weather it directly‍ reduces MS-driven symptoms.

The use ⁤of HRT declined sharply after a 2002 women’s Health Initiative (WHI) study linked a combination of estrogen and medroxyprogesterone to increased risks of breast ⁤cancer, cardiovascular disease, and ⁤stroke. However,Petheram argued that subsequent data have largely refuted these claims,citing flaws in ⁢the WHI study design.Current evidence suggests HRT may even lower ⁢cardiovascular risk.

While HRT may slightly increase the risk of breast cancer, Petheram noted that the⁤ risk of dying from⁢ breast ‍cancer is ‍not substantially elevated. Despite this, the reevaluation⁤ of HRT’s ⁢safety has not gained enough traction to reverse the negative perceptions formed by the original WHI study. HRT use remains low in the U.S.‍ compared to the U.K.

Petheram pointed out that HRT remains one of the most effective treatments⁣ for vasomotor symptoms, sexual dysfunction, and urinary complaints, which are⁢ common in both menopause and MS. Studies, including a 2016⁤ analysis in Neurology, suggest that women with MS who started HRT after menopause experienced meaningful⁣ improvements in quality of life.

“Menopausal women do well ⁢on HRT, and they do less well when ⁢they quit,”⁣ Petheram said, emphasizing that HRT effectively⁣ targets⁢ a wide ⁤range of overlapping symptoms.

Dr. Jennifer Graves, director of ⁤the⁣ Neuroimmunology Research Program at the University of ⁢California,⁤ San Diego, acknowledged that overcoming biases against⁢ HRT in the U.S. will require targeted education. She emphasized the need for greater awareness of the ⁤challenges of menopause in women with ‍MS and better education for ⁤clinicians on the⁤ intersection of aging, ⁤menopause, and MS.

Petheram clarified that while⁣ she doesn’t prescribe HRT, she discusses the potential ⁣benefits and risks‍ with patients to help them make informed decisions. ⁢She believes neurologists should understand⁣ the interaction between menopause and MS to better manage overlapping symptoms.

What’s next

Further research and education are needed to address the challenges of menopause in women with MS and to ‍promote informed decision-making regarding⁣ HRT.