Mobility may stumble with menopause in MS, according to study

January 14, 2025
A new study suggests menopause may increase the progression of multiple sclerosis. Following menopause, patients’ walking slowed down. The authors found more subtle changes in fine motor skills and cognitive ability.

The study by UC San Francisco researchers followed 184 women before and after menopause. It was based on data from two UCSF studies – EPIC and ORIGINS – that seek to discover the causes of MS and the way it develops. Participants were evaluated each year for an average of 13 years.

Other research has reached contradictory conclusions about the role of menopause in MS progression. Some studies used a tool called the Expanded Disability Status Scale that primarily focuses on walking assessment. In the current study, researchers used the MS Functional Composite, which captures walking speed as well as other tasks. 

They found that following menopause, it took participants longer to complete a 25-foot-walk after accounting for age, weight, and tobacco use. They also found more subtle declines in dexterity and cognition. The researchers also found a biomarker in the blood called neurofilament light chain increased after menopause. This indicates increased degeneration of nerve cells – a hallmark of advancing MS – and validates the MSFC findings.

Just 31 of the 184 participants took estrogen therapy, not enough for researchers to be able to draw conclusion about its benefits. Women account for 75 percent of MS patients, and hormones play a significant role in the course of the disease. The study raises new questions about whether hormone therapy can help the 30 percent to 40 percent of MS patients who are perimenopausal or postmenopausal. Research in animals suggests that sex hormones have neuroprotective effects, and one small study has tested the protective effects of testosterone in men. 

The researchers said the study shows menopause represents a unique factor in MS progression, even when the effects of aging are taken into consideration. However, large, randomized trials are needed to compare hormone treatment to a placebo before the true effects of hormone therapy in a condition as complex as MS can be known.

The study was published in the journal Neurology.

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