A large study has found that menopause does not increase the risk of disability progression in women with multiple sclerosis (MS). The findings, based on nearly 1,000 women followed over several years, provide reassurance for patients navigating both MS and the transition through menopause.
Menopause and MS: what the study found
MS is more common in women than men, and most women living with the disease will experience menopause while managing their condition. Previous reports suggested that hormonal changes could worsen MS symptoms, but the evidence has been inconsistent.
In this study, researchers analysed data from the MSBase Registry, including 987 women with relapse-onset MS who reported their menopausal status and had multiple disability assessments recorded. Women were recruited from eight Australian specialist centres between 2018 and 2021, with follow-up extending to 2025.
Using advanced statistical models, the team compared outcomes before and after menopause. They found that menopause was not linked to faster disability progression or a higher risk of developing secondary progressive MS. In fact, the hazard ratios showed no meaningful difference between pre- and post-menopausal groups.
A secondary analysis of 209 women tracked across the menopausal transition confirmed these results: there was no inflection point in worsening disability once menopause began.
What this means for women with MS
The results suggest that while ageing naturally affects MS progression, menopause itself is not the leading factor behind disability worsening in midlife.
Lead author Francesca Bridge, MBBS, and colleagues note that reproductive ageing may add to the broader effects of somatic ageing, but it should not be considered a main driver of MS clinical progression.
For women living with MS, the findings are encouraging. They indicate that menopause does not signal a turning point towards faster disability, helping to reduce concerns at a stage of life already marked by change.
Reference
Bridge F et al. Menopause Impact on Multiple Sclerosis Disability Progression. JAMA Neurol. 2025;DOI: :10.1001/jamaneurol.2025.3538.
