Menopause as a transition: embracing your next chapter with MS

For many women with MS, menopause can feel like yet another curveball — but it doesn’t have to be a fearful one. While menopause brings big changes to hormones, body and mood, emerging research offers reassuring news: menopause itself does not necessarily worsen disability in MS.

Why this matters

A major 2025 study from Australia followed nearly 1,000 women with MS for over a decade — comparing those who had gone through menopause with those who hadn’t — and found no increased risk of accelerated disability or faster progression to more advanced MS*. That means the commonly observed increase in disability in the 50s likely relates more to natural aging than menopause alone.**

For many, that’s a relief — one less source of worry at a time already full of change.

But let’s be real, menopause can still shake things up

Though menopause may not accelerate MS progression, the transition often overlaps with symptoms that can mimic or amplify MS:

• Hot flashes and increased sensitivity to heat can temporarily worsen fatigue, bladder issues or cognitive difficulties.
• Mood swings, sleep disruption, brain fog, vaginal dryness and changes in libido are common — and may feel more intense when combined with MS.
• Reduced bone density (osteopenia or osteoporosis) becomes more relevant. Women with MS already have an elevated risk because of decreased mobility or certain medications — making bone health a key concern.

In short: menopause may not make MS “worse” in a long-term sense, but the overlap of symptoms can make the transition very challenging — emotionally and physically.

Looking ahead: managing the transition with confidence

Treat menopause as another crucial milestone, not a setback.

Understanding that menopause itself is not a guarantee of increased MS severity can empower you. It can encourage you to approach this phase proactively and with agency, instead of fear.

Lean into holistic health strategies

• Exercise — especially gentle weight-bearing strength or balance-based routines — can help support bone strength, mood, sleep and even cognitive health.
• Nutrition — a balanced, anti-inflammatory diet may help support overall health, energy, and reduce risk factors tied to heart, bone, and immune health.
• Mental health support — talk to your GP, MS nurse or psychologist if you experience mood changes, anxiety or depression. Open communication helps separate what’s hormonal, what’s MS-related, and what’s just life stress.

Use tools to guide care and conversations

Bringing a menopause and MS symptom diary to your appointments can help you and your neurologist or gynaecologist spot patterns: what’s due to hormonal shifts, what’s MS, what’s ageing. Many services encourage this approach.

Consider — but don’t rush into — medical options

For some, hormonal therapies (HRT) or non-hormonal treatments may help alleviate menopausal symptoms. But evidence is mixed, and what works for one person may not suit another. Always speak with your GP about what will work best for you.

A new frame: menopause as potential opportunity

Rather than viewing menopause as ‘adding insult to injury,’ there’s an opportunity to see it as a fresh chapter and a chance to re-evaluate routines, prioritise self-care, and build resilience. Knowing that, for many, menopause does not accelerate MS can offer hope. And you can pair that hope with action: gentle movement, good nutrition, and support to help ensure this next life stage becomes one of empowerment.

View the perimenopause, menopause and MS symptoms checklist opens in new tab

* https://www.monash.edu/news/articles/menopause-does-not-worsen-multiple-sclerosis-ms-disability-studyopens in new tab

** https://www.msaustralia.org.au/news/menopause-does-not-worsen-disability-in-ms/opens in new tab