Influence of Surgical or Natural Menopause on Disease Symptoms for Women with MS

Background: Menopause is an important milestone and typically occurs during peak years of productivity for mature women relative to social, family, and professional responsibilities. Limited data is available on this topic in relation to patients with MS. 

Objectives: To evaluate the effect of natural or surgical menopause on MS disease status using patient reported outcomes.

Methods: This study is a targeted analysis from a reproductive events study that included 237 women enrolled at Jacobs MS center and registered with the New York State MS Consortium (NYSMSC) who completed an extensive questionnaire about reproductive events. Independent Samples T- tests and chi-square tests were conducted to investigate differences between women who had a natural or surgical menopause. Logistic regression modeling was used adjusting for covariates

Results: Eighty-three women reported natural menopause and 39 reported surgical menopause. Of women with a natural menopause, 78.2% reported an improvement in, or stabilization of, MS symptoms after menopause vs. 75% of women with a surgical menopause. We observed that women who bore a child before the onset of MS were slightly less likely to have a natural menopause compared to those who had a child after onset of MS (OR .47, p=0.071). Women with a natural menopause were significantly older at age of MS symptom onset (mean age= 34.7 [SD 9.1]) compared to women who underwent a surgical menopause (mean age= 30.6 [SD 8.3 ], p= .037). In logistic regression modeling, only age at onset of MS was significantly related (OR .93, 95% CI .88, .99). Age at menses and birth before or after onset of MS were not significantly associated with natural or surgical menopause. Type of MS at registration (relapsing or progressive) and EDSS at registration or age of using an assistive device did not differ.  

Conclusions: A majority of woman reported feeling better or the same following menopause regardless of menopause being natural or surgical in nature. Our results suggest that women with younger age at onset of MS were more likely to have surgical menopause. We plan to investigate associations of birth control, hormone replacement therapy and use of disease modifying therapies.