ECTRIMS 2025 | Menopause and MS: overlapping symptoms and advice for management

Yes, the menopause is more and more important in the last years because our patients, because of the new high and very high-efficacy treatments, our patients, they are living longer and with a better quality of life. It means that we have more and more women with menopause that we should treat with DMT treatments. And that is important because in the menopause, we have different symptoms. The gynecologists, they say there are 41 symptoms of the menopause, but okay, we can summarize in three or four, like sleep alterations, urinary alterations, fatigue, and some mood disorders as depression and anxiety. So that is the typical symptoms of the menopause in the healthy women. But these symptoms are the same for the MS patients. And the problem is that there is an overlapping between the MS symptoms and the menopause symptoms. So that sometimes we think that the patients are progressing and really they are not progressing. The patients, they are telling us more symptoms because they are in the menopause and this overlap between symptoms from the menopause and symptoms from the MS. So the most important thing first is to be aware that in the menopause we have symptoms and some of these symptoms, they have an overlap with the MS symptoms so that the patient perhaps complains more about fatigue or complains more about some sleep disorders. And really the problem is the menopause and not the multiple sclerosis. So that the first important thing is to be aware. So the awareness of the patients with the menopause, they have symptoms and they’re overlapping. The second important thing is what to do. So that these symptoms, this overlapping of symptoms, they are worsening the quality of life of the menopause. So that important thing is how to try to reduce the symptoms. So that we have seen, we have done a study together with the gynecologist of our hospital, and we have seen that in some patients, really they need to have a treatment with hormones. So the hormone therapy they should have. We have realized that in real life, the healthy people, more or less 30% of the healthy women, they need to have hormones in the menopause. And we have realized the same for the MS patients. So that it means that probably when we treat some of our patients with their hormones in the menopause, these patients, they will have less of these menopause symptoms and they will have less overlapping so that the patients, they will have better quality of life. So that the second important point is we need to look after our patients to send to the gynecologist, really to prove if our patients really need to have hormones, the hormone therapy to reduce these symptoms and to have a better quality of life.

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