Menopause and MS: My Perspective
Today I will talk about Menopause and MS. Menopause is like MS in that it is an individual condition, with different symptoms and individual reactions. What happens when these two conditions meet?
Menopause naturally occurs for women between ages 45 and 55, although it can start as early as the late 20s. Pre-menopause is the time when the level of estrogen, the female hormone produced by the ovaries, begins to drop, and the body begins the transition to menopause.
What most people think of as menopause is actually pre- or peri-menopause. This is when many disturbing physical and emotional symptoms occur. Menopause is the permanent end of menstruation, when there is no period for 12 months. This is an important milestone in the natural cycle of life.
It is sometimes difficult to tell the difference between symptoms caused by MS and those brought on by menopause. Most of the difference seems to be in intensity. We hear about mood swings during menopause, but with MS it seems symptom intensity swings are more common.
For example, an MSer who has headaches around her period may have migraines three to five times a week during pre-menopause. MS-related fatigue might increase exponentially, and anyone with MS who has sleep problems around her period may develop chronic insomnia.
Then there are hot flashes. MS often causes temperature sensitivity. When pre-menopause comes along, hot flashes and night sweats take over. They have the same effect as sitting in a hot bath, bringing on a pseudo-exacerbation. You can step out of a hot or steamy bathroom or away from the sun for quick relief; however, there is no getting away from a hot flash. I have heard women talk about finding themselves on the bathroom floor until a caregiver or family member arrived to help. I understand. More than once I slumped over my Amigo scooter controls and relied on my caregiver to guide the scooter to my bed so I could lay down until it passed. A cool cloth on my forehead or the back of my neck helped, but then I slept, sometimes for hours and often until the next day.
During and after a hot flash, my abilities quickly disappeared. If I was up and in my scooter, I would quickly collapse. In bed, it would be a night sweat, leaving my body wet and clammy, my hair soaked. Unlike MS heat sensitivity, with hot flashes and night sweats the heat starts inside the body and spreads quickly. There is no chance to get away, nowhere to go, and no way to stop the heat from spreading.
Just when I thought I was managing my MS symptoms, pre-menopause added the hot flash, a new symptom altogether, and one I could not manage. I could only wait until it was over. Although I did not have many of these episodes and most of them were short-lived, when I was in the midst of a hot flash, I felt helpless I could not move, nor did I have the energy to talk.
In addition to erratic physical symptoms are the erratic emotional symptoms. I remember an episode of All in the Family. This story showed a perfect example of pre-menopause with Edith going from her usual calm self to yelling at her family despite their attempts to calm or comfort her, then back again to being meek and quiet. We laughed. It was funny then outrageous.
Trying to handle uneven and ever-changing emotions is typical of pre-menopause, "the Change." MS confuses it more, adding a touch of panic. It is not unusual for an MSer with pre-menopause to feel totally out of control.
There are many other symptoms associated with menopause such as weight gain, anxiety, irritability, and the inability to handle stress. All of these can be exaggerated by MS. No woman needs that. For an MSer, it’s just one more thing she cannot control, and it is a big thing. All of this can lead to depression, a very deep depression.
Women in pre-menopause and continuing into menopause can be treated with Hormone Replacement Therapy (HRT). There are several methods of replacing estrogen levels, and the right therapy can be found when the patient and doctor work together. HRT is effective for short-term symptoms, esprcially hot flashes. It is important for blood levels to be monitored when menopause and MS cross paths.
HRT is not right for everyone. I was grateful that my doctor and I agreed I could follow a natural treatment. My lifestyle included a good diet and exercise. Because of that, my menopause was relatively uneventful.
Men have hormone changes, too, but they are not as radical as women in menopause. Hormone production such as testosterone levels drop gradually over a long period beginning around the age of 30. Medically, this is called andropause. Visible signs include decrease in sexual desire, sleep problems, weight gain and lack of motivation. Some men even have hot flashes although they are generally more subtle than the ones women experience.
A healthy lifestyle helps men reduce problems with lower testosterone levels. There is hormone replacement therapy for men, too, but it is riskier than for women.
This is a long article and I am sorry for that. The topic was difficult. There is not a lot of information available. I answered a question two years ago when there was even less information. We have heard whispered conversations . . . shh, don’t tell . . . and the whole topic makes us uncomfortable.
Hormonal changes are inevitable for both men and women. If we keep a positive attitude toward life in general, and understand better how natural bodily changes affect us, perhaps we can survive with a sense of compassion and love. Tackling an awkward topic is often best accomplished through humor, so here is my attempt at making it easy to talk about:
I would like it if men had to partake in the same hormonal cycles to which we’re subjected monthly.Maybe that’s why men declare war - because they have a need to bleed on a regular basis.~Brett Butler
Notes and Links:
Menopause and peri-menopause
Trevis Gleason’s blog - anecdotes in comments
Emotional Roller Coaster
Mayo Clinic on male menopause