department of Obstetrics and
Gynecology at NYU’s Langone Medical
Center, “There is hope for women with
MS who are going through severe
menopause. Estrogen treatment seems
to decrease menopause symptoms
and the frequency and severity of MS
flare-ups. But it’s something we need
to look into much more deeply.”
That’s partly because studies
have linked long-term hormone
replacement therapy, including
estrogen treatment, to an increased
risk for breast cancer, stroke, heart attacks and blood
clots. HRT has been prescribed for a host of things
over the years, but its use—in particular its long-term use—has been controversial. It does appear to
be an effective short-term therapy for some.
bad,” says Dr. Voskuhl, “because there’s lots of evidence
that estrogen and progesterone can affect nerves
and neurons and their ability to conduct well.” A more
holistic approach, she argues, is warranted. “It should
be studied, but it hasn’t been.” n
Dr. Benedetto prescribes a combination of estrogen
and progesterone in the smallest dose that can be
given and still relieve symptoms. She prefers to use
the estrogen patch because it bypasses the liver and
because the women who use it generally respond
well. For women who are reluctant to use HRT
because they are already taking a lot of medications,
the patch can be a workable solution.
Dr. Voskuhl is cautious on the subject of HRT,
commenting, “It hasn’t been studied yet in MS. We
don’t know.” But she adds that the risk-to-benefit ratio
of short-term hormone use is relatively safe compared
with other MS drugs.
Many neurologists tend to tell patients to talk to their
gynecologists about menopause issues. “That’s too
Alison Dale was diagnosed with MS at age 15 and lives
in Los Angeles, Calif., with her husband. She is a member
of the Writers Guild of America West and serves on the
Writers with Disabilities Committee.
Menopause resources
The No-Nonsense Guide to Menopause
Available at
amazon.com
The North American Menopause Society
440-442-7550,
menopause.org
WebMD’s Menopause Health Center
webmd.com/menopause
