Patients report worse MS symptoms after menopause: Findings from an online cohort

• We leveraged a patient-powered research platform to rapidly test a research hypothesis.
• Prospectively collected MS severity scores were more severe after menopause.
• Women with early, surgical menopause had worse MS severity scores.
• These findings require validation in clinical cohorts.

BackgroundMany women with multiple sclerosis (MS) are postmenopausal, yet the impact of menopause on MS symptoms is unknown.ObjectiveTo investigate patient-reported impact of menopause in a large online research platform, PatientsLikeMe (PLM).MethodsA detailed reproductive history survey was deployed to PLM members, and responses were linked to PLM׳s prospectively collected patient-reported severity score (MS Rating Scale, MSRS). The MSRS has previously shown good correlation with physician-derived EDSS scores.ResultsOf the 513 respondents, 55% were postmenopausal; 54% of these reported induced menopause. Median age at natural menopause was 51. Surgical menopause occurred at an earlier age (p<0.001) and was associated with more hormone replacement therapy use (p=0.02) than natural menopause. Postmenopausal status, surgical menopause, and earlier age at menopause were all associated with worse MSRS scores (p≤0.01) in regressions adjusting for age, disease type and duration.ConclusionPostmenopausal patients in this study reported worse MS disease severity. Further, this study highlights a utility for online research platforms, which allow for rapid generation of hypotheses that then require validation in clinical settings.